When Should A Dentist Pull Baby Teeth?

Tooth extraction is a surgical procedure in which the dentist pulls the teeth out, but is it our first solution or the last one? When any tooth becomes injured, the dentist has multiple options:

-If the injury is minor, they remove the damaged part and restore the tooth using composites, glass ionomers, or amalgam.

-If the infection is greater and the tooth is too carious to be restored, the dentist does an endo treatment and places a crown.

-The last option is extraction, which is done when the tooth is unrestorable, and you need to pull it out to prevent the further spread of infection.

Should I Have My Child’s Tooth Extracted?

As we see above, the dentist first adopts the most conservative methods for tooth treatment, but extraction becomes inevitable when there is no other option. But when is the extraction of a baby tooth necessary?

-There is extreme tooth decay that can’t be restored by restoration or a filling: Unfortunately, the baby tooth is more susceptible to tooth decay, and that’s due to its thinner outer covering (enamel), the larger pulp chamber which is easily exposed, and the most important factor, having a high sugar intake. In babies, milk may be an important factor causing a type of caries called early childhood caries. Keep in mind that if you don’t extract a very damaged, infected baby tooth, infection will spread, harming the permanent successors and causing life-threatening infections.

-There is trauma: Childhood is associated with a higher incidence of falls and accidents, so there is a higher risk of tooth injury and cracked or chipped teeth. Treating these teeth can be done through pulp therapy and crown placement, but if the injury is severe, the only option we have is tooth extraction.

-Time for adult tooth eruption has passed: Every tooth erupts at a certain age, with variations among individuals. When the adult tooth hasn’t come out yet, one of the reasons would be the baby tooth. Normally, the baby tooth guides the permanent tooth into its correct place. But sometimes, it becomes an obstacle, causing the retention of the permanent tooth.

-To avoid adult tooth misalignment: When the baby tooth doesn’t shed due to any cause, the adult tooth won’t have a space to erupt in, so it will erupt in a misaligned way, causing crowding or crookedness.

How Do I Prepare My Child For Tooth Extraction?

Here we come to the extraction procedure itself; it’s very important to prepare the child for the procedure. The family should choose a trusted dentist who specializes in pedodontics to make sure they have the skills required to deal with kids with kindness and patience. Tell your child about the positive aspects of the procedure and how it will improve their oral health. Give your child something to look forward to after the extraction, such as a toy or a gift. The family should follow the post-extraction instructions as they are as important as the procedure itself. Also, it’s better that the child has an introductory visit to the clinic before the visit in which the dentist extracts the tooth so that they are more familiar with the dentist and the tools.

What Are The Steps Of The Extraction Procedure?

-A radiograph: Before dental extractions, it’s better to take an X-ray to determine the number and shape of the tooth roots and also to predict if there will be any complications and be ready to deal with them.

-Local anesthesia: For extractions, the dentist first applies a topical gel for numbness, then introduces local anesthesia, which is a safe drug that doesn’t result in a loss of consciousness. In children with high anxiety levels, other drugs such as sedatives or general anesthesia can be administered, but general anesthesia is the last resort as it has some health risks.

-Tooth removal: After administering local anesthesia, the dentist removes the tooth with surgical instruments.

-Stitches: After the tooth is extracted, the dentist covers the socket with sterile gauze and asks the child to apply pressure for 30 minutes. According to the child’s case, stitches may be needed.

How Do You Take Care Of A Child After A Tooth Extraction?

The family should ensure that the child follows the post-extraction instructions.

What the child should do:

-Bite firmly on the gauze for 30 minutes.

-Use ice packs to reduce inflammation and pain during the healing process.

-Maintain good oral hygiene.

-Eat soft foods such as mashed potatoes and cold drinks like smoothies.

-Take the medication prescribed by the dentist, which may be an anti-inflammatory, analgesic, or, in special cases, an antibiotic.

What the child shouldn’t do:

-Eat hot or hard food or drinks as it can dislodge the blood clot that forms after the extraction procedure and may require additional treatment.

-Forcefully rinse out or spit out blood or saliva.

-Use a straw to drink.

You can find it confusing that when we talk about permanent teeth, we say that we want to be conservative as possible. This is logical as these are adult teeth which, if extracted, no other teeth will come out, and the options would be replacing them with prosthetics such as crowns, dentures, or implants. However, when talking about baby teeth, why don’t we make their extraction our first choice, especially since the baby tooth will eventually be replaced by a permanent tooth? Yes, baby teeth are temporary, but they have great importance:

-They help the child in eating, speaking, and other functions.

-Create an aesthetically pleasing appearance.

-They play an important role in guiding the permanent adult teeth during the eruption process, as the adult tooth knows exactly where to erupt with the help of the baby tooth. Keep in mind that deciduous baby teeth normally fall out when permanent teeth reach a certain level of development. So after extraction, the dentist sometimes places an appliance called a space maintainer, whose function is to maintain this space till the permanent teeth erupt and fill it; otherwise, the space will be partly closed by the tilting of adjacent teeth into the space

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