What you need to know about child tooth extraction

Here at Macarthur Paediatric Dentistry we do everything we can to save our patients’ tiny teeth if they have been heavily impacted by decay or infection before we consider child tooth extraction.

In the event that your child may have a tooth that is beyond repair with a filling or typical dental restoration, we may advise that they have the tooth removed – however this is always a last resort. 

FACTORS WE CONSIDER BEFORE CHILD TOOTH EXTRACTION

Level of pain 

If the tooth is already badly infected or abscessed it can cause severe pain. In some cases this can snowball into more severe problems like facial swelling and systemic infections. Serious tooth pain should never be ignored.

How long the tooth has been in the mouth

Prior to tooth extraction we need to assess the lifespan of the tooth. If it’s unlikely to stay in the mouth for a long time then it may not be worthwhile having your child go through an extensive and potentially traumatic procedure.

Age and attitude 

Your child’s age and their temperament will also play into the decision for tooth extraction, especially if they’re fairly young. In some cases extensive restoration may be a better option, however we want to ensure your little one doesn’t create a fear around going to the dentist because of those treatments. 

IF IT’S A BABY TOOTH, WON’T IT JUST FALL OUT ANYWAY?

While it’s true that baby teeth will fall out between the ages of about 6 to 13, an extensively decayed or traumatised tooth will not necessarily fall out on its own. 

In fact, sometimes when they become infected they can remain in the mouth long enough to cause localised infection, pain, and eventually affect the developing adult teeth. Naturally it’s important to try and save baby teeth as they help to hold space for the adult teeth to come through, but if a tooth is damaged to the point above, it’s better to be extracted.

ARE THERE LONG TERM EFFECTS OF EXTRACTING BABY TEETH?

As an extensive dental procedure there are long term effects to extracting baby teeth. One of the main issues is tooth movement, where a loss of space for the developing adult teeth underneath is reduced. 

There are solutions to help hold the space open such as inserting space maintainers, or in some cases you can regain that space in the future through orthodontic treatment.  

Of course there are a number of ways we go about treating our little patients, so if you’re worried that your child is too young for tooth extraction it’s best to talk to your paediatric dentist who will assess the situation during your initial visits. 

HOW ARE CHILD TOOTH EXTRACTIONS PERFORMED?

The technique to perform child tooth extractions hasn’t changed in years and is a far gentler process than you may initially think – particularly in kids.

Your child will be quite numb so they won’t feel any pain, just some slight pressure. We find that our little patients are often fine with the extraction itself, but take a bit of time getting used to the numbness or lack of sensation afterwards. Thankfully, that feeling will only last a few hours after the procedure. 

WHAT DETERMINES IF MY CHILD HAS THEIR TOOTH EXTRACTED IN THE CHAIR OR IN HOSPITAL? 

This is based on a range of factors that your child’s dentist will discuss with you. We will consider things like:

• How many teeth need to be treated
• Your child’s cooperative ability
• Whether it’s a baby tooth or an adult tooth
• Their medical history and background

WHAT ARE THE RISKS FOR BOTH?

Child tooth extraction in the chair

Treatment in the chair is done with nitrous oxide – also known as ‘happy gas’. Nitrous is incredibly safe and will help your child feel calm during the procedure; you can read our blog on happy gas here. For a child who is known to be a bit squirmy or wriggly, this should help to relax them throughout.  

There are a few situations where your child’s dentist may avoid using nitrous oxide which will be discussed with you prior. In this case, they may opt to use a general anaesthesia instead.

Child tooth extraction in the hospital

More difficult extractions may be performed in the hospital under general anaesthesia, however complications still remain quite low. General anaesthesia is relatively safe and can be given to children of all ages, including newborns. 

We work closely with paediatric anaesthetist’s whose role is to ensure your child is comfortable and pain free. The anaesthetist will stay with your little one at all times during the operation and monitor them closely. 

In Australia and New Zealand, specialist paediatric anaesthetists are among the world’s most highly trained doctors, having spent years undergoing training in anaesthesia, pain control, resuscitation and managing medical emergencies. 

HOW SHOULD I DISCUSS TOOTH EXTRACTION WITH MY CHILD?

As adults, how we communicate with our kids about dental procedures can have an impact on how they cope with it when the time comes. 

Words create imagery for most children, so the use of expressions like ‘ripping teeth’, ‘extracting teeth’ or ‘needles and injections’ are a big no-no at our practice. Instead, we will talk to our little patients about the process using simple phrases which we refer to as the ‘narrative’. 

It’s important that you maintain the narrative at home to help your child feel more comfortable and at ease. 

HOW DO I LOOK AFTER MY CHILD POST TOOTH EXTRACTION?

This will be dependent on your child’s case and how the extraction was performed. We will walk you through in detail what you should do after the procedure during your initial visit, covering things like pain relief and management, types of foods to eat after, and how to care for the extraction site. 

Your little health hero will have been very brave to undergo a tooth extraction, so expect there to be a lot of requests for ice cream!

If you’re concerned that your child may require a tooth extraction the first step is to make an appointment with a paediatric dentist. Give us a call on (02) 9188-0202, email us at hello@macpd.net.au or book online here – no referral necessary!

This article is intended to promote understanding of and knowledge about general oral health topics and to help begin the conversation with your children’s dentist. It should not be used as a substitute for professional advice, diagnosis or treatment. Always seek the advice of your health care professional prior to incorporating this as part of your child’s diet or health regimen.