In some situations, tooth extraction is needed for children. Usually the milk tooth falls off and gets replaced by a permanent tooth. But sometimes this does not happen. To make certain that the oral health of a child is not compromised, tooth extraction is performed. Situations that call for tooth extraction can be a badly damaged tooth or when there is overcrowding or overlapping of teeth.

Tooth extraction is a very simple procedure that is performed in dental clinics. The fear and anxiety felt by children when having their tooth pulled out need to be addressed before they go to the clinic. Parents can talk with their children and let them know how the process is going to be done. Dentists also usually explain to the child and help them understand why this process is being done.

Understanding the need for extraction and having support from their parents will help to bring down the fear of going to a dentist.

Reasons why tooth extraction is needed

Most of the food consumed by children is sweet– be it milk or juice or the cereals. This sugary food usually gets stuck on to the teeth. If proper brushing or flossing is not done, then this food debris attracts bacterial action. Bacteria act on the food and release an acid which will slowly work on the dental enamel. This protective covering of the teeth is eroded and decay sets into the teeth. Dental cavities are then formed on the teeth. If this is not treated in time, then to avoid decay spreading to other teeth, dentists recommend a tooth extraction.

The baby tooth does not fall out in time for some children. By around 6-12 years of age children start losing their milk teeth. During this age they have both milk and permanent teeth. Teeth falling and new teeth taking its place happens normally for all. But for some children, milk teeth do not fall out in time. They are ‘retained’ in the mouth. This will cause overcrowding of teeth in the mouth. In this situation, tooth extraction is done to remove the milk teeth.

Getting hurt while playing, sports accidents are quite common in children. Accidents can bring trauma and injury to the oral region. Mouth, lips, teeth all can get injured especially through contact sports. In this situation, if the teeth are chipped or broken, then tooth extraction is done to remove the damaged teeth. If it is a milk tooth that is damaged or broken, usually dentists will remove them. ’Spacers’ are placed in the mouth to help keep the place for the permanent teeth when they appear.

Some children would need to undergo orthodontic treatment. If they have ‘too many teeth’ then teeth overlap and some might jut out. Dentists provide braces to help straighten the teeth. When the teeth are pushed to their desired position, some teeth that are inside the mouth need to be removed to accommodate all the remaining teeth. Then tooth extraction is done.

Extraction procedure

Tooth extraction procedures are of two types – simple and surgical.  The difference is in the complexity of the procedure that is conducted. In simple tooth extraction, the tooth that is to be extracted is visible. The dentist will perform this extraction under local anaesthesia. After the area is numb, the dentists use forceps to pull out the tooth.

In a surgical extraction, the procedure is a bit complex. This is required in a situation where the tooth that is to be removed is embedded in the jaw bone. Simple extraction will not be possible. The tooth can be partially or fully impacted in the jaw bone. The surgery is conducted under anaesthesia. The jaw bone is cut open and then the tooth is extracted. Both the procedures are conducted after dentists examine the tooth structure using X rays and also after checking the oral health.

Post care

Pain might start after the effect of anaesthesia wears off and mouth will be sensitive for a few days following the procedure. Dentists will place gauze on the site and it can be held in place by the gentle pressure of the teeth. This will help to reduce the bleeding after some time. Though if the bleeding persists or it re-appears because of any pressure applied to the spot, need to check with the dentist. Care should be taken on the food that is consumed. Drinks should not be consumed using a straw, the mouth should not be rinsed forcibly and hot food should also be avoided. This might dislodge the clot that is formed at the time of surgery.

Following a tooth extraction, swelling and pain will also be felt in the jaws and cheeks. Applying a cold compress in the area, will help reduce the swelling. This will also help reduce the pain felt. Difficulty in swallowing, pain while eating may also be felt. This is quite natural after surgery, this will return to normal after 3-5 days.

Take care to keep the head elevated, and reduce engaging in sports or other activities that involve moving around. Brushing and cleaning the mouth after surgery should also be done with care. This should be done with care, avoiding the teeth or the place of surgery, the rest of the teeth should be cleaned. This should be followed for only a day after the surgery, after that normal brushing can be done. Extra force or pressure though should not be applied to the area where surgery has been done.

For a few days after surgery, soft food can be consumed like soup, yogurt, pudding etc. This will help to reduce the pressure that is applied to the teeth and gums when chewing. After the pain has subsided and swelling has reduced, can start consuming other food depending on each child’s healing.