Kids Extraction

Despite advances in prevention and access to dental care, caries is still affecting many children. If early childhood caries or dental decay in children is left untreated, it can lead to the extraction of the primary teeth (removal of the tooth from the bone socket).

Parents should familiarize themselves with how to relieve the anxiety surrounding visiting the dentist for the children.

Compared to the permanent adult teeth, the primary teeth have lower value and therefore the decision to extract them is normally easier for parents. However, it is important to know those primary teeth:

• Are important for food mastication swallowing
• Contribute to the appearance of the child
• Facilitate speech
• Act as space maintainers for the erupting adult teeth

Leaving an infected primary tooth untreated can harm the permanent successor. And on the other hand, the loss of primary teeth can cause issues for children. A pediatric dentist considers many factors when deciding for the extraction of a baby tooth.

Sometimes teeth may require removal a little bit earlier than the natural shedding. Infection or trauma can damage teeth. Sometimes extraction of badly-damaged baby teeth is necessary. Removal of an unrestorable tooth is sometimes necessary to prevent the spread of infection from the primary teeth to the developing successor adult teeth. Typical reasons for the extraction of the primary teeth include:

Primary teeth easily fall victim to caries and decays because baby teeth have smaller structures compared to adult teeth. This means that decay of the same size damages more structures in a baby tooth compared to an adult tooth. Extensive destruction of a tooth structure prevents adequate restoration of a tooth and the tooth is rendered “non-restorable” or “non-retainable”.

When a badly damaged tooth is non-retainable it needs to be extracted because it no longer can be retained in the mouth for a significant or predictable time. Extraction is usually recommended when the natural tooth can no longer be saved and when delaying the extraction leads to possible infection, tooth abscess, and pain.

Children are usually quite active and childhood involves a significant amount of movement, running around and unfortunately sometimes accidents. The primary front teeth may be injured due to falls, impacts, etc. impact energy can chip teeth, crack or dislodge teeth from the tooth socket.

Depending on the severity of the damage to the tooth structure, a baby root canal procedure or a stainless steel crown may save the natural tooth of the child. In some cases, if the natural tooth cannot be saved, extraction and placement of a space maintainer may be required until the permanent tooth erupts into the space created by the missing baby tooth.

For some children, one or more teeth may require removal if they are getting dental braces. The removal of these teeth makes enough room for shifting teeth as part of their orthodontic treatment.

Loss of a primary tooth may cause a variety of problems. Dental extractions in kids can sometimes be avoided using root fillings or stainless steel crowns. The dentist will never recommend extraction unless there is no suitable alternative treatment option. A pediatric dentist can provide dental care for the missing teeth if a tooth extraction is deemed necessary for your child, this includes the use of space maintainers to facilitate a health eruption of the permanent teeth under the primary teeth.

The teeth play an important role in chewing. Teeth are required for the reduction of the size of the food to a point ready for swallowing. With missing baby teeth, the masticatory efficiency reduces which makes swallowing difficult for children. Missing teeth can limit the food choices for the child because of the chewing difficulties.

Children have a LOT to learn including proper speech. Consider a sentence like: “Thanks so much for this” and try to articulate it without using your teeth. Teeth play an essential role in sounds like: ‘th’, ‘v’, ‘f’, ‘s’ and ‘z’. Teeth support the clarity of the speech in daily communications and consequently, the child’s confidence and his or her social interactions.

Parents should be aware that it is important to look after primary teeth because their purpose extends way beyond food consumption and smiling. Ensure your child is screened by a Brisbane pediatric dentist for oral development.

Before the extraction of the primary teeth, the dentist may need to assess and evaluate the topographic relation of the primary tooth to the developing permanent successor. The dentist studies the x-ray of the tooth and checks the position of the tooth, size of cavities or infections, and the surrounding blood vessels, nerves, and the bone. Depending on the X-ray of the tooth, the dentist can choose the extraction method. They plan for a simple, sectional, or surgical extraction depending on the tooth.

Deep carious lesions can lead to pulp infection in primary teeth. Pulp infection then can cause an abscess in the oral tissues. Unlike abscess in adults, the source of infection is typically superficial in children and therefore surgical cuts to drain the pus is usually not required. In such cases, usually, extraction of the infected primary tooth will solve the problem caused by the abscess.

Referral to paediatric dentists for the extraction of the primary teeth is usually (not always) due to unmanageable behavior in children. In such cases, tooth extraction under general anaesthesia (GA) may be recommended by the dentist to prevent traumatising the child.

The picture of treatment under general anaesthetic may be concerning to some parents, however, when the child is considered a suitable candidate for treatment under GA, they benefit from a treatment which is stress-minimised.

GA can be avoided if a child needs a tooth extracted and can cope with the treatment in the dental chair. Dentists understand tooth extraction can be stressful for children and their parents. There are a few techniques that can be used to reduce the stress and discomfort associated with tooth extractions. Relative analgesia (happy gas) can reduce patients’ anxiety and increase their pain threshold. This is used at the start of the treatment. At the same time, a topical anaesthetic agent is applied to the gum next to the tooth being extracted. A local anaesthetic is then administered very gently into the adjacent tissue. Usually, due to the effect of topical anesthetic and happy gas, children don’t feel the injection. After 2-5 minutes the tooth will be completely numb, and the dentist can remove the tooth. Healing after extraction is usually uneventful.

Common risks of removing a baby tooth include the following:

• Risk of damage to the lips and cheek because children may bite the numbed area without realising the damage they may cause. Children may need supervision until the numbness has worn off
• Jaw pain due to movement of the jaw during extraction
• Short term swelling, infection or bleeding
• Dry socket when a blood clot does not form to support the healing of the wound

Rarely, tooth extraction can lead to complications. Uncommon risks of removing a baby tooth include the following:

• Loss of space for adult teeth which can be prevented by a paediatric dentist
• Prolonged nerve damage (it can happen for a small number of people)
• Bone or root fragments may remain in the gum
• Loss of life as a result of extraction is extremely rare

The term space maintainer refers to an appliance designed to retain the space created by the premature loss of a tooth. Space maintainers are used for the management of proper dental eruption. It’s a dental appliance that holds adjacent teeth of an extracted baby tooth in place. 

Space maintainers prevent the adjacent tooth from drifting into the space created by the missing tooth. This space is necessary for the normal eruption of the adult permanent tooth. Extraction of a primary tooth permits the successor tooth to erupt forward and close the space.

Dental care for children is quite different from dental care for adults (Pure Dentistry Dentists in Brisbane). For some children going to the dentist can be a new experience. It is important to make this new experience as positive as possible so the child can benefit from optimum dental care. 

Children, in general, require less anaesthetic than adults. Extraction is an easy procedure for the majority of children and it is with little or no discomfort during the majority of the procedures. Each case is different and individual assessment is required for each child.

For kids with extensive breakdown of molars due to MIH, the management may include the extraction of the permanent molar.