CHILDREN'S DENTISTRY
Tooth Extraction in Children
The final step when the options for saving the tooth are exhausted
Provided at our clinic in Altunizade, Üsküdar (Istanbul).
IN SHORT
Tooth extraction in children is the controlled removal of a milk tooth that cannot be saved, or in certain cases of a tooth. Extraction is considered as a last option in situations where preserving the tooth is not possible, such as advanced decay, infection, trauma or an orthodontic need. Because the early removal of a milk tooth can cause the space needed for the permanent tooth to narrow, a space maintainer may be needed afterwards.
When is tooth extraction in children needed?
Most milk teeth fall out on their own when the time comes and do not require extraction. Tooth extraction is the last option resorted to in situations where preserving the tooth is no longer possible; when possible, the tooth is preserved with fillings or other treatments.
A tooth that cannot be saved because of advanced decay.
An infection or abscess that cannot be resolved by treatment.
A tooth that is severely broken or damaged as a result of trauma.
Situations required as part of orthodontic treatment.
A milk tooth that has not fallen out in time and is blocking the eruption of the permanent tooth.
What these situations have in common is that preserving the tooth is no longer in the child's interest. For example, an advanced infection can threaten not only that tooth but also the surrounding tissues and the developing permanent tooth. In such cases, extracting the tooth is a step that prevents the problem from growing further. Even so, this decision is made after the options for saving the tooth have been assessed.
The difference between natural shedding and extraction
A loose milk tooth falling out on its own is a natural process and most of the time requires no intervention. Extraction, on the other hand, is done by the dentist in a controlled way in situations where the tooth cannot fall out naturally or where waiting would harm the child. Which situation applies is determined by examination.
Sometimes the permanent tooth can erupt behind the milk tooth before the milk tooth has fallen out. Although this situation often corrects itself, in cases where the milk tooth persists in not falling out or affects the position of the permanent tooth, an assessment is needed. Rather than trying to force out a loose tooth at home, it is safer to consult the dentist in cases of doubt.
In which situations is extraction postponed or unsuitable?
The decision to extract is not always the first option; the following situations are assessed first.
If the tooth can be saved with a filling or other treatments, it is not extracted.
If there is an active and widespread infection, this situation may need to be managed before extraction.
If there is a bleeding disorder or certain systemic conditions, additional precautions are needed before the procedure; for this reason the child's general state of health and the medicines they take should be reported to the dentist.
The procedure step by step
Examination
The state of the tooth and the surrounding tissues is assessed, with an X-ray in cases judged necessary.
Reassurance and anaesthesia
The area is numbed with local anaesthesia; it is important that the child is reassured and informed about the process.
Extraction
The tooth is removed in a controlled way.
Information
Aftercare is explained and, if needed, an assessment for a space maintainer is planned.
After the procedure and healing
Protecting the clot that forms in the area after extraction is important for healing; for this reason, in the first hours after the procedure, disturbing the area and rinsing forcefully should be avoided. On the first day, soft and lukewarm foods are preferred. Advice on pain and healing is given by the dentist.
If the milk tooth was extracted early, an assessment for a space maintainer may come up in order to preserve the space needed for the permanent tooth.
The child's feeling of numbness after the procedure may continue for a while. During this period it is important to watch that they do not bite their cheek or lip, because the numb area can be harmed without being noticed. When sensation returns fully, this risk disappears. In the event of more bleeding, swelling or pain than expected, the dentist should be consulted.
Preparing the child for the procedure
Anxiety plays an important role in how children approach dental treatment. Giving the child a short explanation before the procedure, in language they can understand and that does not frighten them, makes the process easier. Avoiding anxiety-increasing expressions such as "it will hurt" or "needle", and meeting the process with a calm attitude, helps the child to relax.
The child being reassured and feeling trust during the procedure is decisive in the experience being a positive one. In situations where anxiety is marked, extra time is taken for the child and the process is introduced step by step, which can help them relax. A positive first experience also helps the child approach later dental visits more comfortably.
Risks and possible situations
Temporary bleeding, swelling and discomfort may occur after the procedure.
If the care advice is not followed, healing may be delayed or an infection may develop in the area.
The most important outcome is that, when a milk tooth is lost early, the space for the permanent tooth may narrow; in this case a space maintainer may be needed.
Natural shedding and dentist intervention
The natural shedding of a healthy milk tooth and an extraction done by the dentist correspond to different situations. The table below compares the two.
Compare the options
| Natural shedding | Dentist intervention (extraction) | |
|---|---|---|
| Process | The tooth becomes loose and falls out on its own | The tooth is removed in a controlled way |
| When | A healthy milk tooth whose time has come | Advanced decay, infection, trauma, orthodontic need |
| Pain/infection | Usually none | Aimed at resolving an existing problem |
| Next step | The permanent tooth erupts on its own | An assessment for a space maintainer if needed |
Which option is suitable is decided together after an intraoral examination.
Frequently Asked Questions
A healthy milk tooth whose time has come is expected to fall out on its own. However, if there is advanced decay, infection or trauma, waiting can harm the child; in these situations extraction is needed. The decision is made by examination.
Because the area is numbed with local anaesthesia, no pain is felt during the extraction. Reassuring the child makes the procedure easier.
If a milk tooth is lost early, a space maintainer may be needed to preserve the space for the permanent tooth. The need is assessed according to the tooth that has been lost and the age of the child.
On the first day, soft and lukewarm foods are preferred; very hot, hard foods and those that could disturb the clot are avoided. Following the dietary and care advice given by the dentist supports healing.
Related treatments
The content on this site is for information only and does not replace a clinical examination. The suitability, duration and scope of treatment are determined after a clinical assessment.
This content was prepared by Dt. Mevlüt Yazıcı.
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Altes Diş Kliniği
Altunizade, Üsküdar, İstanbul
- PHONE+90 533 474 43 94
- EMAIL[email protected]
- ADDRESSAlperen İş Merkezi, Valide-i Atik Mahallesi, Altunizade, Nuhkuyusu Cd D:191/B, 34664 Üsküdar/İstanbul
- WORKING HOURSWeekdays 10:00–19:00 · Saturday 10:00–16:00 · Sunday closed