Pediatric Tooth Extraction

About Pediatric Tooth Extraction

A pediatric tooth extraction is a dental procedure that involves removing a tooth from its socket in the jawbone. It specifically refers to the removal of primary teeth in young children or adult teeth in older kids.

Although we do everything we can to avoid pulling a tooth, there are some cases where a pediatric tooth extraction may be necessary.

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Reasons for Pediatric Tooth Extraction

There are several reasons why a pediatric tooth extraction may be necessary:

• Severe tooth decay: If your child’s tooth is severely decayed and cannot be saved with other dental treatments such as fillings or crowns, a tooth extraction may be recommended to prevent further damage to surrounding teeth.
• Crowded teeth: In some cases, there may not be enough space in your child’s mouth for all of their teeth to properly erupt. This can lead to crowding, which can cause dental problems and may require a tooth extraction.
• Injury or trauma: If your child’s tooth is fractured or severely damaged due to an injury or trauma, a tooth extraction may be necessary to prevent infection and other complications.
• Orthodontic treatment:  Sometimes, a tooth extraction is necessary as part of orthodontic treatment to create space for proper alignment of teeth.
• Over-retained baby teeth: In some cases, baby teeth may not fall out on their own and need to be extracted to allow the permanent teeth to emerge properly.
• Ectopic eruption:  This is when a tooth emerges in the wrong position, potentially causing discomfort or disrupting the development of other teeth.
• Infected tooth: If a tooth is infected and cannot be treated with a root canal, extraction may be necessary to prevent the spread of infection.

Tooth Extraction Procedure

The following are the general steps involved in a simple and surgical tooth extraction procedure when performed at our pediatric dental office.

Simple Extraction

A simple tooth extraction is performed on a tooth that is visible in the mouth.

• If your child requires dental sedation, we will administer it before the procedure begins. We will then administer local anesthesia to the area around the tooth being extracted. We use the NuSmile Soan Cordless Electronic Injection Pen to ensure a comfortable and precise delivery of anesthesia. 
• Once the area is numb, we will gently loosen and remove the tooth with special dental tools.
• If the tooth being extracted is a baby tooth, a space maintainer may be placed after the tooth is extracted. This device keeps the space open for the permanent tooth. 
• The area will be cleaned, and a gauze pad will be placed to help stop any bleeding.

Surgical Extraction

A surgical tooth extraction is necessary for teeth that are not visible in the mouth or more difficult to extract and must be sectioned. This procedure may require cutting the tooth into sections or making a small incision in the gum tissue to access the tooth.

• If your child requires dental sedation, we will administer it before the procedure begins. We will then administer local anesthesia to numb the area around the tooth being extracted.
• A small incision may be made in the gum tissue to access and remove the tooth. If the tooth is too large to remove in one piece, or if it is severely impacted, it may need to be removed in smaller pieces.
• After the tooth is removed, if there is an incision, it will be closed with dissolvable stitches. A sterile gauze pad will be placed over the site to control bleeding and promote blood clot formation.

Sedation Options

We offer three types of dental sedation at our office:

• Nitrous oxide: Also known as “laughing gas,” this is a safe and effective sedative that can help your child feel calm and relaxed during the procedure.
• IV sedation: For more complex cases or children with severe dental anxiety, we offer intravenous (IV) sedation, which is administered by a specially trained pediatric anesthesiologist.

Aftercare and Recovery

After a tooth extraction, it is important to follow proper aftercare instructions to ensure proper healing and prevent infection.

• Your child may experience some discomfort and swelling at the extraction site, which can be managed with over-the-counter pain medication and an ice pack on the outside of the cheek (20 minutes on, 20 minutes off). Always follow the dosage instructions on the medication label.
• Their mouth will be numb for a few hours following the procedure. Try not to give them anything to eat until the numbness has worn off to prevent them from accidentally biting their cheek or tongue.
• Encourage your child to rest and avoid any strenuous activity for at least 24 hours after the procedure.
• Provide soft foods such as soup, mashed potatoes, and smoothies for the first few days after the extraction.
• Encourage them to drink plenty of water.
• Avoid using a straw or spitting, as this can dislodge the blood clot and delay healing.
• Have your child gently rinse their mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of water) several times a day to help keep the extraction site clean and promote healing.
• Make sure your child continues to brush their teeth, but avoid brushing directly over the extraction site for the first few days.
• If your teen smokes cigarettes or vapes, make sure they refrain from doing so for at least 72 hours after the procedure, as it can delay healing and increase the risk of complications.

If your child experiences…

• persistent bleeding
• swelling or pain that worsens instead of improving after a few days
• symptoms of infection such as fever, difficulty breathing, or excessive swelling and redness around the extraction site
• a foul taste or odor from the extraction site

…contact our office immediately so we can evaluate and address any potential complications.

Soft Foods to Eat After a Tooth Extraction

While your child is recovering from a tooth extraction, it is important to stick to soft foods that will not irritate the extraction site. 

Here are some examples of soft foods your child can enjoy during this time:

• Soup (broth-based or pureed) 
• Mashed potatoes 
• Smoothies (drink directly from the cup, do not use a straw) 
• Oatmeal 
• Scrambled eggs 
• Applesauce 
• Jell-O or pudding 
• Yogurt 
• Cottage cheese 
• Mashed avocado 
• Hummus 
• Soft tofu 
• Cream of wheat 
• Soft-cooked pasta (like macaroni or noodles) 
• Rice pudding 
• Soft bananas (mashed if needed) 
• Steamed and mashed carrots 
• Soft-cooked squash (such as butternut or pumpkin)   
• Soft fish (like flaked salmon or cod)
• Soft cheese 
• Soft-baked sweet potatoes 
• Ice cream (without hard chunks or cones) 

Avoid crunchy foods and hard or sticky foods that may get stuck in the extraction site and disrupt healing.

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