Parents often ask whether a decayed milk tooth is worth saving, since it will fall out anyway. Usually it is. But there are times when removing a child’s tooth is the right call.
Why milk teeth are worth keeping
Milk teeth hold the space for the adult teeth growing underneath. If one is lost years early, the teeth beside it drift into the gap, and the adult tooth can come through crooked or get blocked. Children also need their back milk teeth to chew properly until about age eleven or twelve.
When an extraction may be right
- Decay too deep to repair. If a tooth has broken down too far for a filling or a nerve treatment, or keeps getting infected, taking it out stops the pain and protects the adult tooth below.
- An abscess or swelling. Infection around a milk tooth can affect the adult tooth forming underneath it.
- A milk tooth that will not come out. Sometimes the adult tooth comes through behind or beside a milk tooth that is still firm, giving a double row. If the milk tooth has not loosened within a few weeks, removing it lets the adult tooth move into place.
- Crowding. As part of an orthodontic plan, some teeth may be removed to make room. This is decided with an X-ray and a long-term plan, never on its own.
- An injury that has split a tooth or pushed it out of position.
What we try first
Before deciding on an extraction, we look at whether the tooth can be saved with a filling, a crown made for milk teeth, or a nerve treatment. If a back milk tooth does have to come out years early, a small space maintainer can hold the gap open until the adult tooth arrives.
Preparing your child
- Keep it matter-of-fact. Tell them the dentist will make the tooth sleepy so it does not hurt, and avoid words like needle or pain.
- Bring a comfort toy, and come when they are not tired or hungry.
- Afterwards, watch that they do not chew their numb lip or cheek. It is the most common problem after a child’s extraction.
- Soft, cool food for the rest of the day, and no rinsing or straws for the first day.
Our aftercare for tooth removal covers the days after. If your child has toothache now, see tooth pain, or read about tooth removal.