Baby teeth and adult teeth are two very different dentitions. It is evident from the shape and size of the teeth. Similarly, the technique to remove the baby tooth as compared to the adult tooth also has some modifications.
Usually, baby teeth are extracted when they are retained for a longer time. However, several dental conditions may lead to the removal of the baby tooth, such as a decayed tooth, periapical infection, supernumerary teeth, and orthodontic purposes.
Typically, the forceps and elevators are different for the removal of baby teeth as compared to that of an adult tooth extraction. Moreover, it requires high precision and cares to modify a child’s behavior while performing surgical treatments. This is because children are fearful and anxious.
Today’s article will highlight the purpose of baby tooth extraction. Furthermore, we will discuss the procedure followed to remove a baby tooth.
What is baby tooth extraction?
Baby tooth extraction is a type of dental procedure that involves painless removal of the whole tooth or root with minimal trauma to the surrounding supportive tissue such as the bone and gums. Moreover, the dentist takes extra care not to disturb the developing permanent tooth bud present apical to the baby tooth.
Such precautions are taken to allow proper healing of the extraction wound. Moreover, to avoid any postoperative prosthetic problems.
How is baby tooth extraction different from an adult tooth extraction?
The difference in the type of armamentarium and technique for baby tooth removal comes because of changes in the shape, size, and anatomy of the baby tooth. Let’s examine the differences between baby teeth and adult teeth before understanding the modifications in the extraction technique.
Baby teeth Vs. Adult teeth
- Baby teeth are usually smaller in size as compared to the permanent teeth.
- The tooth crown of baby teeth is more bulky or bulbous. (1)
- Additionally, the furcation of baby molars is more cervically positioned as compared to their permanent counterpart.
- The tooth root of primary teeth tends to resorb naturally. However, the tooth root of permanent teeth shows signs of resorption only when there is an abnormality.
- Younger patients have more elastic bony alveolus as compared to the rigid alveolar bone of adults.
Modifications in the extraction technique of baby teeth
- Change in the type of forceps – usually, the extraction forceps used for baby tooth removal have smaller beaks and handles. This is specially designed to accommodate the bulbous crown structure. Moreover, the beaks are more curved to adapt well to the curvature of each tooth. (2)
- During the tooth’s luxation, a little more expansion of the socket is required to avoid breakage of widely divergent primary molar roots.
- The cervical positioning of the mola bifurcation in the primary tooth roots requires the use of forceps with deeply plunging beaks.
- The dentist needs to inspect the socket of the primary tooth to check of the developing tooth buds are intact and not been damaged.
- Usually, if a root piece or a fragment is left behind in the socket, it is best to avoid reentering the surgical wound as the roots will physiologically resorb overtime.
When is a baby tooth extraction performed?
Some of the prime indications for baby tooth removal include –
- Grossly decayed tooth
- Over retention of the primary tooth which may pose a threat for proper eruption of the permanent successors
- Periapical infections that may interfere with the development of permanent teeth
- Orthodontic treatment
- Supernumerary teeth in the jaw (3)
- Vertical fractures of primary teeth
- Ankylosis of primary teeth that may interfere with the proper eruption of permanent teeth
- Primary tooth impaction
- Ectopic positioning of primary teeth
What are the contraindications of baby tooth extraction?
While there are several indications for primary tooth removal, some contraindications for removal of aby tooth include –
- Children with bleeding disorders
- Oral infections such as herpetic stomatitis and vincent’s infections
- Acute cellulitis
- Dentoalveolar abscess (4)
- Children with heart disease
- Children with kidney disease
What is the procedure for a baby tooth extraction?
Typically, the procedure for baby tooth removal is divided into three crucial parts –
This step primarily includes the preparation of the child as well as the parent before starting the procedure. Some of the preparatory steps include –
- Written parental consent which also contains a confidentiality contract
- The dentist and dental assistants prepare the operative room by placing all the instruments behind the chair.
- Every step is explained and then performed. The first step includes the explanation and administration of local anesthesia. (5)
- More anxious patients may also require additional sedation techniques to provide comfort.
- The dentist then looks for signs of numbness by asking the patient to differentiate between pressure and pain.
Once the local anesthesia is administered correctly, the patient is seated in a reclined position. The tooth is then luxated with the elevator and removed using the forceps. The socket is examined to look for trauma to the developing permanent tooth. Usually, sutures are not placed. However, if the wound is toot wide, the dentist may place stitches for rapid healing.
Some of the postoperative instructions include –
- The child is kept under observation until the blood clot is formed
- A small pack of cotton is placed to stop bleeding from the wound
- The patient is advised to not bite on the lips
- Also, the patient is asked to not touch the wound with finger or tongue
- No rinsing of the mouth for the first 24 hours
- Parents are advised to keep a check on the meal and analgesics. Moreover, reinforce the child for instructions.
What is the cost of baby tooth extraction?
The cost of baby tooth removal depends on the type of tooth and; location of the tooth. Moreover, it also depends on the dental condition and age of the child. On average, the cost of baby tooth removal range between $90 – $150.
Take away message
Baby tooth removal is one of the most deadly dental procedures for children. However, the dentist takes every precaution to manage the child and painlessly remove the tooth. Usually, the technique for removal of a baby tooth is different as compared to adult tooth extraction.
This usually includes the difference in forceps design and more precautions while tooth removal to ensure that the developing tooth bud is not disturbed. Postoperative instructions are equally essential to maintain the integrity of the permanent tooth.