Whenever possible we as pediatric dentists try to save and restore primary teeth. Sometimes the decay is too advanced and the tooth must be extracted. The signs and symptoms that a tooth cannot be restored are:
- any sign of an abscess or swelling
- pain from the tooth when the child is not eating
- pain from the tooth that prevents the child from sleeping
An x-ray will likely be taken to confirm the diagnosis of the tooth, and under local anesthesia the tooth will be removed.
We often use nitrous oxide (“laughing gas”) to help make the child more comfortable during the appointment. Local anesthesia is also used in the area of the extraction.
Our doctors know that for a child, the idea of someone “pulling a tooth” can be very frightening (and even for some adults!). When this treatment is necessary, we always use non-threatening language to explain to the patient what we are doing. Once a patient is comfortable in the dental chair, we will likely explain that we need to “wiggle a sick tooth” and that they will feel us “pushing” the tooth.
After an extraction the child will be numb for about 1-1.5 hours, depending on the amount of anesthesia that was given. During that time the child:
- should not participate in any sports or outdoor play
- should avoid eating solid food. Soft food such as yogurt and plain noodles are appropriate if the child is hungry.
- should be discouraged from chewing or biting on their numb lip, as this can cause significant swelling. One of the most common dental emergencies following a dental procedure is a swollen lip, caused by the child biting their lip while numb.
- should NOT use a straw for 24 hours, as this can disrupt the healing of the area.
- should be given Ibuprofen (Advil, Motrin)or Acetaminophen (Tylenol) for pain.