Extractions

There are a number of reasons your child’s tooth may need to be removed (which we so gently call “wiggled out”). Some teeth have to be “wiggled” if they are severely decayed; sometimes they have to be “wiggled” if they are broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your child’s chewing ability, problems with their jaw joint, and shifting teeth, which can have a major impact on your child’s dental health. Many times, small metal “space maintainer” appliances are needed.  Dr. Tara will discuss your child’s alternatives to extractions, as well as replacement of the extracted tooth, with her staff who will then tell you her recommendations and inform you of your options.

The Extraction Process

At the time of extraction, your child will breathe “laughing gas” (nitrous oxide) to relax them and to give them an analgesic effect. Dr. Tara then puts “sleepy jelly” (topical anesthetic) on your child’s tooth and gums to begin numbing them and then she ever-so-gently “drops” the “sleepy juice” (local anesthetic) very slowly one drop at a time around the tooth until they are numbed. In almost every case, the child doesn’t even know what has happened! She then tells the child later what she did and why their mouth is feeling “like a great big marshmallow” (numb) and they do not even believe her!  She is that good!

During the extraction, she tells them they will feel a lot of pressure, or as she describes it, “it will feel like it’s getting a great big hug.” She literally “wiggles” and rocks the tooth back and forth, instead of “pulling” it, per say.

They only feel pressure with no pain because the anesthesia has numbed the nerves stopping the transference of pain. 

After Tooth Extraction

After a tooth is extracted, a blood clot forms to stop the bleeding and to begin the healing process. She recommends they bite on cotton gauze immediately after the appointment (we will send them several home in a baggie). As it bleeds or oozes, they need to replace the cotton gauze to stop the blood flow. This acts as a “bandage” until it stops.

If your child has had a permanent (or “adult” tooth) extracted, we need them to not disturb the blood clot so please do not let them rinse vigorously, suck on straws, spit, smoke (if they’re older) for several days. These activities may dislodge or dissolve the clot and hinder the healing process. We do not want a permanent tooth to get a dry socket. Thankfully, the extraction of a baby tooth does not usually lead to a dry socket.  Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.

Dr. Tara recommends the child take a half of a dose of acetaminophen (Tylenol) and a half of a dose of ibuprofen (Advil or Motrin) at the same time, as soon as possible, before the nerves in the extraction site “wake up”. Dr. Tara recommends the same combination every 4 to 6 hours, as needed, for several days until the socket heals.

If antibiotics are prescribed, continue to take them until they are gone, even if signs and symptoms of infection are gone. Drink lots of fluids and eat soft, nutritious foods for a few days after the extraction. Please keep your child from eating chips, spicy foods, etc. until the socket heals.

It is important to resume your child’s normal dental routine after 24 hours. This should include brushing twice a day and flossing their teeth at least once a day. This will speed healing and help keep their mouth fresh and clean.

After a few days, they should feel fine and can resume normal activities. If they have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.