Should My Child Have Oral Surgery To Remove Baby Teeth?

Ideally, oral surgery to remove baby teeth would be rare. The reality is tooth extractions are considered the most common surgical procedure in the United States. Most of the time, this surgery is very simple and is performed by a pediatric surgeon; this is the case when a simple extraction is recommended, requiring only the use of local anesthesia, forceps and a gentle but firm tug.

Sometimes, however, the process required to remove a baby tooth entails the removal of gum tissue and some cutting into the jaw bone. If so, oral surgery may be necessary, and preparing your child for all the steps ahead will relieve his or her anxiety and help the process move forward smoothly.

The type of extraction required depends on what is found via dental x-rays. This is one reason why bi-annual dental checkups are so important. Waiting too long to perform certain oral surgeries can have more long-standing repercussions.

Why Is Surgery Required to Remove My Child’s Baby Tooth?

There are several reasons why your surgeon, orthodontist and/or oral surgeon will recommend oral surgery to remove – or extract – a baby tooth. Some of the most common include:

Dental Decay

In most cases, with routine bi-annual dental checkups, pediatric dental decay is caught and repaired before it progresses to an irreparable place. When tooth decay progresses to the point that it cannot be removed, filled and crowned, surgeons may opt to remove the tooth.

Dental decay is a serious condition. In addition to causing physical discomfort or pain for your child, decaying teeth may also be a source of embarrassment – particularly if the tooth in question is visible when they talk or smile – becoming a source of teasing. More importantly though, unchecked tooth decay can lead to more serious complications including:

• Severe pain and discomfort
• Tooth abscesses
• Swelling and/or pus around the tooth/teeth
• Difficulty chewing food, which can lead to malnutrition
• An adjusted bite, which can affect jaw muscles and structure
• Repositioning of teeth that alters how adult teeth come descend
• Tooth loss
• More serious and complicated infections if rot gets into the root or becomes more systemic

Once the baby tooth, or teeth, in question are removed, your child’s adult teeth will fill in. A proper diet and routine dental checkups should prevent further decay.

A Broken Tooth

If a tooth was broken during a simple extraction, oral surgery is often required to remove gum tissue, and potentially bone fragments, and to access the rest of the tooth. If the tooth was broken as a result of an injury, the surgeon may opt to remove the tooth – rather than repair it – especially if the adult tooth is due to emerge sooner rather than later.

This is simpler than going through the expense of the tooth repair process – which probably isn’t worth the investment if the baby tooth would have fallen out soon anyway. However, if a broken tooth is so damaged the surgeon can’t use simple extraction procedures, anesthesia and oral surgery would be the solution.

A Baby Tooth Is Impacted

Most people are familiar with wisdom teeth extractions. Although these aren’t technically baby teeth, the process remains the same for any baby teeth that may be impacted and aren’t breaking through like they should. For example, if a child has impacted canines (cuspids) and the surgeon feels they aren’t moving in as they should or their location compromises the function or health of the mouth, extraction may be recommended.

Similarly, a surgeon may determine that the child’s jaw structure is simply too small to accommodate the full spectrum of baby teeth, in which case certain teeth might be flagged for extraction. This would minimize crowding and possibly the need for complicated orthodontics. Then, the hope is that time and diligent attention to tooth location and more standard orthodontic approaches will be all that’s necessary for adult teeth to fill in as they should.

Your Child Is Getting Braces

After the first round of baby teeth are lost (or not) and adult teeth are making their way into place – the surgeon or orthodontist may feel extractions of existing baby teeth are the best course of action to facilitate the healthy emergence and movement into place of the adult teeth.

What Happens During Pediatric Oral Surgery

The more prepared your child is the better. A few things to consider are:

• Make sure someone who specializes in, or has a reputation for, being great with kids does the work. Kids are understandably more wary of surgical procedures because it’s difficult for them to logically understand the what's or whys of it. Patience is a must, and your children should be told – in age-appropriate language – exactly what will happen and that extra care is taken to minimize their discomfort.
• Know the difference between a local anesthetic and anesthesia. A local anesthesia blocks pain/feeling in a very specific area. This is administered topically to the gum, and then via a shot. Ideally, the child should feel zero pain from the shot since the gum is locally numb. For more invasive surgeries – where we have to cut into gum and/or bone material – we may use general anesthesia that fully sedates the patient. This requires a mask with nitrous oxide to calm the patient and to help him/her drift off, while the IV anesthesia creates a state of unconsciousness such that we can work quickly and efficiently. It also ensures the child avoids pain, discomfort or the trauma of hearing the more intense sounds and motions associated with more complicated extractions.
• Honor the doctor’s post-surgical instructions. For sensitive children, it’s easy to follow the post-extraction surgical instructions – eat soft foods, take care when brushing, etc. – because the discomfort they feel ensures they not overdo things. Other children have much higher pain thresholds and may be stubborn about the restrictions – which involve taking pain meds/anti-inflammatories for at least 48 hours after the procedure, taking it easy and eating softer foods until comfort levels permit other options, brushing and flossing very gently the following day, etc. Any unusual pain, bleeding and/or swelling should be reported to the oral surgeon or surgeon as soon as possible in case there is a post-surgical complication.

Have questions about recommended surgical extraction to remove your child’s baby teeth? Contact us here at Los Gatos Oral & Facial Surgery. We’ll be happy to discuss your concerns and schedule a consultation.