My Child’s Tooth is Loose! How do I get it out?

Nothing can be more frightening than realizing that your child’s tooth is loose and not knowing what to do about it. Do I pull it? Do I leave it to come out on its own? Should I call the dentist?

Most people would rather unclog a toilet than pull their child’s tooth. So let’s talk about if and when you need to actually do something about the loose tooth.

If you see two rows of teeth…
Most commonly referred to as “shark teeth.” If you see the permanent tooth behind or in front of the baby tooth, check to see if the baby tooth is loose. Call the dentist if you are unsure of which tooth is the baby tooth and which is the adult tooth. If the baby tooth is loose, take a kitchen paper towel (after you wash your hands of course) and use your thumb and index finger to “wiggle” the tooth back and forth a little every day. This will help loosen the fibers that are holding your child’s baby tooth into the gum tissue. You want the baby tooth to come out so that the permanent tooth can come into the mouth in the best position possible. Baby teeth that are left in the mouth for a long period of time after the permanent teeth are coming into the mouth, can sometimes make the permanent teeth come in crooked (which makes braces more likely down the road). If you check the baby tooth and it is not loose, and the tooth does not become loose over time as the permanent tooth comes further into the mouth, then it is time to call your dentist. The dentist at this point may recommend pulling the baby tooth so that the adult tooth can come into the mouth in a good position. A lot of times the baby tooth is not loose because the adult tooth did not dissolve the root of the baby tooth all the way.

IF the baby tooth looks broken…
Sometimes when the baby tooth is ready to come out, it is so thin that the child can break the tooth into pieces when biting into something hard or crunchy. This situation is not unusual and happens a lot with baby teeth. If you feel comfortable, try to see if any of the broken pieces are loose and wiggle those pieces just like you would if the tooth was not broken. If you can get one piece out at a time great, if not, then call the dentist. Most of the time when the tooth breaks into pieces, the child and parent have a difficult time removing it and need help from the dentist.

If the baby tooth is a different color…
When baby teeth are ready to make a visit to the tooth fairy, sometimes they will appear “pink” in color. A pink tooth should alert you that it is time to try and wiggle this tooth out! The adult tooth is right underneath and ready to take its place.

Best technique to help get the tooth out…other than tying the floss to the doorknob!
Use a kitchen paper towel and use your thumb and index finger to wiggle the tooth back and forth. The positioning of the child is important – if it’s a front tooth, sit the child on the countertop so the tooth is easier to get to. If it’s a back tooth, lie the child on a sofa/couch/bed with their head in your lap and use a headlight or penlight to see in the back of their mouth.

When in doubt, call the dentist! Sometimes the dentist can use a numbing spray or apply a numbing gel to the gum tissue to numb the area before helping the tooth out – and it does not create as stressful a situation as it might be a home. Other times, the child may prefer the parent to work on the tooth at home. Either way, the important thing to remember is that the goal is to get the adult tooth in the best position possible and to continue great oral hygiene throughout the process. So if your child is not brushing or eating well because of a loose tooth, or if you’ve been trying to get the tooth out at home for weeks unsuccessfully, then it’s time to call the dentist!

When your child loses a tooth, don’t forget to call the Tooth Fairy at 804-215-1675!

Elizabeth Cook Miller, D.D.S., M.S. is a pediatric dentist at Atkins, Maestrello, Miller & Associates Pediatric Dentistry in Richmond, VA. She is a new mother, active runner and her favorite movie is "Finding Nemo".

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