Prior to doing any extractions, we will evaluate your child’s medical history to make sure they don’t have any conditions, such as diabetes, bleeding disorder, or hemophilia, before suggesting an extraction procedure. Then we evaluate the x-ray (or panoramic film or 3D CBCT) to make sure which tooth is the problem, look for any potential complications such as a curved root, sinus infection, another tooth very close to the root, any nerves that might be near the tip of the root, or finally, any infection which might affect the timing on the extraction. In addition to looking for complications, we look at adjacent jaw anatomy for deep sinuses, nerve or artery proximity, and any other irregularities, or even missing adult teeth. On rare occasions, we have seen incidences where we were ready to remove a baby tooth that has stayed in longer than average and leaving it in typically would cause delay of the permanent tooth eruption, and we find there is NO adult tooth waiting to erupt under the gums! In these cases, we might consider leaving the tooth in longer and hope that the tooth can stay in many more years.
Next, we will look in the mouth and do a clinical exam to evaluate the tooth, the adjacent gum tissue, the cheek, the TMJ, and look for a limited opening in the jaw. The reason we do this is that in very rare instances, when the child either couldn’t sit still or, perhaps they have a narrow opening, we may give them a muscle relaxer to allow them to tolerate the treatment rather than creating trauma for the child.
At Coastal Pediatric Dentistry in eastern South Carolina, we understand the concerns you may have as a parent, especially when it comes to removing a tooth. This is why we take the time to review your options and provide multiple solutions for making the visit for your child as comfortable as possible.