Tooth Extraction in Children: When It Is Necessary and How the Procedure Is Performed

Why baby teeth need to be extracted

Tooth extraction in children is not only a forced measure in case of complications, but also an important stage in the proper development of the dentoalveolar system. According to the European Academy of Paediatric Dentistry, up to 25% of children aged 6–12 experience complicated tooth replacement, and in CIS countries the rate reaches 30–35%. In such cases, the baby tooth does not fall out on time and prevents the eruption of the permanent one, which creates a risk of crowding and malocclusion. Clinical studies confirm that timely extraction of primary teeth reduces the frequency of orthodontic problems by 20–25% (PubMed).

Age-specific features of tooth replacement

Baby teeth begin to loosen around the age of 5–7, and the process of replacement continues until 12–13 years. In some cases, replacement is completed by 14–15 years, which is related to individual developmental characteristics. If a baby tooth remains immobile longer than normal, it may hinder the eruption of the permanent one. In Eastern European countries, an increase has been observed in visits related to delayed tooth replacement: according to dental associations of Romania and Moldova, between 2020–2023 such situations were recorded in 18–20% of school-aged children.

Extraction of baby and permanent teeth: indications

The main reason for extracting baby teeth is pathological mobility and persistence after the eruption of permanent teeth. Additional indications include complicated caries, chronic pulpitis, or inflammatory processes. In clinical practice, cases requiring extraction of permanent teeth in children are becoming more frequent. According to WHO statistics, the prevalence of caries among adolescents in Europe exceeds 70%, and in CIS countries it reaches 80%. This means that without timely caries prevention in children, treatment may result in the extraction of a permanent tooth. In such cases, a safe approach and subsequent prosthetics are especially important.

Anesthesia methods and procedure

Modern methods make tooth extraction in children as comfortable as possible. Both local infiltration anesthetics and topical anesthesia in the form of gel or spray are used. European protocols (EAPD) recommend the use of dosed carpule systems to reduce the risk of complications and to adjust the dose according to the child’s weight. Studies show that the use of modern anesthetics reduces pain levels on the VAS scale to 1–2 points (PubMed Clinical Study).

Postoperative care and risks of complications

After tooth extraction, the child must strictly follow the doctor’s recommendations: avoid hot foods, not touch the wound with the tongue, and limit physical activity for 24 hours. Failure to follow these rules increases the risk of infection and alveolitis. It is also important to consider the condition of the gums. For example, in cases of chronic inflammation of the soft tissues, the likelihood of complications is higher, which makes the topic of gum treatment in children a necessary part of a comprehensive approach.

Extraction and orthodontic consequences

Delayed extraction of baby teeth can lead to crowding and the development of malocclusion. The European Journal of Orthodontics notes that up to 40% of children whose baby teeth were extracted late later required orthodontic treatment. This highlights the importance of close cooperation between dentist and orthodontist at all stages. In some cases, permanent teeth are extracted for orthodontic reasons, when space needs to be created for proper alignment of the other teeth.

Extraction and psychological aspect

The child’s psychological readiness for the procedure plays a key role. European studies show that a positive experience of the first dental visits reduces anxiety levels by 30–40% in the long term. That is why it is important to entrust the extraction to a pediatric dentist who knows how to work with young patients, creating an atmosphere of trust and calm.

Conclusion

Tooth extraction in children is not just a mechanical procedure, but an important step in ensuring oral health, correct occlusion, and harmonious development. Experienced dentists use modern anesthesia methods, follow international protocols, and prevent complications. Combined with prevention and regular visits, this minimizes the need for extractions and ensures a healthy smile for the child.