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How to safely remove baby teeth

Updated: May 1, 2023

When a child starts losing their baby teeth, it’s an exciting time full of funny smiles and sideways eating. The teeth usually come out on their own, but sometimes they need a little help. So how do you know when to pull a loose tooth and when to leave it alone?

Why baby teeth fall out

Typically, baby teeth, or primary teeth, start falling out on their own around age 6 or 7 as the adult teeth take over the roots of the baby ones. They fall out in a fairly predictable pattern, with the two bottom front teeth (lower central incisors) and the two top front teeth (upper central incisors) falling out first, followed by the lateral incisors, first molars, canines, and second molars.

When to pull baby teeth

Baby teeth help guide adult teeth out of the gums and into the mouth, so removing them prematurely can cause excessive pain or impact jaw structure development. Once a tooth is wiggly, it is held in the gums by a small amount of tissue. Kids will play with their loose tooth with their tongue or fingers, which makes it easier for the tooth to fall out on its own. When the tooth falls out naturally, there is little or no pain, and maybe a little blood, but nothing to be concerned about.

Sometimes a loose tooth may bother your little one and they will ask for you to pull it out. But in order to prevent unnecessary pain, crooked adult teeth, or infection, make sure you follow these general guidelines for pulling baby teeth.

When not to pull out teeth:

  • The tooth is barely loose. Even if the tooth started wiggly quite a while ago, being pulled when it is not ready to come out can cause more bleeding and hurt for your little one.

  • The tooth is loose because of an accident or a dental problem.

  • Your child is under age 5. If a tooth is pulled too early, it can cause the adult tooth to grow in crooked.

How to pull out a baby tooth

  • Place a clean ice pack on the gums near the tooth for a few minutes to numb the area

  • Grip the tooth with a clean tissue, gauze, or piece of paper towel

  • Quickly, but gently, twist the tooth until it falls out

Do not pull teeth like this:

  • Tie a string around the tooth to pull it out. This can cause increased pain, or painful memories for what should be an exciting childhood event.

  • Twist or wiggle the tooth to make it looser. If the tooth doesn’t come out after two twists or a short wiggle, it’s not ready.

When to call the dentist

  • A baby tooth that stays wiggly for 6 months or longer without getting looser or falling out

  • Most of your child’s baby teeth have fallen out, but a few won’t. The dentist may need to pull them.

  • Your child has swollen gums, pain, or a sign of infection

  • A baby tooth is knocked loose from an accident

Tips for after-care

After a tooth is pulled, or falls out on its own, have your child bite down on a clean, damp gauze, tissue, or paper towel to help the blood clot quickly. Your child should still brush and floss normally, but leave the area where the tooth fell out alone for a couple of days. Once brushing has resumed, be gentle around the newly exposed gum line to avoid discomfort or gum irritation.

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