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Extracting Teeth

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5 year old having 'extra' tooth extracted

Oct 2010

My 5 year old son is having a tooth extracted (an extra adult front tooth growing in the upper roof of his mouth). We've been referred by our wonderful pediatric dentist, Dr. Leticia Mendoza-Sobel, to Dr. Larry Franz in Oakland who, in an initial consultation, seemed very nice and has very good reviews for adults on Yelp. But I am still nervous becasue it involves general anasthesia and well, surgery. Have you a) worked with Dr. Franz or another oral surgeon for your child's extractions before and have a review, and/or b) have advice about the procedure or recovery for a 5-year old? Thank you. Heather


Our 4 year old son had his extra tooth extracted last May by Dr. Richard Berger (510.848.1055). It went extremely well in spite of my anxiety about it. My son is slightly obsessed with airplanes and anything that moves for that matter, so we pretended that the chair was a Blue Angel's chair, and the gas mask was a Blue Angel's mask (navy airplanes that participate in fleet week). We also did quite a bit to focus on the tooth fairy's visit. He was soooo excited about going to the oral surgeon that morning, that his twin sister was in tears that she couldn't have her tooth extracted as well.

In our earlier consultation Dr. Berger had explained to us that there were 3 possibilities for anesthetizing my son, each more invasive (sorry, can't think of the correct word). 1) nitrous oxide or laughing gas, 2) a shot of some drug to relax him (something like valium), or 3) general anesthetic. I desperately wanted the first option, so I really worked on making it seem like fun option for him. Dr. Berger was prepared for all three levels, and would escalate only if necessary. And with my iPod in hand, my son was totally comfortable and a great patient. We were out of there in 30 minutes because it was only the nitrous. All in all, I think that our son remembers it as a very pleasant experience.

The only thing that I wish that we had done better is that when we walked into the procedure room, all of the extraction tools were out on trays. Most of them were above my son's line of vision, but there was one tray with some really scary looking instruments on it, which I jumped in front of until the nurse could cover it with a paper towel. Ours was not a pediatric office, and I don't know if there are pediatric oral surgeons as an option. It wasn't as inviting as a pediatric dentist office is, but the staff was very sensitive to children. And they even had a basket of cheap plastic toys as a reward once the procedure was complete. annette


My daughter broke a tooth at age 5, which had to be extracted. Craig Bloom in Berkeley (http://www.berkeleyoralsurgery.com/)did the extraction, and he and his office were great. Recovery was pretty fast. I don't remember a lot of complaining. We had to avoid straws and other sucking, of course. Carrie

Extraction of baby teeth??

Jan 2010

I just took my 8 year old son to a new (to us) Delta dentist who recommended extracting two of his baby teeth due to crowding of the existing permanent teeth. There is no sign that these baby teeth would come out on their own any time soon. As I understood it, this would potentially allow the permanent teeth enough room to straighten out to avoid the need for braces. It would be done under local anesthetic. I was surprised, and now I'm worried it is not necessary and unsure of the pros and cons to consider. I'd be grateful if other parents who have confronted this issue would share their thinking about it with me. Kimberley


Both of my kids had baby teeth extracted to make room for the adult teeth to come in straighter. I was reluctant and then very pleased with the results. It is very quick. If your child is very anxious, I would recommend a valium, which you can get from the oral surgeon. We only used valium for adult teeth extraction.
my daughter's teeth were extrqactedfor the same reason, and the teeth that were crowded behind her teeth have in fact moved more to the side. I was skeptical, but it seems to have helped. (we'll probably still need braces, but less work already)
Hi there, My 8YO son had four of his baby teeth pulled a couple of weeks ago, so I wanted to respond to your posting.

My situation is a bit different because we are considering a retainer for my son due to overcrowding and an overbite. His orthodontist took x-rays and recommended the extraction of the baby teeth (so that his permanent teeth would have more wiggle room). From the x-rays, I could see that one of his permanent teeth was having difficulty coming out because the baby tooth was still there. The four baby teeth did not show any indication that they would be coming out anytime soon.

Initially, I was a bit nervous about having his baby teeth extracted, but was completely comforted after I met Dr. Bryan Krey (in Berkeley). He is a great oral surgeon with a wonderful demeanor. We had a brief initial consult with him during which he answered all my questions, but more importantly, he interacted and assessed my child's anxiety-level (so that he could determine what approach to take). He spoke directly to my son and explained the entire process to him. My son ended up having a topical ointment followed by the injection (local anesthetic).

If you decide on having the procedure, I would recommend that you consider Dr. Krey - I'm sure he will put you (and your son) at ease with the process. http://www.berkeleyoralsurgery.com/splash/splash.html Nina


I haven't had to face this issue with my stepson, but I had a few baby teeth removed when I was a child. (Actually, I had 11 teeth removed under full anesthesia when I was in 6th grade, but I think only 2 or 3 of those were permanent teeth.)

If those teeth hadn't been removed, there is no way all my teeth would have fit without major overlapping. Before my molars came in during late adolescence, I had great spacing on both top and bottom teeth. After the molars, the top teeth are straight and tightly packed, while the bottom teeth ended up with a bit of overlapping (making me wish they'd removed one more tooth!) So my orthodontist was absolutely correct that the permanent teeth needed to be pulled.

Your child's dental picture may be different, so perhaps a second opinion would help you make a better decision? Niki


12-year-old worried about getting teeth pulled

May 2009

My daughter Emily will be getting four permanent teeth removed next month. She is 12 years old and she is really scared. I got mad at the dentist for acting like it was a big deal and scaring her. I had 2 adult teeth removed over 25 years ago and I don't remember what it felt like that. She was been constantly asking me how much it hurts and what the steps are. I can't tell her anything because I don't know the answers. Can someone please help me explain to her? Please answer the following questions By Emily Rosewood: ''On a rate 1 to 10, how much does it hurt?'' ''I've always heard it was a big deal and is extremely painful. Is that true?'' ''What are the steps in this process?'' Please tell her anything that would calm her down and any advice you can. Thank you so much!


Dear Emily, I had all my wisdom teeth removed when I was 17, so I was a little older than you but I still remember it. On a scale of 1-10, pain was maybe a 3 during the surgery (mostly the injections to numb the area) and 5 the day after the surgery. I had this done while at college, had it done for free at the local dental school, and went back to my dorm room afterward. My roommate kept running out to get me ice cream. I skipped class the day after surgery but two days later felt much, much better. The two things I remember most were pressure (not pain) when the teeth came out and then the small ''wells'' in the gums. That was the most annoying part -- the small holes that were left that you had to clean with special brushes. It's not the most fun I've ever had but it wasn't that painful overall. The worst part was the night before and not sleeping because I was so worried. Before you go to your appointment, call the dentist and talk to him or her about pain killers -- both during the dental work (nitrous oxide is good because it lets you relax) and what kind of pain killers you'll have when you go home. And you can email me and ask any questions you want. Ann
Whoa! Unless these adult teeth are wisdom teeth, I would definitely seek a second dentist's opinion on extracting them. If it is absolutely necessary to do this now, then my next advice would be to make sure it is done by a competent oral surgeon and not an ordinary dentist. If you go to someone like Drs. Bloom, Berger and Krey (510-848-1055), they will explain the entire process to your daughter in terms she can understand. My daughter had her wisdom teeth extracted when she was 15 and Dr. Krey and his staff were wonderful in showing her the x-rays, letting her know what to expect, doing a great job on the extractions themselves, and giving her excellent, and quick, follow-up care, especially when one site became inflamed. Good luck! anon
Hi Emily, When I was about your age (end of eighth grade), I had four adult teeth and my four wisdom teeth removed at the same time. The four adult teeth had to go for spacing, and my orthodontist and dentist figured it made sense to remove the wisdom teeth at the same time so I'd only have one procedure. That made a lot of sense to me when I was 13, and it still makes sense today at 47.

An oral surgeon removed the teeth. I was under what amounted to general anesthesia, so there was no pain during the surgery. For the most part, I was asleep. At one point, I remember feeling a weird sensation in my mouth as the doctor was removing one of the wisdom teeth. It wasn't pain; more like a small noise.

The surgery was in the morning, and I came home in the early afternoon. It was pretty hard getting out of the car with only one person to help -- the anesthesia hadn't fully worn off -- so make sure to have two. I slept pretty much until the next morning. For the first two days, my cheeks were very swollen. I had a pain killer -- I think it was vicodin -- but the pain wasn't bad and I only took it once or twice. Eating anything that required chewing was impossible for several days. The upside was that I figured out how to live on a diet that was heavy on chocolate milkshakes.

Assuming this is being done for orthodontia, I'd highly recommend dealing with the wisdom teeth at the same time. Also, I'd highly recommend an oral surgeon instead of a dentist. And don't forget to buy enough ice cream! Allen


I had four wisdom teeth extracted. They gave me laughing gas and I don't remember anything of the extraction. They mentioned something about having to jackhammer the teeth out of the bone, and had the x-rays to prove it. All I remember is waving happily to people on my way home - it felt great. With ice afterwards, my face didn't swell up much and there wasn't much pain. Unfortunately they haven't needed to do it again. fiona
dear emily,hi!my name is sarah and i am 11 years old.i have been getting teeth pulled since i was in first grde.it hurts,but it is not unbearable.first they put the novicane in to numb your mouth.then they pull your teeth out.it is important to stay calm and try to take deep breaths.i hope this advice helps with the process. sarah
My daughter had about 12 teeth removed between the ages of 8 and 15. The only part that bothered her at all was the mild soreness she felt after the procedure. However, if you take pain medicine as prescribed, you should not feel any pain at all! you will be fine. Keep taking the pain medication and you will not feel a thing. Good luck... kendall's mom
This sounds like it is to make space for orthodontics, not about pulling wisdom teeth. In the far distant past, I had the same thing done and I, too, was very apprehensive. I asked my mother to have me ''knocked out'' and, when it was all over, I thought they hadn't started yet! They don't really knock you out -- it is NOT general anesthia. But, from the patient's perspective, you are not aware of anything at all. It is very easy. I slept for the rest of the afternoon, and by the next day, I was back at school. I don't think there was any pain at all by the next day.

Local anesthesia is much-improved these days, but why have the child awake if it is not necessary? (Maybe for one tooth, but not for four...)

Wisdom teeth are another story, but only from a recovery standpoint -- recovery can be painful for a while, and prescription painkillers are called for. But the advice about sleeping through the procedure is the same. anonymous


Dentist wants to remove 4 of middle schooler's permanent teeth

April 2007

The orthodontist wants 4 permanent teeth removed from my daughter's mouth. That worries me, though my daughter says it's okay with her. If anyone can offer thoughts from experience on this, I would appreciate it. My girl is on round two of orthodontic treatment. The first 3+ year treatment was during elementary school years, and the second round started about a year ago (middle school.) Just recently the orthodontist group (Nelson, Meyers et al) told me of their new recommendation: 4 tooth extractions. Instinctively, I wonder about this--her mouth is not a small one, and it looks like there's room, but I'm no expert. I'd love to have some advice. hesitant to pull


My orthodontist, 25 yrs. ago, recommended rearranging my teeth rather than pull four permanent teeth. What a mistake! I suffered thru headgear, braces, and retainers for years. Now at 38, I still have a permanent retainer that attempts to keep my teeth in place. How I wish they had just pulled a few when I was younger. Having had 4 wisdom teeth pulled and a root canal, it's not a big deal. There are just some of us who have way too many teeth for our little mouths/jaws. My cousin's parents had her perm. teeth pulled and, in my opinion, it turned out MUCH better in the end. Been there 25 yrs. ago
When we went to get braces for the middle child, when he was 12, the orthodontist recommended pulling 4 teeth. I balked because it sounded so extreme. I asked him if there was any alternative. He said yes, we could work around it with braces and retainers. Well, now that kid is 21 and his teeth are noticibly bowed out - there just wasn't enough room in his mouth for all the teeth, so they slant outwards slightly. I see in retrospect I should have listened to the expert. I recommend getting a second opinion but then listen to what they say. They might know what they are talking about! Mom of a cute buck-toothed son
I'm no orthodonist, but I can tell you that I had also had 4 permanent teeth (2 top and 2 bottom) pulled before I had braces put on in middle school (which was admittedly 20 years ago). It gave some room for the teeth to move into position as they realigned. I haven't had any problems, and don't even remember it as being too traumatic. Getting my wisdom teeth out was much worse. If you're concerned, get a second opinion. Too many teeth
With 4 1/2 years into the process I don't blame you for being concerned. We recently got the same advice on a second round of braces but before the work was started. We got a second opinion and that recommendation was for no extractions. The second orthodontist explained that extractions can achieve the result but you have to ask what the child's appearance will be after the extractions. In our case that would have been a negative. I assume the second round treatment plan did not mention the possibility of extractions so you should get an explanation of why it is necessary, how it will change your daughter's appearance, and what the alternatives are. Good luck. anon
I am 37, and my orthodontist extracted four permanent teeth when I was a bit younger than your child. It was a great move; I never had to have braces, and my teeth/smile look and function well. I loved it because I had another visit from the tooth fairy :) I still had to have my wisdom teeth removed at nineteen, since my teeth are pretty big, but I think they were hoping to avoid that as well. happy smiles
I had 8 perm teeth extracted - two upper/two lower each side. No ill effects this far out - but I do still hate to go to the dentist. But my teeth are still straight and they were a mess. gl
Because I had extractions which I have mixed feelings about, I sought alternatives for my son when his orthodontist recommended extractions for him. In an effort to find someone who would provide a good alternative (like palate expansion) I consulted with four top orthodontists in the area (I researched this), especially those who were known for being current and who employed other methods. Their collective wisdom and my better understanding through this process helped me make a good decision: to do the extractions. BTW, I switched to the ortho who was the most respectful of my involvement in the decision (Dr Righellis, Montclaire) and also highly recommend Dr Krey (in Berkeley) for the extractions. In that anxiety is the most difficult part of the extraction, I also recommend a valium (for your child, not you.) It was easy. Ruth

Pulling permanent teeth at age 12

March 2006

My son is 12 y/o and has been wearing first retainers and now braces. His orthodontist has recommended pulling his 4 (!) permanent premolars and gave me all the technical explanation of why this is necessary. In short, little space big teeth coming out, but pulling PERMANENT teeth from children sounds like a terrible, permanent decision. I am ready to figth the orthodontist for not pulling these teeth, but I really don't know what to do. I am asking for second and third opinions from other dentists but would like to know what are parents doing about this. Anybody with thoughts about this issue ? Has anybody decided not to pull and is happy with that decision ? Thanks for your comments. G.


when I was about that age I had 2 permanent teeth pulled. they talked about pulling four but ended up deciding not to pull the bottom ones I forget why. I also had an over crowded mouth and was in the process of trying to straighten my teeth. I don't suffer from having fewer teeth and my braces went ahead as planned. I think its pretty common to do this. teeth to spare
I can comment on this from a patient's POV - I had the same four permanent teeth pulled when I was about your child's age, and don't miss them at all. It sounds like a similar situation - B big teeth, small jaw. Having them pulled allowed the rest of my teeth to be moved around into proper alignment. I shudder to think of what my mouth would look like now if they hadn't been removed. There is seriously no room in there! So, I have 8 fewer teeth than some people out there (got my widsom teeth out too)but you can't tell. You can definitely get a second/third opinion, but your ortho probably has your son's best interests in mind. Good luck! toothy
Our son is also going through the retainer/braces thing right now. We haven't had to pull any teeth yet because he is younger than your son. But our orthodontist is very conservative about pulling teeth. I can give you his name if you'd like. That being said, I had permanent teeth pulled when I had braces and I don't regret it. It was necessary at the time to be able to have straight teeth. A proper bite alignment now will prevent a lot of pain for your son later. Ruth
I had the same 4 perm. teeth pulled when I was your child's age, as well as wisdom teeth as a young adult (for a total of 8 altogether), for the same reasons: I had a lot of teeth and a small mouth.

When the braces came off at age 14, I had a beautiful smile which I still have to this day (I'm now 39). I have no regrets about the ''missing'' teeth, and there has been no effect whatsoever on eating, talking, etc.

I am so glad my orthodontist suggested this, as I have seen other adults with a mouthful of crooked teeth, and they are invariably self-conscious about this (smiling with their mouth closed, for example). If either of my 2 children need to have teeth pulled as adolescents, I'd do it in a heartbeat.

Hope my perspective helps you. Christine


Please get a second opinion!!! My orthodontist did the same thing to me when I was about 12. It was a horrible experience, and I now have gaps between my teeth because my jaw did continue to grow as I did. Lisa
I had four permanent teeth pulled when I was about that age to get ready for braces. The reason given was that my mouth was too small for the amount of teeth, thus causing them to grow crooked. Also, I had two teeth missing so they had to make the bite even or something to that effect. I remember the teeth pulling as not being very pleasant. They also pulled six baby teeth that were taking forever to fall out. Given that, I wore braces for 2.5 years after that and 30 something years later, my teeth are still straight.

That said, I do think getting another opinion is important before you move forward. somewhat toothless


I had the same 4 teeth pulled at about the same age. If my daughter's orthodontist suggests this for my daughter, I will find another orthodontist. It would take 3 opinions from very current, up-on-the-latest-technology-orthos to get me to give in on pulling the teeth. The reason is that although my bite and teeth LOOK beautiful, my bite in not still correct and my jaw joints suffer from this. I really think that I should have had a few years of spacer-retainers before the braces. B My molers lean in and if they were pushed out my bite feel would better. Unfortunate if I have this fixed now, I would have holes where those permanent teeth used to be. I think you are right to be concerned but in the end, if he does get those teeth pulled, rest assured that my teeth do look great - over 20 years after the pull. Lisa
I had four permanent teeth pulled as a 14-year-old when I first got braces, and honestly, I could have done away with a couple more. As a 29-year-old adult, my teeth are crowded again and I am starting to get fangs! I also have an overbite. (I lost my retainers years ago.)

Really, it's no big deal. Unfortunately some people -- and it sounds like your child, too -- have crowding that can't be remedied any other way. Prior to having my permanent teeth pulled, I couldn't even fit dental floss in between the mollars! I had overlapping teeth that simply had no room to move. I felt so terrible about it that I wouldn't even smile.

While much better, I still have a crowded mouth of pearly whites. I wouldn't worry about your son's teeth looking funny -- you couldn't tell with me that I had teeth pulled -- or not being able to eat certain foods because of the gaps. Believe me, those quickly close. Elisa


hi, our son had a super duper overbite, big teeth and small palate/mouth. his ortho even shook his head when he looked at the exrays and his drawings (that show the alignment etc.)

my son had something like a 10 (in whatever increment they measure) and a regular overbite is a 2. but he didn't recommend pulling teeth and said that many adults face a ''flat'' profile or collapsed looking face when they got older after pulling molars so he didn't recommend it w/ my son. instead he used a spring type system that pushed his molars back and something to expand his palate (narrowed by thumb sucking) and it worked. he said if this failed, you could then go back and pull if you had to.

our son just completed his ortho and looks great, never got the teeth pulled. his ortho was dr. kevin carrington on broadway in oakland. i'm not saying your kid will have the same diagnosis, but worth a second opinion! good luck all straight now...


I have a small mouth, and not enough room for all 32 teeth. So my dentist recommended my parents to remove premolars when I was a child. I too have 4 premolars less, and I can eat just fine!

These are just teeth, and if that can prevent braces in the future, I think it is the best solution. My current dentist actually thought my childhood dentist did a great job: I never needed braces. Relax: it's only teeth!


I had 4 permanent teeth pulled when I was about 12 or 13, related to braces. It wasn't a big deal (didn't scar me nearly as much as wearing braces for several years -- I still cringe with horror and dull ache when remembering the tightening of the braces, but I have no bad memories about the tooth extractions).

I'm very happy with the results -- my teeth look and feel great, there's plenty of space (I've never needed my wisdom teeth pulled or had any trouble with them), and my teeth are now extremely healthy and easy to care for (last year at age 37 I had my first cavity EVER). I'm sure that without the teeth being pulled, there wouldn't have been enough room for everything. I'd rather have premolars yanked at 13 than oral surgery at 25 to remove wisdom teeth. Larry


I am 37 and had my four permanent bicuspids removed when I was about your son's age before having braces. My teeth, like your son's, were too big for my smallish jaw. The overcrowding had made a couple of teeth come in high above the gum line and these had to be pulled down, over time, with the braces. I also later had my wisdom teeth removed. I've never missed the teeth - in fact there is no room for them so it's a blessing they were taken out and everything got straightened up.
Our orthodontist advised pulling 4 teeth when my son was 14. he was getting braces for the first time. I was appalled at the idea and didn't want to, so I asked him if there was any way to fix his teeth without pulling any teeth. He told me he could try a different strategy that didn't involved pulling teeth. So, my son wore braces and then a retainer for what seemed like the rest of his teen years but no teeth were pulled. Anyway, he is now in his twenties, and his teeth are not crooked, but they definitely bow out. He is very toothy looking. He is a handsome guy with a big smile, and this is probably something that only his mother would notice, but I think in retrospect the dentist was right - we should have pulled the teeth! I recommend you get a second opinion and then put your trust in the dentist's expertise. Live and Learn

Extraction of 8-y-o's baby teeth

Feb 2005

My 8 year old needs two baby teeth extracted. I welcome advice about what has helped your children through this procedure and experience, as well as information about who should perform the procedure - dentists vs. oral surgeons. Thank you. Nancy


my two year old had to have a front tooth extracted (by oral surgeon) after falling and chipping it at a park and then after about 7 months the tooth abscessed. i was very concerned about the procedure, especially the fact that they wanted to put him under. i went in to talk to the oral surgeon the morning of the extraction about not having my son put under and we were able to avoid that by talking to my son about what is going to happen. they give the series of shots (two or three i think) of the local right around the tooth (also, laughing gas is an option in addition) and then they just pull the tooth. the actual extraction took seconds. my son was fine. he was a little whimpery when he got up out of the chair, but we went straight to the grocery store w! here he had fun picking out yogurt, pudding, and even a little ice cream. stayed home the rest of the day and he was back at school the next day. hope this helps! feel free to email me with any other questions you may have. kate
My 10 year old recently had two baby teeth extracted for her on- going orthodontia. Her regular pediatric dental office did the extractions. They used the topical local anesthetic as well as the injectable--and they also used nitrous oxide. My daughter tolerated the procedures very well, despite the fears that she had prior to the procedure. She was even able to attend her after-school program directly after the extractions. I did give her some ibuprofen an hour before the extractions and she took one more dose that night at bedtime. Baby teeth c! an be easily extracted by a pediatric dentist. Rita
My 9 year old had 2 baby teeth pulled, in 2 sessions. It was traumatic (but she is very sensitive to and scared of pain). Her dentist, who is very patient and gentle said next time we'd use an oral surgeon so my daughter could better maintain her relationship with the dentist (eg not associate pain/trauma with her). I think if she had nitrous oxide to relax prior to the extraction, it would have all been fine either way. anon
My daughter had to have several baby teeth extracted. The first time we were a little nervous about it, but it went so well that we didn't worry about it too much the next couple of times. The first time we did it, she was about 8. Our dentist recommended that we go to the oral surgeon and we ! did. The main thing was, the oral surgeon was kid-friendly. He had young children himself and was relaxed and friendly-- definitely non-threatening. I did not want my daughter to have laughing gas or other drugs besides the injection they used to numb the teeth. He was fine with this, and the whole thing went well. She definitely did not need more pain medication or sedation. The procedure itself was very quick--those teeth popped right out! I had talked it over with my daughter ahead of time, explained what they were going to do and that it would hurt, but I didn't think it would hurt too much, and that it would be over quickly. All of this was true! I stayed in the room with her. The oral surgeon didn't want me to hold her hand, but he let me sit where she could see me out of the corner of her eye. Afterward, we talked about it and she confirmed my observation that it really was not a very scary or painful procedure. Paula
I don't know if this will help much, but I had several baby teeth extracted as an 8 yr old, and that would have been several decades ago, and my parents didn't take notice of it at all (didn't worry about how I'd feel), and I have no negative recollection of it at all. The one thing that probably did help was that I got to save the teeth, and I still got to put them under the pillow for the tooth fairy (maybe the tooth fairy could be more generous in this case??). Probably also helps to explain why it's necessary and how special the kid is to go through this, etc. jan
We have nine year old twins and tried both ways. Our daughter had four teeth extracted by an oral surgeon, on the recommendation of the orthodontist. It was a bit traumatic for her, she had to get an IV and she felt pretty groggy coming out of the anesthesia. Her twin brother had four teeth extracted by the pediatric dentist. A few shots, a twist with the pliers and we were home waiting for the tooth fairy in less than half an hour.

In retrospect, I wish we'd asked the orthodontist more about why he thought we needed the oral surgeon. I suspect it was a case of ''That's what we always do.'' Unless your child will really need to be sedated, I'd go with the regular dentist. It was faster, easier, and many, many hundreds of dollars cheaper. Cheers, Brian


Baby teeth extraction for 6-year-old?

Jan 2003

Our pediatric dentist referred our six year old twins to a pediatric orthodontist, who now wants to extract a number of baby teeth in both children in the hopes of making the permanent teeth grow in straighter. This might be done under local anesthetic, but might require a general. (These are not, by the way, baby teeth that are in any way ready to fall out.)

The orthodonist made clear that while this might help, my daughter would almost surely need orthodontia later, and my son might as well.

I'm not at all convinced that the benefits (perhaps making orthodontia easier later on) outweighs the costs (pain, enough discomfort to create a possible fear of dentists, and the risk, however minor, of general anesthesia if we have to go that route.)

I'd be grateful if other parents who have confronted this issue would share their thinking about it with me. Worried Mom


We have had a similar situation with our 9 year old son. When he was seven, his dental x-rays showed permanent teeth jumbled up behind his baby teeth. Then when the permanent teeth started to push through, the baby teeth did not come out and began to force the permanent teeth to come in very crooked. He had two of his four top incisors pulled to allow the permanent teeth to drop down straight (which they did). Then he had a couple other baby teeth pulled when they were in the way of more teeth. Those permanent teeth also came in straight.

This sounds like a lot for a pain adverse child, which our son is. However, the oral surgeon we used, Dr. Brian Krey, was great. He explained everything to our son in a consultation appointment. During the extractions, he and his assistant made sure our son was as comfortable and calm as possible (even holding his hand during the hardest part.) It was such a good experience (especially the ice cream and video afterward), that our son actually looks forward to his next extractions (scheduled for March). Toothless in Berkeley


Tooth extraction seems a major event. If the X-rays show teeth coming in crooked behind the baby teeth, two things come to mind that may be helpful. 1) Ensure your children have the most nutrient-dense diet (avoid refined foods and sugars) as this is compatible with the research of Dr. Weston A. Price, DDS, who studies the effects of diet on dental arches and general health (see his book NUTRITION AND PHYSICAL DEGENERATION or the more readable TRADITIONAL FOODS ARE YOUR BEST MEDICINE by Ron Schmid). Foods that help are vitamin A-rich foods (liver, egg yolks, raw dairy). 2) Seek out a Jin Shin Jyutsu practitioner who works with children. This touch therapy has been known to correct errors that occurred in the womb. Two very skilled people I know are Pam Reynolds (in Berkeley on Spaulding) and Leah Statman (in Albany on Cornell, 525-5080). Children in Japan are taught JSJ (from where it came to the US) and licensed practitioners there work in the hospitals along side medical staff. It is being used now in cancer clinics in the Bay Area to mitigate the adverse effects of allopathic cancer treatments (nausea, diarrhea, hair and energy loss, etc.), it's that powerful! Good luck! Nori Hudson
We have gone through a tremendous amount of cappings and extractions all under the age of 6 for my child. From our experience it was enormously radical and tramatising to go through general anesthesia TWICE. Our childs teeth look fine now with orthadontia to come after all the adult molars come in. Even under ''general'' anesthesia my child was awake and struggling. It was horrendous and I am the kind who stayed in the room holding and encouraging and making sure the team respected all perameters for my childs comfort and not just their need to move on with the procedure. And these were the best and ostensibly kindest of the available dental practioners. Knowing what I know now I would have waited. All in all my child will still need 2 years of braces and years of retainers. Good luck in your descision. Remember to floss!
Yikes! I've written in before on a related post about anticipatory tooth extraction because of my own fairly nightmarish history of orthodontia, so I won't give all the details, but suffice to say I had very aggressive, very early orthodontic ''care'' that began with the extraction of recalcitrant baby teeth when I was about nine (complete with holes drilled into the hard palate to ''bring down'' the adult teeth). Twenty-five years, twelve of those in braces, one massive jaw-surgery and about forty titanium screws in my jaw later, I can't say that my teeth are even that straight. I am really an advocate of getting second and third opinions in all matters orthodontic, and also of taking the low-intervention path. My parents and I long ago agreed that we were too taken in by the ''experts'' and that we didn't ask enough questions, especially about the Platonic ideal of the bite that my orthodontist imagined for me. It didn't work for my mouth or my teeth, and I urge you to think hard about subjecting your kids to major surgery (anytime you're given a general anaesthetic it's major) unless it's absolutely necessary. If you've ever had a tooth pulled, you'll recall that it hurts a lot, afterwards. Alexa
While I am not a parent who has confronted this, my father is a retired dentist (30 years active), and I have adult friends who had baby teeth extracted for these puposes. If you asked my father, he would not recommend such action. The adult teeth may be late in arrival, and no one can accurately predict how they will grow in. Yes, there may be problems later, but he would suggest dealing with them when they arise rather than anticipating them with such drastic measures. I also have two adult friends who had baby teeth extracted. One's adult teeth didn't come in for years aferwards, so she had numerous problems: both social and physical. Another one's adult teeth still came in with problems, so she had to wear braces anyway. She remembers the extractions as traumatic and wishes her parents had not made that choice. Amy
RE Baby teeth extraction for 6 year olds...Before embarking on such a journey think about a plan. Dr. Broderson is a unique and skilled DDS on Gilman in Berkeley who does a kind of orthodontia that doesn't start with extractions. Unfortunately he is retiring and not taking on new clients but has a very capable associate who I am sure can help. Too many orthodontists depend on extractions and headgear which can lead to serious long term cranial problems. anon
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