4 Year Old Needs Tooth Extracted:(

Updated on September 14, 2012
L.T. asks from Elkton, MD
13 answers

My 4 ( almost 5) year old son fell and chipped his front top tooth when he was 2. At the time it happened the dentist did xrays and said he was going to leave it alone and keep an eye on it. He had regular check ups and there were no problems that the dentist saw. The tooth eventually turned gray and the dentist said that was normal, not to worry about it. I do believe though that the dentist mentioned a small bump on my son's gum a year or so ago though and said they would keep an eye on it. It's hard to remember for sure though since they didn't think it was anything serious and never seemed concerned before.

My son has never complained about his tooth hurting or any discomfort in his mouth, but last week at his teeth cleaning the dentist ( a new dr, same office) noticed a very small bump on his gum above the tooth he chipped and said it was an abcess. She said he would need to come back in 2 weeks and have his tooth removed!

I was told by an employee at the dentist that they would give my son some "laughing gas" and a shot of novicane, and then just wiggle the tooth out. I am a nervous wreck thinking about my son having to go through this. I would even rather them not give him the laughing gas and just give him the numbing shot but I know he won't sit still when he sees the dentist with a needle. Also, I am questioning if it really needs to be pulled if he hasn't had any problems with it! Plus he will be losing the tooth pretty soon anyway. It is already a little loose.

Any moms out there with any similar experiences, please give me some input! Has your child had laughing gas? Had a tooth pulled?I am so stressed out about this! I would really just like to leave the tooth alone and keep watching it as we have been. I don't even know how long the bump has been on his gums because even though I brush his teeth for him I never noticed it...I guess because I don't lift up his lip to brush his teeth, but if it has been there for 6 months and hasn't caused any problems then what is the rush to pull it?

I am planning to call the insurance co, tomorrow to see if a second opinion would be covered, but it is medicaid, so I am thinking probably not...?

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So What Happened?

Thanks for all the input. I am a little relieved to know that this procedure is pretty easy and quick. I spoke to the dentist and she said there was nothing in my son's records that indicated any infection at his last visit. She reassured me that the tooth does need to be pulled. She also said even if they gave him an antibiotic the infection would eventually come back because the tooth is still there and that is whats causing the infection. So his tooth extraction was scheduled for tomorrow but the day after I spoke to the dentist my son woke up complaining that the infected tooth was hurting. He never complained before. I looked at it and I could definitely see the infection now. It was more swollen for sure. I didnt need a second opinion afterall. I got him into the dentist thinking they would have to pull it right then, but instead the dentist said he needed antibiotics to get the swelling down before they could pull it. Apparently it is hard to numb. I am not sure why they did not prescribe the antibiotic before though. Anyway, the dentist said to bring him back in a few days for his scheduled extraction, that the infection should be down enough, but I rescheduled for the following week. Well he has been taking amoxicillin for 2 days (2 times a day), 5 doses all together and am not seeing the swelling go down. If anything I think it actually looks more swollen and I can see white spots under the bump. I thought the swelling would have started to go down by today but maybe I am wrong. Will be calling the dentist in the morning. Atleast my little guy doesnt have any pain.

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C.W.

answers from Washington DC on

I don't know if he needs the tooth out--you could ask another dentist that. My daughter had laughing gas last year when she had her cavity filled. No novacaine as she hates needles. It went so much better than expected with the laughing gas. She was back in school 20 minutes after they finished. Teeth can be loose for a long time before they come out. Both my nephew and a friend's child had a problem with the tooth getting loose after a fall. The friend's child had his be loose for a year before it finally came out. My nephew's tooth still hasn't come out over a year later. My daughter's front tooth was loose for months before it finally came out. So a little loose is no guarentee that it will fall out soon.

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D.B.

answers from Minneapolis on

My daughter had all 8 of her front teeth pulled before she was 7 because her adult teeth came in & the roots of the baby teeth never disolved. Laughing gas for all of them. My son had pretty much the same thing.

That said, I would question whether the tooth needs to be extracted. If the bump has been there for 6 months without causing any discomfort, it is not an abcess. Were it an abcess, he'd be in considerable pain. The new dentist is just being extra-precautionary. Tell them you want to postpone 1 month, and if it's not causing any problems by then, it probably can wait until it falls out on its own. Remind them the bump has been there for almost a year now. (do they know that?) The baby tooth most likely will fall out in 1 year if your son is almost 5 now. Pulling teeth out early can really mess with the teeth that oppose the area and cause them to shift unnaturally.

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G.B.

answers from Oklahoma City on

Good grief. It's just a little laughing gas. Ours put the kids to sleep to do ANY work. It's so much easier on them.

Let the doc do his thing but I would not go to a doc that didn't put them out to do stuff like this. That's just my choice. He'll be fine!

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L.A.

answers from Austin on

I promise this will be harder for you than your child.. Our daughter had an impacted tooth, but since it was a baby tooth, there were no roots, so it was not a big deal..

Just be strong for your son.. You do not want that abscess to stay in there.. the infection could get bad..

Have your husband go if you cannot deal with it..

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M.B.

answers from Austin on

My son, when he was about that age, ended up with a bad cavity and needed basically a root canal.... he had the laughing gas, and darn near fell asleep in the chair, he was so relaxed!

Everything went just fine..... it is very easy, and not a stressful thing at all... they breathe the nitrous oxide through a small mask over their nose, and it relaxes them. Some dentists also give them a cassette player (16 years ago, anyway), or probably an mp3 player with earphones for them to listen to to help drown out the sound of any drilling, as they would with the root canal.....

Even though the tooth is loose and he would be losing it soon anyway, I would get it extracted.... the dentist can then see how much infection is in there, and prescribe appropriate antibiotics, too.

Go for the laughing gas... it will make the procedure much easier, and much less stressful for your son.

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E.V.

answers from Phoenix on

Abcess is not good. You have two weeks actually, when you are done with the antibiotics for Abcess, try to wiggle the tooth everyday when he is asleep. My mom did this to me when i was a kid. It wasn't hurt because i was still asleep, and didn't remember.
It is not about the tooth I am concerned, but the abcess, because it may spread.
My son just had two molars pulled 6 months ago, he was given oral anaesthesia and laughing gas and he was okay. It actually depends on the kid. Can you ask if they just give him anaesthesia based on his reaction. If he can deal with oral, maybe the can give him just numbing shots. If it is front teeth and loose already, it will be very quick.
Anyway, ]'d say, try to pull it yourself after medication done and bump is gone.

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J.K.

answers from Wausau on

My son has needed a couple of teeth removed - baby teeth would just not let go. The whole thing was over in less than 10 minutes. The gas helps a lot if your child is anxious at all. Heck, it sounds like they should give you a hit first. ;-)

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M.P.

answers from Portland on

My grandson has had teeth pulled and they used nitrous oxide. The gas just makes them relaxed making it much easier to pull the tooth. My grandson is quite hyper. They wouldn't have been able to pull the tooth without the gas. He didn't seem to remember anything about the procedure. I recommend that you go with the gas.

As to an abscess it's it's important to clear that up. I wonder why they don't try an antibiotic first. You could ask them to look back in his chart to see if he has had it for 6 months.

Perhaps they want to pull it because it's less harmful to his body than an antibiotic. As you say he'll be losing that tooth anyway.

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S.G.

answers from Grand Forks on

Both my boys have had multiple teeth pulled because of crowding. They just had the shot, no gas. It was no problem without the gas, but I'm sure it would be even better with the gas! I had the gas when I delivered both babies, and I loved it!

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D..

answers from Charlotte on

Do you have trouble finding a good ped dentist with medicaid? If you don't, maybe it's not a bad idea to get a second opinion.

Did you see a series of xrays? What does it show on the xray? Can they see the absess? Is the adult tooth close to coming down?

Laughing gas makes things easier. One of my kids got so stressed out during dental procedures that without it, he would have been a wreck. As it was, he cried throughout his procedures, but at least he could manage. My other one? Slept through his front two teeth being removed - LOL! (I cannot imagine!) So I am a firm believer in laughing gas and children. I have paid for it out of my pocket when insurance didn't cover it.

I don't know about this bump, but I would really want to see the xray and someone SHOW me an abcess. I'd also want an explanation as to why it can't wait for the adult tooth to come down.

Just to make sure you understand, I'm not dissing your dentist. I'd just want a better explanation so that you feel comfortable in your decision.

good luck!
Dawn

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C.B.

answers from San Francisco on

I would ask the dentist for a prescription of antibiotics to get rid of any infection - that's what's causing the bump and leave the tooth alone. Like you said, it's already lose so he'll be losing it in a month or so anyway. No need to incur any costs/expenses other than for an antibiotic. It's kind of funny, because usually they don't pull teeth until the patient has had antibiotics to get rid of infection BEFORE they pull a tooth.

If you're unsure, get a second opinion before you let them pull this tooth. Having teeth pulled is traumatic, at least for me. I've only got about 10 teeth left, so I've had A LOT pulled. Even the thought of it makes me shake! Don't do that to your son unless you really have to. btw, it's not the actually pulling of the tooth that I hate so much - it's the shot and then the first 1 - 3 days after the extraction that bothers me the most.

J.E.

answers from Erie on

My dd had a tooth pulled right after she turned 5. She has 2 teeth that have some sort of enamel defect, so the tooth that got pulled was bad. It was abscessed and caused her a lot of pain and discomfort. She was freaked by the thought of having it pulled, but I knew it would be better for her in the long run. So, she toughed it out. They didn't give her laughing gas though...just gave her a shot or two in the gums and then pulled it out. Did it hurt her? Yeah...but only for a few mins. She obviously doesn't want another tooth pulled, but the experience hasn't ruined her opinion of the dentist. She still likes to go.

I say, do what your dentist thinks would be best for your son. They usually don't recommend a tooth extraction unless the kid really does need one. If you let the tooth go, it might just get worse and worse...then it will be a lot more pain for him to deal with.

Good luck!

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J.J.

answers from Allentown on

Well just because the tooth is loose does not mean it will fall out on it's own. My daughter had a loose front tooth that died and was eventually capped, and it was loose for two years. turned gray and everything. Was capped after chipping it a second time. Took her to an orthodontist at age 5 and he recommended removing both front teeth. She is 7 now and her top teeth are finally beginning to come down. But have not broken through yet. She was fine without them better actually no more accidents chipping the teeth. As for the actual removal they both came out easily despite one was not even loose. They gave the laughing gas helped a lot and then the Novocaine was next. the Novocaine shot was the worst, once she got over that she didn't even notice them removing the teeth. She had to bite on gauze til the bleeding stopped which wasn't too long, and then she was fine. This is a kid with major sensory issues and a very low pain tolerance, she thinks she broke an arm when she bumps it on something, and she did fine. It isn't as bad as it sounds. We had it done at age 5 and even tho the tooth was loose the orthodontist said it wouldn't fall out until around age 7/8. The lower teeth start falling out at age 6/7 and uppers around 7/8. So you have at least two to three years before it falls out on its own and he basically said the risk of infection isn't worth it to keep it in as it is almost guaranteed it will get infected. Orthodontist also assured us it would not change her mouth in any way or cause any problems. So we decided to go ahead with it and i was a nervous wreck, but in the end I am so glad we did it. They didn't have to remove the other front tooth, but the orthodontist said she had chipped that one slightly as well and might as well take both rather than have to go through it again should that tooth get more damaged. since your child only has a problem with one tho, you would only need the one removed. I say go for it. Have it removed it isn't worth the risk of infection and the procedure really isn't that bad. Worse for you than him probably. Let them give the laughing gas to relax him, as the shot will be the worst part. He won't even notice them taking the teeth out once the Novocaine takes effect.

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