A baby tooth that does not fall out when expected does not necessarily need to be extracted. In children, there are normal variations in the pace at which teeth are replaced.
However, a dental visit is recommended if the permanent tooth has begun to emerge but the baby tooth remains firmly in place, if there is pain, or if the baby tooth persists well beyond the time it should have been replaced.
At what age do baby teeth start to fall out?
In general, the process of losing baby teeth begins around school age, though the exact age varies from child to child.
As a rule, the incisors are the first to fall out, after which the process gradually continues with the other teeth.
More important than an exact age is how a child's teeth develop.
Two children of the same age may be at different stages of tooth replacement, and both may still be within the normal range.
Why won't a baby tooth fall out?
There may be several explanations.
The permanent tooth may not be close enough to erupt yet.
In other cases, the root of the baby tooth has not resorbed sufficiently.
Sometimes there are also situations in which:
- the permanent tooth erupts in a different position;
- there isn't enough space;
- there is an obstacle in the way of the eruption;
- the baby tooth is more firmly anchored than one might expect;
- The development of the permanent tooth is delayed.
- The permanent tooth has not formed at all
For this reason, simply comparing a child to other children of the same age is not enough.
How can you tell if a tooth is ready to fall out?
A baby tooth that is about to fall out becomes increasingly loose.
The child can feel it when he or she touches it with his or her tongue or when he or she eats.
If the tooth is barely loose or not loose at all, it is not recommended that you try to pull it out by force.
When might an extraction be necessary?
The dentist may recommend extraction, especially when a baby tooth is preventing a permanent tooth from erupting normally or when keeping it no longer provides any benefit.
A common example is when a permanent tooth erupts behind a baby tooth.
Other reasons may include:
- extensive tooth decay;
- infection;
- pain;
- fracture;
- abnormal mobility;
- problems that affect the development of permanent teeth.
Before the extraction, the doctor examines the child and determines whether the procedure is truly necessary.
Does it hurt to have a baby tooth pulled?
The procedure can be performed using pain management methods tailored to the situation.
For a very loose tooth, topical anesthesia may be sufficient, while for a more firmly anchored tooth, local anesthesia may be indicated.
At SmileCity, we offer both options for the extraction of baby teeth.
Another important factor for children is how the procedure is presented. A calm experience can influence how the child will view future visits to the dentist.
What happens after the extraction?
After the extraction, there may be slight local bleeding for a short time.
The doctor provides parents with instructions tailored to the procedure and the child.
In general, the area should be allowed to heal without the little one constantly touching it with their fingers or tongue.
If you experience severe pain, uncontrollable bleeding, or significant swelling, contact your doctor.
Will the permanent tooth come in normally after extraction?
In many cases, removing the obstruction caused by the baby tooth allows the permanent tooth to continue erupting.
However, the final position also depends on the available space in the dental arch and on how the teeth develop.
That is why the doctor may recommend monitoring the child over time.
When should we schedule an appointment?
It is helpful to see a doctor if:
- The permanent tooth has come in, but the baby tooth hasn't fallen out;
- the baby tooth doesn't wiggle at all;
- two rows of teeth appear;
- there is pain;
- the tooth is severely decayed;
- the gums are inflamed;
- there is pus or a swelling;
- The parent notices an unusual rash.
At SmileCity, children can receive consultations and orientation sessions, as well as treatments for their baby teeth and permanent teeth that are coming in.
The clinic is located at 158 Ghencea Boulevard, Sector 6, Bucharest.
How long is it reasonable to wait?
There is no universal number of days or weeks after which any baby tooth must be extracted. The pace at which teeth are replaced varies greatly among children and even among the teeth of the same child. What is more important is whether the baby tooth becomes progressively loose and whether the permanent tooth is on a favorable path to eruption. If two rows of teeth appear, there is obvious asymmetry between the left and right sides, or there is a lack of any progress, a consultation provides a more reliable answer than comparing the child to other children of the same age.
Why is an X-ray sometimes necessary?
An X-ray is not routinely necessary for every tooth that is slow to fall out. It may be useful when the dentist needs to assess the position of the permanent tooth, confirm its presence, evaluate the root’s development, or identify a possible obstruction preventing eruption. The X-ray is recommended only if the information obtained could change the diagnosis or treatment plan. For parents, the advantage is that the decision is not based solely on what is visible on the surface.
What happens if a baby tooth has a cavity but still doesn't fall out?
If a baby tooth is decayed, painful, or infected, the fact that „it’s going to fall out anyway” is not a good enough reason to ignore it. The dentist will consider how long it should remain in the mouth, whether it can be treated, and whether extraction would create a gap that needs to be managed. The right choice depends on the specific tooth and its stage of development, not just the child’s age.
Frequently Asked Questions
Should we pull out a loose baby tooth at home?
Most of the time, it's best to let it fall out on its own. Don't force a tooth that's still firmly attached.
What should I do if the permanent tooth has already come in?
Schedule an appointment if the baby tooth is still present, especially if it isn't loose. The dentist can determine whether extraction is necessary.
Can a baby tooth stay in too long?
Yes. There are situations in which a baby tooth persists longer than expected and needs to be evaluated.
Is an X-ray necessary?
Not in every case. The doctor decides after the consultation whether the information provided by an X-ray is necessary for the diagnosis.
How much does it cost to have a baby tooth extracted at SmileCity?
According to the current SmileCity price list, the cost of extracting a baby tooth is 150 lei with topical anesthesia and 200 lei with local anesthesia. Prices are subject to change and should be verified at the time of scheduling.