Tooth exfoliation is a natural process in a growing child’s mouth where permanent tooth comes in under the primary (baby) tooth and gradually push the tooth out. Our teeth are anchored into our jaw bones by their roots. Front teeth usually have only one root while back molar teeth have two or three roots. As the permanent tooth pushes from underneath, the roots of the baby tooth gradually resorbs (becomes shorter and thinner) until they eventually dissolve completely. When there is no more root for the tooth to hang on, the tooth loses anchorage and becomes mobile and wiggly. Exfoliation then occurs after a combination of the child’s actions including brushing, chewing, and moving the tooth around with either his fingers or his tongue.
Tooth on the left has full roots, tooth on the left have roots that have already been resorbed.
I always encourage my patients to wiggle out their own loose baby teeth. This should only be done after hands are washed with soap and water to minimize bacteria exposure. For most children, wiggling their tooth out is fun and definitely preferred over going to the dentist to get it pulled. I usually instruct kids to hold on to their tooth with two fingers and wiggle it side to side, front and back, then twist it a little bit too. They can do this when they’re watching TV or chatting on the computer. Once a tooth becomes loose, it usually takes 2 to 3 weeks for the child to get it out.
Of course, there are times when we dentists do need to step in to help out with stubborn baby teeth that just want to stay in the mouth forever. Here are a few scenarios when going to the dentist for extraction becomes essential:
1. The loose tooth is hurting your child which makes eating and brushing difficult. (Your child might become anxious and unable to concentrate in school)
2. The gum tissue around the tooth is red, swollen, or inflamed due to plaque build-up. (Prolonged inflammation of gum tissue can lead to other gum problems)
3. You can already see the permanent tooth coming in from underneath yet the baby tooth doesn’t look like it’s super loose yet. (The permanent tooth can become crooked and misaligned if the baby tooth is blocking its path)
4. The baby tooth used to be loose but now it’s firm again. (Excess gum tissue grew into the baby tooth and grabs onto it. The tooth may also look a little pink instead of white)
Permanent tooth coming in below baby tooth
Permanent teeth coming in behind baby teeth