YouTube is full of how-to videos that use “creative” techniques to remove stubborn baby teeth, but these techniques are rarely safe. If your child is frustrated by a loose baby tooth, don’t imitate the bad ideas you see online. If you do, you might make your life a lot harder than it needs to be.
So What’s the Deal With Stubborn Baby Teeth?
Whether you call them baby teeth, milk teeth, primary teeth, or deciduous teeth, those initial non-permanent teeth are a fact of life for humans. They serve as developmental placeholders for later permanent teeth, and they play an important role in how facial structures develop. But they don’t always stick to tight timelines.
The average child will have their full set of primary teeth by the time they turn three, and those primary teeth gradually fall out (and permanent teeth come in) between the ages of six and twelve. This long and gradual timeline makes it easy for parents to lose track of what teeth their children “should have” if they aren’t writing down when the teeth are appearing and falling out (something they shouldn’t necessarily need to).
Combine that lack of a timeline with the natural fears and frustrations of being a parent, and it’s easy to see why so many parents end up giving stubborn loose teeth a bit of assistance on their way out.
What’s important to understand here, though, is that stubborn primary teeth aren’t “stuck.” It’s easy to imagine a process where the larger permanent tooth is somehow pushing the baby tooth out, and that the stubborn baby tooth is “in the way.” But that isn’t what’s really going on.
The Tooth Loss Process
We don’t know the exact process that causes teeth to come in, but we do know that it isn’t through simple linear force. Where, when, and how teeth come in is primarily influenced by the structure of the jaw and mouth. Primary teeth can influence the paths that permanent teeth take as they come in, but they are not main influencing factor in whether or not an individual will develop impacted or maloccluded teeth.
When a permanent tooth is ready to emerge, the body begins dissolving the roots of the corresponding baby tooth. As the tooth loosens in the gums, it still retains a fairly deep anchor with those (slowly dissolving) roots, leading to wiggly teeth that nonetheless remain stubbornly attached.
That last connection inside the gums might seem unnaturally tenacious in some cases, but that tenacity ensures that the tooth won’t rip out and create an opportunity for infection. Instead, the relatively constant low-level stimulation caused by the natural mechanics of the mouth and the natural curiosity of young children tends to do the job, eventually working the tooth free without causing excessive pain or inflammation.
Stubborn baby teeth are either a non-issue fixed through patience or a complex issue that Dr. Halsema should handle. You can skip the part with the floss and the bowling ball.
Why You Shouldn’t Pull Stubborn Baby Teeth
Since baby teeth fall out after their roots dissolve and the surrounding gum tissue is effectively “ready for it,” yanking them out can create some clear issues. A tooth that is pulled too early leaves the gums vulnerable — vulnerable deep inside the gum line, where it’s hard to clean and easy for infections to set in.
If an infection develops inside the gum line, the result is usually the formation of a pocket. This pocket in the gum line isn’t just problematic in worse-case scenarios where the infection spreads or migrates; by reducing the amount of gum tissue in a region of the mouth meant to support teeth, the pocket can influence the positioning, stability, and health of the subsequent permanent teeth that come in. Trying to prevent an impacted or crooked tooth by pulling a primary tooth early can actually make things worse.
What To Do When The Tooth Is A Problem
Of course, there’s always an exception to the usual rules. In this case, the exception arises when you need to pre-empt your child’s own removal attempt or otherwise manage the situation in light of exacerbating circumstances. You don’t need to worry too much about the tooth being swallowed, but the last thing you want to deal with is an eight year old who tried to tie his own teeth to a door knob. Anything beyond that (permanent teeth coming in behind baby teeth, notably late tooth loss or emergence, excessive inflammation, etc) is “talk to your dentist” territory.
For teeth that meet the conditions for the exception that are loose enough to be removed with gentle force though, you can gently pull on them. If you have to yank on them, or if you’re looking for a tool that will give you some extra leverage, the tooth isn’t ready.
Using an oral analgesic beforehand and an age-appropriate NSAID afterwards can be helpful. A water pick and an approved oral rinse will help you manage any infection risks, as will reinforcing proper brushing and flossing procedures after removing the tooth.
The vast majority of baby teeth work their way out without help. It takes patience, and some extra work to reinforce good habits, but the effort pays off in the long run. Removing a tooth too early and/or with too much force can be easier for the parent, but it can create later problems for the child. It’s better to talk to Dr. Halsema about your worries than it is to try anything on your own, especially for teeth that seem unnaturally stubborn.