In most instances, a pediatric dentist has the capability of saving a troubled tooth; however, there are several reasons why a tooth extraction may be necessary on those under the age of 18.

tooth extractions

What is a Tooth Extraction?

A tooth extraction is the professional removal of a tooth from the socket it rests in within the bone that supports it. According to estimates given by professionals, approximately 20 million teeth are professionally extracted in the United States each year.

Most occur in conjunction with an orthodontic procedure. Many are performed due to the development and/or presence of tooth decay.

Here are the top reasons why a tooth extraction may be deemed necessary in children that are under the age of 18.

Reason #1: Trauma and/or Injury

The top reason for tooth extractions among children and teenagers is trauma and/or injury. When a tooth becomes damaged, a pediatric dentist will make every effort possible to save the tooth. They often use crowns or fillings for this purpose. Crowns are used to cover teeth from the gum line in order to protect a compromised tooth structure. Fillings aid in repairing teeth that have become damaged – typically by decay. If the trauma and/or injury has resulted in damage that is considered to be beyond repair by the pediatric dentistry team, an extraction will be performed.

Reason #2: Teeth Are Crowded

The second reason why a tooth extraction may be needed on a person under the age of 18 is because the teeth are crowded and it would aid in ensuring the alignment of the other teeth that are present within the mouth. If braces or other types of treatments are necessary, the target tooth may get in the way of the process. Then, there are instances where there is not enough room in the mouth for a tooth that is attempting to come through due to overcrowded teeth. An extraction will be necessary in this instance, too.

Reason #3: Tooth Decay

The next reason why one under the age of 18 may need a tooth extraction is tooth decay. In some instances, the decay may spread to the center of a tooth. This area contains blood vessels and nerves. If this occurs, bacteria may enter into the pulp of the tooth. This, in turn, could result in the onset of infection. Most pediatric dentists will opt for a treatment plan that combines antibiotics and root canal therapy; however, if this treatment plan does not work or if the dentist deems the decay “severe”, chances are, a tooth extraction will need to be scheduled and performed. This is done to prevent the spread of the decay and to eliminate the possibility of any present infection from entering into other areas of the body.

Reason #4: The Presence of Gum Disease

According to information derived through research, the number one cause for tooth loss is gum disease. This is also referred to as “periodontal disease”. While adults most often suffer from this condition, it is becoming increasingly prevalent among teenagers in the United States. When this occurs, the gum actually moves away from the teeth. This then results in the formation of pockets that attracts bacteria and other harmful debris. When these substances gather within these pockets, infection may develop. If this happens, the connective tissue and the bone that help in holding the teeth in their place breaks down due to the toxicity. This then reduces the immune response of the body. If a tooth extraction is not performed, the teeth, the connective tissue, the gums, and the supporting bone may all be detrimentally impacted and even completely destroyed. Furthermore, the bacterial infection may spread to other regions of the body.

Reason #5: Immune System Problems

The next reason why tooth extractions may be performed on a person under the age of 18 is if their immune system has problems. Many children suffer from cancer, auto-immune conditions, have had transplants of their organs, or are on chemotherapy. All of these children have compromised immune systems. If it is determined that a tooth may result in infection within the body of children who have immune system problems, a pediatric dentist will professionally extract that tooth. This is because a troublesome tooth that poses a risk for infection to the body could result in severe medical complications with a kid with immune system issues.

Types of Tooth Extractions

In general, there are two types of extractions; these are a simple extraction and a surgical extraction. In a simple extraction, a pediatric dentist will use a tool to loosen the troubled tooth from its socket. The professional will then use the forceps tool to remove it. Children are provided with only a local anesthetic for the procedure. A surgical extraction will require anesthesia. This is done when the tooth is situated below the gum line. An incision is made in the gum. In some instances, bone may be removed or the top-half of a tooth may be removed. While it is possible for your dentist to opt for a surgical extraction, most prefer to perform a simple extraction when such is necessary for those that are under the age of 18.


If your child requires a tooth extraction – be it simple or surgical – there is no need to fear. It is being done to protect their other teeth, the supporting structures in their face, as well as their general health. Yes, there may be some discomfort immediately following the procedure, but, it is considered to be mild. If the pediatric dentist sees fit, he may prescribe pain pills or encourage the use of over-the-counter pain products. You may place a cool pack on the face – near the extraction site – in order to alleviate swelling. Healing takes approximately two weeks. Remember, though, tooth extractions are a last resort.

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