Extraction of primary teeth: when it is necessary and how to protect your child's dentition

Extraction of primary teeth is a common procedure in paediatric dentistry, indicated when the primary tooth cannot be preserved by restorative treatment or when its presence compromises the development of the permanent dentition.

The decision to extract is always carefully considered, and preservation of the tooth is favoured wherever possible.

At Clínica Dr. Paulo Cardozo in Benavente, primary tooth extractions are carried out using child-adapted techniques, under local anaesthesia, and with planning that includes assessment of the need for space maintenance to protect the alignment of the permanent teeth.

If your child has tooth pain, an infected primary tooth, or a tooth that has not shed at the expected time, book an assessment appointment.

The decision to extract is always carefully considered, and preservation of the tooth is favoured wherever possible.

At Clínica Dr. Paulo Cardozo in Benavente, primary tooth extractions are carried out using child-adapted techniques, under local anaesthesia, and with planning that includes assessment of the need for space maintenance to protect the alignment of the permanent teeth.

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Technology Supporting Primary Tooth Extraction

At Clínica Dr. Paulo Cardozo, planning for primary tooth extraction is supported by digital imaging examinations that allow assessment of the root condition, the position of the underlying permanent tooth, and the need for space maintenance.

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Diagnosis with Periapical Radiograph

The digital periapical radiograph allows detailed assessment of the primary tooth root condition, the presence of periapical infection, and the position of the underlying permanent tooth germ. This examination is essential for determining whether extraction is necessary and for planning the procedure safely.

Panoramic Assessment with Orthopantomogram

Panoramic Assessment with Orthopantomogram

The digital panoramic X-ray provides an overall view of the child's entire dental arch and allows assessment of the developmental stage of the permanent teeth, their position, and the degree of root resorption of the primary teeth. This examination is essential for planning extractions and determining whether space maintenance may be required.

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Caries Detection with Bitewing Radiographs

Bitewing radiographs are used to assess the extent of interproximal caries in primary teeth and to determine whether the tooth can be restored or whether extraction is the most appropriate option. They are an important complement to clinical decision-making.

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“Extracting a primary tooth is always a last resort. When it is necessary, we plan each case individually to ensure that the space and alignment of the permanent dentition are protected. The child's future oral health begins with responsible clinical decisions today.”

Dra. Daniela Cardozo

Dentist

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when it is necessary to extract a primary tooth

When is it necessary to extract a primary tooth and how is the procedure carried out?

Extraction of primary teeth is indicated in clinical situations where preservation of the primary tooth is no longer possible, or where its presence is detrimental to the development of the child's dentition.

The decision is made based on clinical assessment and imaging examinations, and is always discussed with the parents.

The most common indications for primary tooth extraction include:

  • extensive decay that does not allow restoration,
  • periapical infection that does not respond to endodontic treatment,
  • primary teeth that have not shed at the expected time and are preventing the eruption of the permanent tooth,
  • teeth with abnormal root resorption, and
  • impacted or supernumerary teeth.

The procedure is carried out under local anaesthesia, quickly and in a controlled manner.

In paediatric dentistry, behavioural management techniques are used to ensure the child feels safe and comfortable during the procedure.

After the extraction, the dentist assesses the need for a space maintainer — a device that preserves the space in the arch so that the permanent tooth erupts in the correct position.

The AAPD (American Academy of Pediatric Dentistry) recommends assessment of space maintenance whenever a primary tooth is lost prematurely.

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What our patients say

My son's primary tooth was infected and there was no other option. The extraction was quick, he felt no pain and the recovery was very good.

Fernando Cardoso

The dentist explained why extraction was necessary and fitted a space maintainer. We were reassured knowing the space for the permanent tooth was protected.

Marta Ramos

I was very worried about my son's reaction, but the team was exceptional. The extraction went well and he was back to playing on the same day.

Luís Dinis

4 Steps for Your Child's Deciduous Tooth Extraction

4 Steps to Your Child's Primary Tooth Extraction

Primary tooth extraction at Clínica Dr. Paulo Cardozo follows a structured protocol, from clinical assessment through to post-extraction monitoring, to protect the development of your child's dentition.

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Clinical Assessment and Imaging

The dentist carries out a clinical examination and requests imaging, such as a periapical radiograph or panoramic X-ray, to assess the condition of the primary tooth, the position of the underlying permanent tooth, and the complexity of the extraction. The diagnosis and treatment plan are presented to the parents.

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Preparation and anaesthesia

The child is prepared for the procedure using a behaviour management approach appropriate to their age. Local anaesthesia is administered to ensure the extraction is painless and comfortable. Parents are informed about what to expect during the procedure.

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Extraction of the primary tooth

The extraction is performed in a controlled manner using instruments adapted to the child's oral cavity. The dentist removes the tooth carefully to avoid any damage to the adjacent tissues and the underlying permanent tooth bud.

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Post-extraction care and space maintenance

After the extraction, parents receive guidance on aftercare for the following days: diet, oral hygiene and warning signs. When indicated, a space maintainer is placed to preserve the space in the arch and protect the alignment of the permanent dentition.

Everything you need to know about primary tooth extractions

Everything you need to know about primary tooth extractions

Primary teeth serve essential functions during childhood: they allow chewing, are important for speech, and above all, they maintain the space necessary for the correct eruption of the permanent teeth.

For this reason, extraction of a primary tooth is always considered a last resort, when conservative treatments are not viable.

The premature loss of a primary tooth, before the natural time of shedding, can have consequences for the development of the dentition.

Adjacent teeth may drift into the empty space, reducing the space available for the permanent tooth and compromising the alignment of the dental arch.

For this reason, when extraction is unavoidable, assessing the need for space maintenance is a fundamental step.

Space maintainers are devices that preserve the space in the arch after the premature loss of a primary tooth.

They may be fixed or removable, and are selected according to the location of the extracted tooth, the child's age, and the degree of development of the underlying permanent tooth.

At Clínica Dr. Paulo Cardozo, each case is assessed individually and clinical decisions are made together with the parents.

If your child has a primary tooth with pain, infection, or that is not falling out naturally, book an assessment appointment.

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Main Indications for Primary Tooth Extraction

Primary tooth extraction is indicated in specific clinical situations where preservation of the tooth is not possible or safe.

At Clínica Dr. Paulo Cardozo, each case is assessed individually. Find out about the most common indications.

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Extensive Caries with No Possibility of Restoration

Extensive Caries with No Possibility of Restoration

When decay destroys most of the primary tooth structure and restoration with a conventional filling or paediatric crown is no longer possible, extraction is the indicated option to eliminate the infection and relieve pain.

At Clínica Dr. Paulo Cardozo, the assessment includes a clinical examination and periapical X-ray to confirm the extent of the lesion and evaluate the condition of the underlying permanent tooth before extraction.

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Periapical Infection Resistant to Treatment

Periapical Infection Unresponsive to Treatment

When a primary tooth has an infection that does not respond to pulp treatment (pulpotomy or pulpectomy), or that compromises the development of the underlying permanent tooth, extraction is necessary to eliminate the source of infection.

At Clínica Dr. Paulo Cardozo, radiographic assessment is essential to monitor the response to treatment and determine the appropriate time for extraction, when this is the best option for the child's oral health.

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Retained Primary Tooth Preventing Eruption of the Permanent Tooth

Retained Primary Tooth Preventing Eruption of the Permanent Tooth

When a primary tooth has not shed naturally and is preventing the normal eruption of the underlying permanent tooth, its extraction allows the permanent tooth to erupt in the correct position.

At Clínica Dr. Paulo Cardozo, panoramic X-ray (OPG) is used to assess the position and degree of development of the permanent tooth and to plan the extraction safely.

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Early Loss and Need for Space Maintainer

Premature Loss and Need for Space Maintenance

When a primary tooth is extracted before its natural shedding time, it may be necessary to place a space maintainer to prevent the migration of adjacent teeth and protect the space for the permanent tooth.

At Clínica Dr. Paulo Cardozo, the need for space maintenance is assessed in each case and the most appropriate device is selected according to the child's clinical situation.

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At Clínica Dr. Paulo Cardozo in Benavente, primary tooth extractions are carried out using digital imaging diagnostics, child-adapted techniques, and planning that protects the development of the permanent dentition.

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Book your appointment

If your child has tooth pain, an infected primary tooth, or a tooth that is not falling out naturally, book an appointment at Clínica Dr. Paulo Cardozo and receive an appropriate diagnosis and treatment plan.

  • Clínica Dr. Paulo Cardozo

    R. Vasco da Gama 6,

    2130-197 Benavente, Portugal

  • Telephone: +351 263 516 773

    Mobile: +351 919 366 534

    geral@clinicapaulocardozo.pt

Frequently Asked QuestionsAbout Primary Tooth Extractions

Clinical Rigour and International Standards

The clinical team at Clínica Dr. Paulo Cardozo guides its paediatric dentistry practice in accordance with the guidelines of the leading oral health reference bodies, including the FDI World Dental Federation, the Ordem dos Médicos Dentistas (OMD), the World Health Organization — Oral Health, the American Academy of Pediatric Dentistry (AAPD), and the European Academy of Paediatric Dentistry (EAPD).

The continuous training and professional development of the clinical staff at Clínica Médica Dentária Dr. Paulo Cardozo, together with the integration of international recommendations into their practice, ensures that every procedure is carried out with safety and medical responsibility.

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