and today we're going to talk about pulling baby teeth specifically in that 5 6 7
8 9 10 11 year old should you do it should you not do it what does that have to do with ortho
what do i recommend and i'm going to go ahead and take you through three case scenarios a b
and c and tell you my thoughts and i can tell you that you can ask 20 orthodontists or 20
dentists and you'll probably get 20 different opinions so don't expect the opinions of one
doctor to be the same as another doesn't mean that they're wrong that's just their opinion and
i can tell you that my opinion has changed dramatically in the last decade just based on
more research and more things and more things i've tried and um goodness just just having a
generalized total body health opinion that has really changed on how this is handled i can tell
you when i was a kid i had almost all my baby teeth pulled them because i kind of looked more
like this and that's just what they did as soon as it started to come up you'd go get the baby one
pulled the problem with wet is that there's a some arch expansion that does happen and it's healthy
for the teeth to actually push themselves out and i know nobody likes to have shark teeth and they
can be black and food gets caught in there it can be a little sore but it is better that you
let nature take its course that i feel firmly on don't let parents push you into getting these out
that's also traumatic for the kids it's just not necessary i like to prescribe a diet of candy
to get them out i mean in moderation and certain types of candy i let the child and kids and
parents parents kind of roll their eyes but kids love this prescription so i tell them i'm going
to give you a prescription it is going to be for one chewy sticky candy um you know on the weekends
and the only ones that they're allowed to have is a sugar daddy those are kind of hard to find
they're like the really sticky toffee on a stick sugar daddy not sugar babies sugar daddy or and
they have to bite into it that's part of the deal no licking they have to do it my way or no deal
the parents can take it away okay they have to bite into it um followed by two apples during
the week so it's the candy apple diet you get the candy on the weekends if you've done the apple
homework which means you have to bite into the apple now on your side teeth on your front teeth
a whole apple two apples a week during the week and then you get the one candy on the weekend so
the candy apple or it can be i guess it could be a candida apple that also works for me too so the
apple slash candy diet is alternated you know and of course after they have the candy they have to
let the parents brush that's part of the deal not they brush the parents brush and the parents floss
and the parents get in there with the itty bitty toothbrush and make sure they're getting it all
clean because we don't want any decay to be going on here so that's part of the deal but this puts
the control in the kids if you do that these things will come right out it's not a problem
you know if it comes to the point where these things are fully up and it's been six months like
this then we can always re-evaluate the extraction as needed but usually if you do the apple slash
candy diet the parents brush you set it up like that these things come right out and it really
really helps and it's healthier for the teeth and it's a lot less wonky when you do it this way okay
so that's a let's talk about b and c so for these situations for the most part i don't pull any baby
front teeth so that would be these and these i call these front teeth these are canines this
this this and this these sometimes i will pull so only time i would pull a baby front tooth is
if there was some type of trauma or infection or something like that otherwise
let it come out let it come out on its own um you know the apple candy diet with the brushing
for the baby teeth the baby canines this would be based on a couple different things number one
based on the panoramic x-ray which you need to take if you see signs of impaction it is
helpful and more standard of care to go ahead and pull those baby canines and do arch expansion
concurrently you have to do both the same time just pulling them isn't going to do anything
because right now there's no place for the canines to come down you can see this arch
is constricted this arch is constricted these need expanders so by doing expanders and pulling
the baby canines you reduce the likelihood of having impactions there are white papers to back
it up if you want to see the white papers you can email me at info streetsmilesolutions.com
and i will send you a copy of that white paper um what else sometimes you also need to pull
baby canines if you are starting orthodontics for example i can't straighten these front four teeth
unless i expand the arch right with expanders or pull the canines the problem is if you just pull
the canines without expanding the arch um then you're just you're just making the impactions
go more more posterior you're just making the problem worse and more complicated later you're
just pushing the problem off to a year from now instead of right now right so you'll get
nice straight teeth here but then you won't have any space for the canines to come out
so you again you need to do the expansion and the braces at the same time and the pulling
so all that has to happen together you can't do just the braces and no expansion
you can't just do the braces and you can do the braces and expansion and no pulling sometimes
but you need to let the expansion finish first and let things kind of shift around and it might
delay your braces or your phase one aligners and make it take longer so it's better just to pull um
okay number c so same idea here um don't have probably enough teeth for these to come down
there's a little space here usually these teeth will come down in time and push this together
but if they're getting if they're getting blocked out then we need to do some expansion
and or expansion and pull teeth but don't just pull teeth without the expansion same thing
here you can see that there's not enough space to straighten these teeth this makes zero sense what
they're doing right here because this isn't going to straighten up because you don't have space for
it so again you have to do expansion or pull teeth and expansion but not just pull teeth because then
you're just chasing the problem more posterior all right hopefully that was helpful and again i do
pull baby teeth if and when there's an infection an abscess um or there's any topic eruption of
the permanent tooth otherwise i generally do not pull baby teeth all right thanks so much