Loose tooth after injury

My 2 year old knocked her top front tooth and it is slightly loose. I was told that if it does not "tighten" back into place within two weeks, it would have to be extracted. Is this true? What are the alternatives ?

Question:

Dear Sharon,

No, the necessity for having the tooth extracted is not necessarily true. A two to three week "wait and see" period is a good approach for now, unless your daughter begins to complain of pain or you notice signs of infection (redness and/or swelling of the gum tissue in area and, perhaps, a fever). In the meantime, you might use some caution with certain types of harder foods, such as apples and hard bread crusts. Avoiding these for a few days may help the tooth to " tighten up".

If the tooth becomes painful or infected, extraction is one alternative. The other possible treatment would be a pulpotomy or a "baby" root canal. The pulpotomy procedure removes the nerve inside the tooth but the tooth is left in place. "Baby" root canals are much easier and quicker than root canals performed on permanent teeth. This treatment may not be an alternative if the root of the primary tooth is damaged or if the tooth remains quite loose. If extraction becomes necessary, a space maintainer with a "fake" tooth can be made. This will help to hold the place for the permanent tooth, and create a full complement of "teeth" for esthetics and phonetics.

If two weeks pass and the tooth remains slightly loose with no other problems, and your dentist still wants to extract it, you might want to seek a second opinion. An opinion from a pedodontist might be helpful as well.

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