Swelling Behind Loose Tooth

My five-year-old son has a loose front tooth. The back side of the gum is infected. Should a root canal or extraction be done? Will antibiotics cure the problem?

Question:

It is very common for the anterior permanent teeth to erupt slightly behind the anterior primary teeth--especially in the lower arch. When teeth are erupting, the gum tissue can appear slightly swollen with some associated redness even when an infection is not present. Redness and swelling are also general symptoms for common infections. Accordingly, it is important to be sure that the symptoms are, in fact, due to an infection. Once the infection is diagnosed, it is important to determine the source of the infection so proper treatment can begin.

If it is indeed an infection and the primary tooth is determined to be the source, it is always best to rid the body of the source of infection. If your son was younger, we would expect that the tooth would remain in the mouth for some years. If this were the case, I might recommend a "baby" root canal for treatment. However, your son's age suggests that he will soon lose his primary anterior teeth. The tooth is already loose. Accordingly, I would extract the tooth. A short course of antibiotics to rid the body of the infection would also be advised.

If your dentist determines that an infection is not present, I recommend no treatment at this time. Simply allow the tooth to naturally exfoliate. Please see your dentist to determine the best treatment for your son.

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