Parents are often concerned about their child's milk and permanent teeth. Most of them are not guided by their dentist regarding the shedding and eruption patterns of the deciduous and permanent teeth. There are 20 primary teeth that begin exfoliating from the age of 6 years. By the age of 14 a child will develop an entire set of permanent dentition that are 28 in number. The four remaining teeth are the third molars which may or may not erupt in their lifetime.

When a primary tooth sheds, it falls off in a manner that only the crown of the tooth is appreciable. This is because the roots of that primary tooth get resorbed by the erupting forces of the underlying successor teeth. The resorption of these roots is a gradual process. When the permanent tooth is still in the bone, it erupts at a rate of 1-10 micrometers per day. The simultaneous resorption of the primary tooth's roots leads to the loosening of the milk tooth.

When the milk tooth becomes visibly mobile, parents become concerned whether or not they should pull out the tooth on their own or not. They are apprehensive for they fear their child might swallow the tooth accidentally. So should parents pluck out the wobbly tooth?

There are many factors that parents must consider before pulling out a wiggly tooth. First, they need to assess how loose the tooth is in the oral cavity. It can be moving and slightly firm at the same time, or it can be dangling in the gums with the underlying roots completely lost. In the former scenario, the parent should not make any attempt to remove the tooth. Children often tease the loose tooth with their fingers or tongue and make the moving tooth more loose. But if the tooth is painful upon touch, then parents should definitely seek professional advice instead of trying anything overzealous or detrimental.

In case the tooth is completely detached from the underlying socket and is severely loose, then parents can opt for its removal only if it is painless upon touch and worries them if their child would aspirate such a loose tooth. However, parents must remove the tooth by following a certain protocol. To begin with, the parents must wear medical grade gloves in order to prevent any cross contamination. Then, they must have a topical anesthetic gel which should be applied around the gums of the moving tooth. The child is asked to keep the mouth open. After a couple of minutes, a sterile gauze piece is then used to hold the tooth, after which it is removed in a slow twisting motion. In order to stop the resulting bleeding, the child is asked to bite upon a new gauze piece that is placed in the socket of the removed tooth.

One of the ways in which parents can make their child cooperate with them during tooth removal is by asking them to sneeze on the count of three, while the parent firmly grips the loose tooth with the gauze piece. On the count, as the patient moves their head downwards, the parent can pull out the tooth in one swift motion in a single vertical direction. It is also recommended that parents encourage their children to keep playing with the loose tooth with their tongue so that it can fall off in a natural manner rather than with unwanted forces.

Even though the above-mentioned techniques are relatively easy, parents often feel uncomfortable as their child might not comply with them. Moreover, parents often fail to recognize the mobile tooth that they should or should not opt for removal on their own. In the process, their impulsive technique can even hamper the underlying permanent tooth. At times, the tooth is mobile, but parents attempt its removal prematurely. Such premature removal of the tooth is not only a painful experience for the child but may also result in malalignment of the permanent teeth.

Seeking professional advise is always a safe and recommended route. When a tooth is loose, pediatric dental surgeons know the medically safe and assured methods for the removal of these teeth, ensuring there is no damage to the adjacent tissues.