Extraction chez l'enfant

Abstract

Tooth extraction in a child may seem a simple, ordinary act. It should be remembered, however, that when he becomes an adult, this patient will have an attitude to dental treatment that will depend on how he experienced this “paediatric extraction”. The initial contact and the way one addresses the child are therefore essential. The way of talking and adequately chosen words are a key in the patient/doctor relationship. Milk teeth are morphologically and physiologically different from permanent teeth, first, due to root resorption which confers them their temporary character. The main reasons for tooth extraction in children are the decay and its related infectious complications; other reasons are trauma, and scheduled orthodontic extractions of either milk teeth, or buds of permanent teeth. Between the indication and the extraction itself, anaesthesia is an intermediary stage which can sometimes constitute an obstacle (fear of the injection). This is why much is to be done to make it as non-traumatic as possible. The operating technique must comply with precise rules and take into account factors such as the morphology of the tooth, the presence of underlying permanent tooth buds and, for a time, the co-existence of milk and permanent teeth. For more complicated acts, such as removing odontoids or more generally unerupted teeth, general anaesthesia may be considered.