Pediatric Dental Extractions In Lafayette, CO

If a dentist told you your child needs a tooth pulled, ask whether it has to come out at all.

Some baby teeth can be saved. Some cannot, and trying costs your child a second appointment for the same tooth. The X-ray decides it, and there are published success rates for each option. Here they are, along with whether the gap needs a spacer afterward.

Dr. Alison Grover is a Board-Certified Diplomate Pediatric Dentist in Erie Commons, minutes from Lafayette.

Does the Tooth Actually Have to Come Out?

Often, no.

The American Academy of Pediatric Dentistry reserves extraction for a tooth that cannot be restored, meaning the roots or crown show extensive resorption or destruction. Short of that, there are treatments that keep the tooth in place.

When we try to save it

For decay that has not reached the pulp, a Hall crown seats a stainless steel crown over the tooth with no drill and no injection. A 2024 systematic review in Evidence-Based Dentistry pooled 25 studies and found 98% success at 12 months across 15 randomized trials, with 95% holding as far out as 89 months in the non-randomized studies. The reviewers rate that certainty moderate to low, which is worth knowing. It is still the strongest survival figure in pediatric restorative care.

For a back tooth that needs more coverage, we place white crowns, so a molar does not have to end up silver. For an infected pulp with intact roots, a pulpectomy succeeds in 89% of cases at 12 months, per AAPD's own review of the evidence.

Those options and how we choose between them are on our dental restorations page for Lafayette families.

When extraction is the right call

Two situations move the decision.

The first is a tooth that cannot be restored. Roots gone, crown gone, bone involved.

The second is quieter and it is the one parents rarely hear. Once root resorption has already started, that same pulpectomy drops to 47% success at 12 months. Close to a coin flip. In that case, removing the tooth and holding the space often costs your child less total chair time than a treatment that fails and ends in an extraction anyway.

AAPD also allows something the brochures leave out: extraction can be the right choice even when the tooth is technically restorable, once the family and the dentist weigh the child's ability to cooperate, medical complexity, anesthesia considerations, or an unclear diagnosis. That is a prognosis conversation, not a slogan.

Trauma, an abscess, and a baby tooth blocking its replacement are the other common reasons. If a tooth is broken or your child is in pain tonight, start at emergency dental care for kids in Lafayette. If a permanent tooth is coming in crooked behind a baby tooth that will not loosen, read how tooth eruption normally goes first.

4 questions to ask before you agree

Ask these here or anywhere. Dr. Grover answers all 4 at the consult, on your child's own X-ray.

What do the roots look like on the radiograph, and is there resorption?
If we try to save it, how many months does this tooth realistically have?
Does the gap need a space maintainer, and which kind?
What are the CDT codes on the treatment plan?

If an answer is a script rather than a reference to the X-ray in front of you, get a second opinion.

Will the Gap Need a Space Maintainer?

It depends on which tooth came out and which jaw it came from. The difference is larger than most pages admit.

What the measurements show

A lower primary first molar loses about 1.78 mm of space in the 8 to 9 months after it comes out. That is enough to matter, so an appliance is indicated, and it goes in within 3 months.

The upper primary first molar behaves differently. About 0.52 mm over 9 to 12 months, which is why routine appliances are not indicated there.

The primary second molar is the urgent one. Taken out before the permanent first molar has erupted, that gap closes by roughly 2.12 mm at 6 months and 4.02 mm at 12 months with nothing holding it open.

Front teeth are the easy case. Once the canines have erupted, losing a primary incisor causes no meaningful space loss and needs no appliance at all.

The first-molar figures come from a 2026 meta-analysis in BMC Oral Health covering 7 studies and 312 children, which concluded that maintainers are indicated after lower extractions while upper cases may not need routine intervention. The second-molar figures come from a 48-month study of 100 extracted second molars published in General Dentistry, whose authors noted that placing an appliance a year or more after the extraction has minimal benefit, because most of the loss has already happened.

Timing matters more than the appliance.

What we will tell you that most pages will not

Space maintainers have real downsides, and the professional body says so plainly. In its guidance on managing the developing dentition, AAPD states that consensus or evidence on how well these appliances prevent or reduce malocclusion is lacking. The same document lists what goes wrong with them: they get dislodged, broken and lost, they collect plaque, they can cause cavities, and they can interfere with the permanent tooth erupting.

So we place them where the measurements justify the tradeoff, and we say no where they do not. If a practice recommends an appliance after a front baby tooth, ask which measurement supports it.

AAPD weighs 10 factors in the decision, including which tooth was lost, how much time has passed, dental age, how developed the successor's roots are, how much bone covers it, your child's oral habits and hygiene, and their ability to cooperate with an appliance in their mouth.

Keeping Your Child Calm

Extraction is the appointment children remember, so the 30 minutes around it matter as much as the procedure.

Your child chooses a movie from more than 70 titles and a flavor for the topical. X-rays are taken in the treatment room with a camera-style unit, so the movie keeps playing. Every instrument and sensor is child-sized. Parents are welcome in the room.

Sedation levels we offer

Mild sedation with nitrous oxide. Moderate sedation. Deep sedation with a board certified anesthesiologist. Every room in the office is plumbed for nitrous oxide, so comfort options are available immediately rather than at a separate visit.

Which level fits depends on your child's medical history more than on their anxiety, and we settle it at the consult.

The First 48 Hours

The clinical part is short. The evening at home is where problems get made, so here is what AAPD's own postoperative instructions for extractions say.

Numbness lasts about 2 to 4 hours. A young child will chew their own lip without noticing, and that injury usually looks worse than the extraction site. Watch the mouth for the whole numb window.

Bleeding. Firm gauze pressure until the oozing stops, repeated if needed. Pink saliva for a day is normal.

Do not disturb the site today. No stretching the lip to look, no vigorous rinsing, no mouthwash, and no straw. Suction can pull the clot out. Starting tomorrow, warm salt water after meals.

Swelling builds over about 2 days. Ice on the cheek the first 24 hours, 10 minutes on and 10 off, then switch to warm moist compresses.

Food. Cool and soft on day one. Applesauce, yogurt, gelatin. Normal textures on day 2 as tolerated. Skip nuts, seeds and popcorn.

Pain medicine goes in before the numbness wears off, not after your child starts crying. Dosed by weight. Never aspirin. Ask us for your child's schedule in writing before you leave.

Call us the same day if

Bleeding continues past 2 hours of firm gauze pressure
Temperature goes above 100.5°F, or a fever will not break
Pain worsens after 48 hours, or will not respond to medication
Swelling starts after the 48-hour mark
Stitches come loose inside 48 hours
There is pus, or a foul smell
Deep throbbing jaw pain sets in

Call (303) 500-3202 and press #2 and you will reach the Mini Miners Pediatric Dentist on call.

About Dr. Alison Grover

Dr. Alison Grover is a Board-Certified Diplomate Pediatric Dentist and the owner of Mini Miners. Diplomate status means she passed the oral and written examination given by the American Board of Pediatric Dentistry.

She earned her DDS and a general practice residency certificate at the University of Colorado School of Dental Medicine, then completed a 2-year pediatric residency and a Pediatric Dental Certificate at UCLA. Her undergraduate degree, from Wellesley College, is in child psychology, which is why the approach to a frightened child here is a method rather than a personality. She and her husband designed and built Mini Miners from the ground up in 2017.

Getting Here From Lafayette

We are at 61 Erie Pkwy, Unit 101, in Erie Commons at the corner of Briggs Street and Erie Parkway, positioned between I-25 and Highway 287 and minutes from Lafayette. Parking is easy. Some of our families walk or bike when the weather is good.

We see children starting at age 1. Most extractions are the end of a chain that started years earlier, which is worth understanding if your child has more than one tooth in trouble: see early childhood tooth decay. For everything else we do for Lafayette families, start at our pediatric dentist in Lafayette page.

Common Questions

Does the tooth really have to come out?

Not always. AAPD reserves extraction for a tooth that cannot be restored. A Hall crown succeeded in 98% of cases at 12 months across 15 randomized trials. A pulpectomy on an infected tooth with intact roots succeeds in 89% of cases at 12 months, and drops to 47% once root resorption has started. That last number is usually where extraction becomes the better plan.

Will my child feel pain?

The area is numbed before anything starts, and children typically feel pressure rather than pain. Nitrous oxide is available in every room, with moderate and deep sedation for children who need more. If your child feels something during the procedure, we stop and add anesthetic.

Will my child need a space maintainer?

It depends on the tooth and the jaw. A lower primary first molar loses about 1.78 mm of space by 8 to 9 months, so an appliance goes in within 3 months. An upper primary first molar loses about 0.52 mm, so routine appliances are not indicated. A primary second molar lost before the permanent first molar erupts is the urgent case, at 4.02 mm by 12 months. A front baby tooth, once the canines are in, needs no appliance.

What can my child eat afterward?

Cool and soft on the first day. No straws for 24 hours, because suction can pull the clot out. Normal textures on day 2 as tolerated. Skip nuts, seeds and popcorn.

What about insurance?

We accept major private dental insurance, and families without dental insurance can use the Mini Miners Membership Plan. Call with your plan name and we will tell you what we can bill before you schedule, and ask for the CDT codes on the treatment plan rather than a verbal estimate.