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Dentistry/Pulling Primary Teeth


My son is 7 and has "shark teeth" on his lower front teeth--the adult teeth are starting to grow in behind the baby ones. We took him to the dentist for his 6 month checkup and--as expected--she wants to pull those two primary teeth.

She also wants to pull both adjacent teeth as the x-ray shows the teeth growing in are too big and won't fit in the spot available even if the two loose teeth in front fall out. (The two adjacent ones are not wiggly yet.)

The x-ray--to my untrained eye--looks like the permanent teeth will in fact hit the adjacent ones. But I can't tell if it is just an optical illusion because the x-ray film is closer to the permanent teeth like forced perspective.

How do I know if this extraction is actually necessary or just a procedure driven dentistry act? Any specific questions to ask?

I have attached the x-ray.

Thanks for volunteering your time.


In our office we usually don't recommend extraction of the lower primary incisors at this very early stage of development. Often those permanent incisors that are emerging behind the primary incisors will work their way forward and the primary incisors will often loosen up and fall out without intervention.  This is an early hint that crowding will be a problem over time and that orthodontic intervention will become necessary later on.  I don't think that extractions at this time will change that eventuality and working on keeping the teeth straight right now is not a realistic expectation.  The situation requires watching over the years.


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Dr. Randolph Myerson


Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.


I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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