When things go right, baby teeth fall out on their own without any special attention. The permanent teeth, which lie right below the gums, come in directly underneath the baby teeth. As the permanent teeth grow in, the roots of the baby teeth dissolve away, causing them to loosen and eventually fall out.
Sometimes, permanent teeth don't come in directly under the baby teeth. As a result, the roots of the baby teeth remain strong and fail to dissolve as they should. Other times, the baby teeth become loose, but not loose enough to fall out on their own. In these cases, the permanent and baby teeth end up sitting side-by-side, and we must remove the remaining baby teeth.
If a baby tooth becomes damaged and the permanent tooth below it isn't due to come in for a while, it's usually best to restore the baby tooth. However, if an X-ray indicates that the permanent tooth is ready to come in, it's best to simply extract the damaged baby tooth.
We may remove a baby tooth if it has been damaged beyond repair, even if the permanent tooth isn't ready to come in. We will then use a space maintainer to hold the rest of the teeth in place until the permanent tooth is ready to come in.