Q
My 7-year-old daughter’s baby tooth fell out. It looks like just a shell of a tooth without any inside. There is a red, soft, rounded protrusion left on her gum. It doesn’t hurt her. What is this and what do we do about it?
A
What you’re seeing is common: a little red piece of tissue left in the socket after a primary (baby) tooth falls out. Primary teeth are usually lost when their roots resorb, leaving only the crown. That crown can come away as a hollow shell, and sometimes a bit of the soft tissue that occupied the inside of the tooth or covered the extraction site remains visible on the gum.
Parents often assume the entire tooth—including roots—comes out when a tooth falls, but that rarely happens. The body gradually dissolves the root as the permanent tooth develops and moves into position. Once the root is gone, the remaining tooth crown becomes loose and separates. The small red spot you notice is typically scar tissue or soft tissue from the socket, and it often sloughs off on its own as the area heals.
Finding this tissue can mean the tooth had been loose for a bit longer than average, but it’s not usually a sign of trouble. It’s good that it isn’t painful. Mild bleeding or slight tenderness can occur, but significant pain, swelling, or ongoing heavy bleeding would warrant dental evaluation.
Another common concern is seeing a permanent tooth erupting behind or in front of the baby tooth before the baby tooth is fully gone. This overlap happens frequently and is not necessarily problematic. Usually the baby tooth will become looser and fall out on its own; in some cases a dentist may need to extract the retained primary tooth to allow the adult tooth to come in straight. Only a dentist can determine if extraction or any treatment is necessary.
For the most part, no special care is required. Keep the area clean by continuing normal brushing and routine oral hygiene. Your child can eat normally; avoid very hard or sticky foods for a day or two if there’s tenderness. If you notice persistent bleeding, increasing pain, swelling, fever, or if the red tissue does not resolve over a couple of weeks, schedule an appointment with your dentist to rule out infection or other issues.
In summary: the red, soft, rounded protrusion is likely harmless tissue left after the crown separated from the root. It generally heals and falls away on its own. Monitor the site and consult your dentist only if symptoms worsen or don’t improve.
Mark Burhenne DDS