Steps
Pull deciduous or primary teeth

1. Be sure the milk tooth is ready to come out. Milk teeth need proper care, just like adult teeth, meaning regular brushing and flossing, so your child’s milk teeth may be loose or in pain from tooth decay, infection and other ailments. Pulling a tooth in this state can be extraordinarily painful and cause serious damage and possible hospital visits. Experts are concerned about the prevalence of cavities in baby teeth of children ages 2-5. It increased to 28 percent in 1999-2004, from 24 percent in 1988-94, according to the American dental Association.
2. Check for natal teeth. Some infants are born with teeth, just below the gum line. These are known as natal teeth and are found in about one out of every two thousand births. Natal teeth are not milk teeth or primary teeth. Natal teeth are usually removed by your dentist due to the prevalence of problems associated with them, but an X-Ray must be completed before that determination can be made. Problems associated with natal teeth include:
   
   
   • Pain in the infant
   • Difficulty feeding the infant
   • Maternal discomfort if breast feeding
   • Damage or even amputation of the tip of the newborn's tongue
   • Natal teeth may indicate a hormonal problem called hyperthyroidism
3. Check that your child is in the right age range for the adult teeth to be coming in, or erupting, as dentists say.
   
   
   • Primary teeth usually start to come in between five and seven months, although there is a wide range, up to one and a half years old. Teeth come in at different places at different times, in other words the lower teeth usually erupt before the upper teeth, girl’s teeth erupt earlier than boys etc.
   • Generally the front teeth erupt first at about six months and most children have all their primary teeth in place by three years.
   • The shedding or falling out of primary teeth begins around six years of age and continues until ages up to 13 or 14 years old. During this time the permanent teeth will be coming in, replacing the primary, and your child may well have a mix of milk and permanent teeth for years.
   • Note that is a permanent tooth begins to erupt (become visible above the gum line) before the milk tooth has fallen out your dentist will usually remove the primary tooth.
     
     
4. Once you are sure you are dealing with the normal loss of a milk tooth understand that you are not really pulling the tooth, rather the tooth will fall out naturally given a little more time, rather you are probably indulging your child’s wish to have the tooth removed:
   
   
   • Tie a piece of dental floss into a loop and slip it around the loose tooth. Try not to cause too much pain while doing this. If there is pain, then stop and go to the dentist.
   • Tie other end of the floss to the door knob so there is no slack. Make sure you tie a secure knot on a round knob, not a thin handle. If that knot comes off you will have to do this all over again.
   • Stand on the side of the door where it closes away from you.
   • Slam the door closed. There should be little or no pain or bleeding. If there is, take your child to an emergency dentist or hospital and tell them what you have done.
   • Have the child bite down on a towel or piece of gauze to stop any bleeding.
   • Examine the tooth that came out; if it appears to be missing any parts, see a dentist as soon as possible.

Care for a pulled permanent tooth

All gone! If one or more of your permanent teeth have been pulled it is important to properly care for the empty socket in your mouth. There are two basic kinds of tooth extractions: simple and complicated. Simple extractions are the most common, and are basically a matter of applying local anesthetic and then separating the tooth from the bone, usually by grabbing it with a special pair of forceps and moving it back and forth like removing a post from a hole in the ground. The second kind of extraction is where there are serious complications like cysts, impacted wisdom teeth and other issues that require surgery on your gums. The healing of the lost tooth begins with biting down on gauze to create a blood clot. It takes some weeks, but eventually that clot will turn into bone. During that time it is essential to observe proper post-surgery care to avoid complications like "Dry Socket", a smelly and painful condition that occurs when the clot gets removed in the middle of the healing process. The following care should be taken after extraction:

1. Go home and rest for 12 to 24 hours. Don’t go to work; don’t even get up. Do not exercise.
2. Bite on a gauze pack for 15-20 minutes. In other cases you may need to bite down on that gauze for up to two hours for a clot to form. If you experience excessive bleeding, clean or replace the gauze and bite down some more. Don’t open your mouth or talk during this time.
3. You will experience pain and swelling. This is usually normal after an operation of this kind.
4. Unless you have been advised against this take an aspirin for your pain as soon as you need it, and then one every 3 or 4 hours. Do not hold the aspirin in your mouth or next to your gum as this can cause burns.
5. Avoid biting the lips/cheeks.
6. Do not spit. Hard spitting, rather than wiping the inside of the mouth, can easily destroy the clot from forming.
7. Do not smoke. Chemicals in cigarettes can react with chemicals in your mouth and actually break down a clot. Try to avoid smoking for 48 hours at least.
8. Obviously take any medications you have been prescribed by your dentist in the correct manner.
9. Do not drive or operate machinery while in recovery or on certain medications.
10. Don’t eat until the anesthesia (numbness) has completely gone.
11. Avoid warm food as it can result in bleeding. Eat only soft foods.
12. When eating, try to chew your food on the opposite side of the mouth.
13. Do not drink hot liquids like tea or coffee. Cool liquids are good for you though, so drink plenty of water.
14. The dentist may advise cold fomentation for some patients to reduce the inflammation and swelling.
15. Do not rinse your mouth with salt water and spit. This is dangerous and can wash away the clot.
16. Do not play musical instruments that require pressing the mouth to the instrument like: trumpet, trombone, clarinet, et cetera.
17. If the pain has not receded in 48 hours, or if you have bleeding or foul odors, call your dentist and tell them about these symptoms.

Tooth realignment

In the following months you may experience tooth realignment as your body compensates for the new hole in your tooth line. How much tooth movement you experience depends on many factors including:

1. Age. Young people’s teeth move faster than older folks.
2. The place in your mouth where the hole is located. Hole in the back of your mouth tend to encourage greater movement than holes in the front, for example.
3. If you grind your teeth (known as 'bruxing'), your will help to speed their realignment. 'Bruxing' is not necessarily a desired way of aligning teeth, as it may lead to other complications.

Tips

• This only works for teeth that are falling out naturally anyway, like children's primary teeth.
• This only works properly when the tooth is no longer anchored to any bone, and is only being held in place by gum tissue. Teeth in this state move freely in pretty much every direction and are extremely painful.

Warnings

• If you are an adult or an adolescent and have loose teeth, see a dentist immediately. They can address most problems, as well as offer advice on the risks of pulling it yourself.
• Pulling a tooth is very different than caring for a broken or knocked out tooth, both in adult teeth and primary teeth. If your child’s teeth have been damaged by physical trauma (ie: falling) and appear to be broken, do not follow these directions.
• Do not use excessive force when pulling a tooth. You may accidentally cause injury to yourself or others. Pulling a tooth with too much force will most likely create dental complications.
• If you suspect an infection, see a dentist immediately. Prolonged and untreated infections can develop into greater health risks.
• Children and adults often play with, or otherwise manipulate, loose teeth. This is a bad idea, as doing so can alter the bone and formation of new teeth below. Such manipulation can damage the root canal and cause new teeth to come in at unnatural angles.