Talk to your child about pulling their tooth to settle any fears or anxieties that they may have about it. Explain to them that their tooth is loose and will fall out soon, and ask if it’s alright for you to gently pull it out. If your child wants the tooth to fall out on its own, then let them wait. If they’re ready for you to pull it out, you can do it without them being afraid.  Abruptly pulling out a tooth can scare your child and cause unnecessary pain if they struggle. Some children are excited about their teeth coming out, but many have anxieties about potential pain or bleeding. It’s important that you wash your hands thoroughly to prevent infections. Turn on your faucet, let the water warm up, and hold your hands underneath the stream to get them wet. Add a few drops of hand soap or rub a soap bar between your palms and work the soap into a lather by rubbing your hands together. Then, rinse off the soap and dry your hands to remove dirt and germs from the surface of your skin so you don’t introduce them into your child’s mouth.  Dirty hands can cause an infection or illness and should never enter your or your child's mouth. If you have a pair of sterile rubber gloves, it might be good to wear these as well to further reduce the risk of infection. You need your child to hold still for you to take out their tooth, so before you begin, tell them that everything will be okay and that it will be over before they know it. If it helps, you can promise them a reward or a treat if they’re able to stay calm while you pull out their tooth.  For example, you could tell your child that the tooth fairy will come to take their tooth and leave them a present, or you could promise them some ice cream after you pull out their tooth. This is a very formative time for your child, and you don't want to do something that will cause your child to associate the experience with fear, pain, or panic. Take a cotton ball or a piece of gauze and rub the front and back of the tooth you plan to pull to dry it off and make it easier to grip. Wipe the tooth gently and calmly explain to your child that you’re about to pull their tooth and will be over quickly to settle any anxieties that they may have.  If your child sees that you’re calm, then they’re more likely to relax. If you don't have a cotton ball or gauze available, a tissue will work, too. Just make sure it’s clean! Use sterile gauze to add an extra barrier between your hands and your child’s mouth and to provide you with extra grip to hold the tooth. Take about a 2–3 in (5.1–7.6 cm) long strip of gauze and place it between your thumb and index finger so both of your fingertips are covered by it. If you don’t have any sterile gauze, you can use a strip of clean paper towel to help you grip the tooth. Using the gauze pad, grasp the tooth at its base, where it meets the gum. Gently pull the tooth and slightly wiggle it to help work it free. Continue pulling and wiggling until it pops out. Try to pull it out as quickly as you can to keep your child from getting anxious and moving around.  If the tooth is loose enough, it should pop right out with little trouble. If it doesn't come out after a firm pull, it isn't ready yet. Don't continue to pull on a tooth that isn’t ready to come out or you could hurt your child. Wait a few days and then try again. Even if the tooth was very loose, there will still be some bleeding. Take a fresh, sterile piece of gauze and compress the tooth socket with your forefinger and thumb. Have the child bite on the gauze piece for 10 minutes or so. This will help to control the bleeding and promote quicker wound healing. Take 1 cup (240 mL) of warm water and dissolve 1 teaspoon (5.69 g) of table salt into it. Have your child swish the solution around in their mouth for about 30 seconds and then spit it out in the sink to wash the open wound left after pulling the tooth to help prevent infection.  Have your child swish saltwater in their mouth once a day for the next 3-4 days to keep the wound clean. Make sure your child doesn’t swallow the saltwater or it could make them ill.
Ask your child if they want you to pull the tooth. Wash your hands thoroughly with soap and warm water. Give your child assurance so they’re relaxed and calm. Wipe the tooth 2-3 times with a cotton ball or gauze to avoid slippage. Hold a piece of sterile gauze pad between your thumb and index finger. Grasp the tooth firmly and pull with a slight wiggling motion to remove it. Press a sterile piece of gauze over the tooth socket to stop the bleeding. Rinse out your child’s mouth with saltwater to sterilize it.