Children’s smiles go through many dental changes: getting their baby teeth in from 6 months to 3 years, losing their baby teeth from 6 years to 12 years, and then getting their wisdom teeth in as a teenager. While there is a general timeline of when they lose their baby teeth, not every child adheres to this schedule. While slight delays usually are not a big deal, long delays in tooth loss and development could signal other dental issues. At what point do your child’s baby teeth become a problem? 

Appel Orthodontics knows tooth loss can be both exciting and concerning for parents. Children go through a frenzy of erupting baby teeth in their first year or so, then another frenzy of permanent teeth eruptions a few years later. But if those permanent teeth come in before the baby teeth are gone, or if they don’t come in after the baby teeth fall out, it can lead to dental problems over time. Let’s take a look at a general timeline of when to expect your child’s teeth to come in, and when you should be concerned with slow tooth eruption.

Which Baby Teeth Come in First?

Baby teeth start far earlier than people think! Tiny buds form as early as six weeks into pregnancy, with the enamel starting to form about six weeks after that. There should be 10 hidden teeth on top and 10 teeth on the bottom by the time the baby is born! The first one should start showing through the gums after about 6 months, but not every baby gets their first tooth that early. It could be at 8 months or even 10 months. That’s when the first little incisors, the front teeth, will show up. 

The rest should follow in fairly rapid succession, with the last molars making an appearance when your kiddo is between 2½ and 3 years old. The incisors come in first, then the canines (the pointy teeth next to the incisors), then the premolars, and finally the molars. Once your baby starts teething, it’s a good idea to keep those teething rings and your at-home teething remedies at the ready! 

When Do Kids Start Losing Baby Teeth?

After your child gets all of their baby teeth in, you get about 3 years’ reprieve before the tooth carousel starts to spin again. At about 6 years old, the first baby tooth comes out. They usually will fall out in the same order as how they came in, so the incisors will be the first to go. It is however a slower process to lose the baby teeth and get the permanent teeth. Between ages 6 and 21, those 20 baby teeth will be replaced by 32 permanent teeth.

What Is the Timeline for Losing Baby Teeth? 

When does a baby lose its first tooth? When do the last baby teeth fall out? The first tooth will fall out at about age six, which is about the same time as the first permanent molars erupt behind the baby molars. 

Once all the central incisors are out, the lateral incisors are next. This happens about age 7-8. Then the canines and first molars fall out about 9-11 years of age, and the baby molars come out between 10-12 years. The last of your child’s baby teeth should be out before your child becomes a teenager.

In What Order Do Baby Teeth Fall Out?

Baby teeth fall out in the same general order in which they erupted. Your baby will start by losing an incisor, probably a central one. The lateral incisors will be next, then the canines, then the baby molars. Here is where it gets interesting. 

After the canines came in, your baby then got the first primary molars. When those primary molars fall out, they aren’t replaced by other molars. Instead, they are replaced by bicuspid (two-pointed) teeth, otherwise known as premolars. We don’t have premolars as baby teeth. Only the permanent teeth have premolars. So when the first molars fall out, they’ll be replaced by premolars. 

After the two sets of premolars erupt, the second set of permanent molars will come in to replace the back baby molars. (The first set of permanent molars will already be in.) Finally, your baby — who isn’t so much a baby anymore — will get another set of permanent teeth that don’t have a baby teeth equivalent: the wisdom teeth.

In general, the baby teeth start falling out at age 6 with the center incisors on the top and bottom. By the next year, the lateral incisors (the teeth on either side of your two front teeth) come loose and fall out. The lower canines and the first upper molars fall out about age 10, with the lower first molars following a year later. Finally, the upper and lower second molars and the upper canines fall out at age 12. By the time your child hits puberty, all of the baby teeth should be out and making way for the permanent teeth to take their place. 

The baby teeth fall out in a general order at these general ages. The process may start a bit earlier for some or a bit later for others. When baby teeth fall out, permanent teeth should come in within three months. If that isn’t the case, your child might need orthodontic treatment to bring down the adult tooth. Sometimes, people are genetically predisposed to not have certain teeth; the most common missing teeth are lateral incisors, the teeth directly next to your front teeth. Through x-rays and scans, we will be able to determine if that is the case for your child or if other teeth are preventing the adult teeth from coming down into their correct place. 

Can a Child Lose Their Teeth Too Early? 

This timeline is a general one, which means your child’s teeth may fall in that timeline or slightly out of it. If your child’s teeth erupted earlier or later than usual, they’ll likely start losing their teeth earlier or later, as well. 

It’s OK if your child loses their teeth a few months early or late. However, if baby teeth start falling out long before the permanent teeth erupt, about age 4, you should consult your dentist. 

Since permanent teeth aren’t due for another couple of years, your child’s baby teeth could move and crowd the space, causing the permanent teeth to come in crooked. Your dentist or an orthodontist can place spacers to prevent this from happening.

When Is It a Problem Losing Baby Teeth Late?

It’s generally not a problem for baby teeth to start coming out late, but there are a few exceptions. If the baby tooth doesn’t fall out before the permanent teeth starts to come in, it could cause the permanent tooth to come in crooked, above, or behind the baby tooth. 

Another issue is the order in which baby teeth fall out. Straying from the correct order could mean that permanent teeth don’t have enough room to erupt. They could come in crooked or out of place, causing problems with your child’s bite. Over time, this could lead to jaw pain, headaches, and in the most severe cases, even nutritional deficiencies. 

What if the baby teeth do fall out properly, but the permanent teeth don’t come in? After about three months, the teeth around the gap left by the baby tooth will start to move together. This reduces the space for the permanent tooth to come in. If the tooth doesn’t come in at all, it may be because it never formed properly. If the tooth doesn’t erupt within three months, visit your dentist. They may do x-rays to make sure the tooth is actually there and see what the problem may be.

Losing Baby Teeth and Puberty

We all know puberty causes major changes in a child’s body. Hormones take off, growth spurts occur, and before you know it, your adorable little child is now a surly teenager asking to borrow the car! Puberty can also affect your child’s dental health, too. All those new hormones can cause extra blood to flow to the gums, which can make them swell and feel tender. Your child may even experience bleeding when brushing or flossing. This is called puberty gingivitis, and it should be addressed before it gets worse. 

Puberty gingivitis is also caused by an increase in bacteria in the mouth. Increased microbe growth can also be the result of a change in hormones. This increased bacteria can eat away at the enamel on teeth, leading to more tooth decay. That’s why it’s so important for your child to maintain good oral hygiene habits, especially during puberty. Otherwise, puberty gingivitis can develop into periodontitis, which can lead to tooth loss. Your child should brush and floss after every meal and visit the dentist for an exam and cleaning every six months. 

After a Tooth Falls Out

It doesn’t take much pressure for a tooth to fall out once it’s ready. The tooth falls out because it breaks away from the root. The root is reabsorbed by the jaw, while the crown of the tooth is the part that falls out. Usually, the only thing holding the tooth in at that point is the gums.

Your child may have a little bleeding and soreness when the tooth comes out. This is perfectly normal. Simply rinse your child’s mouth out with cold water to stop the bleeding. If your child’s gums are sore, they can rinse with warm water to soothe the gums and keep the hole where the tooth was clean. 

Have your child stick to eating soft foods for a day or two after losing a tooth. After that, the soreness should be gone and they can resume normal eating. The gum should seal itself up fairly quickly.

When Do Kids Get Adult Teeth?

Children start getting their adult teeth about the same time they start losing their milk teeth. The first permanent molars will erupt behind the baby molars around age 6. These will not replace any teeth. 

The next teeth to erupt will be the central incisors, which come in around age 6 or 7 after the baby teeth fall out. Usually, the lower permanent central incisors are the first to erupt, just as the lower central deciduous incisors came in first. 

The rest of the permanent teeth come in shortly after their baby teeth equivalents fall out. The last adult teeth to erupt are the wisdom teeth, which come in between 17 and 21 years of age, if at all. It’s estimated that about 25% of the population has less than four wisdom teeth, and 35% are born with none at all.

Getting Your Child’s Teeth Straight

Gaining and losing teeth are normal processes in your child’s life, but they don’t always happen as they should. If there are abnormalities in the process, your child may need orthodontic treatment. It’s recommended that children first see an orthodontist by age 7. We’ll be able to let you know if there are or will be future issues with your child’s developing mouth. We can also recommend when your child should start orthodontic treatment with braces or Invisalign, or whether treatment will even be needed. Get started by scheduling a free appointment in our Philadelphia, PA, office! 

Tooth loss and tooth eruption are inevitable. If it happens a few months early or late, there’s no need to worry. Contact your pediatric dentist or Appel Orthodontics with any questions or concerns. We’re here for you!