Losing the first baby tooth, which people may refer to as a milk tooth or primary tooth, is a milestone for children and their parents or caregivers. A child usually loses their first tooth at the age of about 6–7 years, but tooth loss can continue right up until the age of 12 years.
In this article, we examine the typical order of tooth loss in children. We also discuss why some children are more likely than others to lose a tooth early or late and explain what to do with a wiggly tooth.
According to the American Dental Association (ADA), children tend to gain and lose their teeth between the following ages:
|Eruption (months)||Loss (years)|
|Upper baby teeth|
|Lower baby teeth|
Incisors are the sharp teeth at the front of the mouth that are important for biting and chewing solid foods.
Babies and adults have eight incisors, including:
- upper central incisors — the two at the front top
- lower central incisors — the two at the front bottom
- upper lateral incisors — one on either side of the upper central incisors
- lower lateral incisors — one on either side of the lower central incisors
The ADA states that a child usually loses their first baby tooth, one of the lower central incisors, at the age of 6–7 years. Often, the loss of the teeth occurs in the same order as their appearance.
The lower incisors are usually the first teeth to appear, at about 6–12 months, with the lateral incisors, the teeth that sit at either side of the front two teeth, following a few months later.
At 6–7 years old, the process by which children shed their teeth begins. The roots of the lower incisors become loose, and the tooth wiggles, eventually falling out. The upper incisors usually follow and then, finally, the lateral incisors.
Generally, the upper lateral incisors fall out first, with the lower lateral incisors coming out afterward.
Molars help crush, grind, and chew food before swallowing. The first molars typically appear after a child’s first birthday at about 13–19 months. Second molars follow at about 25–33 months.
A child will usually develop first molars on the upper gums and then, shortly afterward, first molars on the lower gums. The second molars usually erupt on the lower gums first, with the second molars on the upper gums following.
Once a child reaches 9 years of age, they are likely to start shedding their molars over the next few years to make way for the permanent molars coming through at about 13 years of age.
The canine teeth are the sharp pointed teeth on either side of the four front teeth. They are essential for ripping and tearing food. Children and adults have four canines — two at the top and two at the bottom.
Canines typically erupt on the upper gums at about 16–22 months of age, with the lower canines appearing afterward. A child may lose their lower canines before their upper canines, at about 9 years old. This makes way for the permanent canines that emerge at around the same time.
All children are different, and some will lose their teeth earlier or later than average.
Early tooth loss in children
Some children will lose their baby teeth at a younger age than other children, particularly if these teeth came through earlier than average. However, premature tooth loss in children may be a symptom of dental caries, or tooth decay, requiring treatment from a dentist to prevent further tooth loss.
A dentist can show a child and their parents or caregivers how to properly brush and care for the teeth to prevent tooth decay. Dentists can also fill holes to prevent further damage and apply dental sealants or fluoride varnish to protect the teeth.
In rare cases, premature tooth loss can be an early warning sign of certain health conditions that require urgent treatment.
For example, a
- Papillon-Lefèvre syndrome: A rare genetic disorder that can develop at 1–5 years. It can cause inflammation and degeneration around the teeth, destroying the tooth support and causing tooth loss.
- Chediak-Higashi syndrome: This rare inherited immune disorder, which usually occurs in childhood, can cause increased susceptibility to infections. These can include gum infection, known as periodontitis, which can lead to tooth loss.
- Hypophosphatasia: This rare genetic disorder causes calcification of the bones and teeth, making them weak and prone to early loss.
- Neutropenia: This rare congenital condition affects the immune system, leaving the body more vulnerable to gum and other infections and increasing the risk of tooth loss.
- Langerhans cell histiocytosis: This rare disease
can affectthe bones, including the jawbone, leading to increased tooth mobility and tooth loss.
Late tooth loss in children
Not all children lose their teeth at the same age. Some children may not start losing their baby teeth until they are about 8 or 9 years of age, so the range of what dentists consider “normal” is wide. A child whose teeth erupted at an older age may also lose their teeth later.
Sometimes, the delayed loss of primary teeth may have an underlying cause, such as a health condition, particularly if late tooth loss affects more than one tooth. The following rare conditions may cause a delay in the loss of milk teeth:
- Andersen-Tawil syndrome: This rare genetic disorder can cause distinctive facial and skeletal features in some cases. It can also cause dental problems, including a delayed loss of baby teeth.
- Osteopetrosis autosomal recessive 2: This rare, inherited skeletal disorder can increase bone density and growth, affecting how the teeth develop.
- Autosomal dominant hyper IgE syndrome: This rare immunodeficiency disorder affects the development of the skeleton, connective tissue, and teeth. Research suggests that
83%of people with the condition experience a delay in losing their baby teeth.
Anecdotally, the best thing to do with a wiggly tooth is to leave it to come out by itself. However, children tend to wiggle the tooth themselves until it comes out.
If a child or their parent or caregiver wants to try to remove a wiggly tooth, they can do this by grasping the tooth firmly using a piece of tissue or gauze and quickly twisting it to remove it.
The ADA recommends that children start seeing a dentist as soon as their baby teeth emerge. This helps children to relax and get used to oral examinations.
Just like permanent teeth, baby teeth can develop cavities and other problems. According to the Centers for Disease Control and Prevention (CDC), about
A dentist can show parents and caregivers how to brush their child’s teeth effectively and handle certain habits that can affect tooth development, such as thumb sucking. The American Academy of Pediatric Dentistry recommends visiting a dentist twice a year for a checkup.
Parents or caregivers who are worried about delayed tooth eruption or delayed tooth loss in a child should take them for a dental examination. However, the likelihood is that a child will lose their teeth eventually.
Children can begin losing their baby teeth as early as the age of 6 years and continue losing teeth until they reach 12 years of age. The order in which teeth appear is sometimes a marker for the order in which the child loses them.
Certain health conditions may cause teeth to fall out prematurely or delay the loss of baby teeth.
Parents and caregivers should take children to a dentist for twice-yearly dental checkups. They should also take the child to see a dentist if problems with the teeth occur between the regular checkups.