A guide

What to do when your baby’s teeth start to fall out

 

Noticed a wiggling of teeth in your child’s mouth? They may be of the age where those baby teeth want to come out and adult teeth want to come in!

So, is there anything you should be doing at this stage to ensure the oral health of your child while their milk teeth fall out? 

Think your baby isn’t old enough for adult teeth yet?
Check out our guide on how to look after new baby teeth instead.

 
 

In this guide

 

When do baby teeth start to fall out?

By the time your child is around two or three years old, they will have a full or nearly-full mouth of 20 baby teeth, also known as milk teeth. These teeth will help their faces develop properly, and also their ability to speak.

But as they get older, their teeth will start to fall out again to be replaced by permanent adult teeth, of which they will eventually have 28 (32 including wisdom teeth, but those come in much later).

As your child turns six years old, you can expect their baby teeth to start to fall out.


In what order do baby teeth fall out?

Typically it is a child’s central teeth that fall out first – those central and lateral incisors, aka, their four middle teeth on both the upper and lower jaw.

From around the age of seven onwards, more teeth will start to fall out towards the back. Children usually lose their molars at around the ages of nine or 10.

By about 12 years old, most children will have lost all of their milk teeth, to be replaced by adult teeth.

What about wisdom teeth? Your child shouldn’t expect to see those until they’re well into their teens, in the vicinity of 17 years or older (usually they come through between 17 and 25 years).

That said, every child is different. You may see teeth fall out at different stages, and that’s OK. Of course, if you’re ever worried you should see a dentist as soon as possible so they can check in on your child’s development with an expert eye.

Common complications and concerns with baby teeth falling out

Baby teeth not falling out

There are some adults out there who never lose some of their baby teeth. This is known as retained primary teeth, or retained baby teeth – a condition where a child does not shed their milk teeth as expected, and keeps them on into adulthood.


So why does this occur?

Well, typically it’s because there’s no adult tooth there to replace the primary tooth. This could be because it never developed in the first place, or because some kind of injury or infection has prevented its eruption.


Is it a problem?

For most people the problem is aesthetic, but there can be clinical concerns with retained milk teeth.

If your child retains some baby teeth to adulthood, their smile may appear crooked or unusual as there are smaller teeth in there than normal, and the surrounding adult teeth may shift to fill the gap.

A more worrying concern would be that baby teeth tend to have shallower roots than adult teeth and may be more prone to falling out. This would create a gap in the mouth, which could cause complications of its own. Your dentist may recommend the removal of your child’s retained teeth if that appears to be a concern, otherwise if the roots are healthy and strong then it’s no issue to leave it in – again, just an aesthetic problem.


Baby teeth falling out and there’s no adult tooth to replace it

Everybody develops differently, and sometimes baby teeth fall out a little early – meaning there’s no adult tooth there yet to replace it. This tooth will grow eventually, it’s just been caught by surprise (perhaps as a result of injury, for example).


Is this a problem?

It can be. If a baby tooth falls out too early, the surrounding adult teeth (if present) may drift over to fill the gap. Should this occur, it could block the adult tooth from erupting properly, so that it erupts into bone instead of gum. The changing formation of their teeth could also cause a child’s bite to become crooked.

The best thing to do if you believe your child’s tooth has come out too early is to get them to a dentist as soon as possible. Fixing drifted teeth can be expensive, whereas it’s much less costly to get a checkup, receive professional advice, and perhaps install a space preserver to keep the opening clear for the tooth to come up in its own time.


Adult teeth growing in behind baby teeth

Occasionally, adult teeth may erupt before your child’s baby teeth are ready to fall out, meaning they have both teeth at the same time – in two rows. Some people call this having ‘shark teeth’, two teeth one behind the other like a shark’s mouth.


Why does this occur?

When adult teeth develop beneath the gums, they usually dissolve and disconnect the baby teeth from the roots so that they become loose and fall out. Then, their permanent teeth can move up and erupt in the exact same spot.

Sometimes, though, this doesn’t happen. If the adult tooth can’t disconnect the baby tooth, it may be forced out a different part of the gum because it still has to go somewhere. It’s common for this to be seen in children whose mouths don’t have enough space yet, but there are many reasons it can occur and it’s quite normal.


Is this a problem?

For the most part it’s not going to cause huge problems because the mouth might fix itself. You can ask your child to give their baby tooth a wiggle to see how loose it is – if it’s loose, they might be able to encourage it to loosen further. It may then fall out on its own.

If it feels strong, you’ll need to take your child to the dentist. Doing nothing may lead to complications down the track, but your dentist can best guide you on what needs to be done – it may be doing nothing, it may require a tooth extraction.

  • Note: It’s common for teeth to act in pairs. If one adult tooth forms that ‘shark tooth’ second row, it’s possible the tooth’s counterpart on the other side of the mouth may do the same. Some dentists recommend waiting before going in to see a specialist to see if the other tooth will also come up early, to save on booking two appointments instead of one.


Difficulty chewing/brushing while baby teeth falling out

Baby teeth coming loose and falling out can be a process which takes months. During this time, you may find that your child feels a little discomfort or difficulty when chewing or brushing their teeth.

There isn’t a whole lot that can be done about this because milk teeth coming loose and falling out is simply a natural part of the development process. To relieve any discomfort or frustration, encourage your child to eat on the other side of their mouth to any loose teeth or perhaps offer them softer foods for a time.

As for brushing, you can’t stop cleaning that part of the mouth just because the tooth is loose. Indeed, any build-up of bacteria now could put them at greater risk of infection as a new tooth erupts.

Until the tooth comes out, that part of the mouth will have to be brushed more gently. A light but thorough brush will keep the area nice and clean, reducing the chances of your child developing a condition such as gingivitis.

Learn more: Gum disease

Should you pull loose baby teeth?

The short answer? No.

Pulling a tooth before it’s ready to fall out can injure the gums in that area, or the surrounding teeth. It may also contribute to your child’s risk of getting an infection, which could cause even more complications.


So is it ever OK to pull a baby tooth?

If the tooth is particularly loose and causing a lot of discomfort as a result, you may be able to see if you can get it out.

You should only pull a tooth if it’s ready to come out. To check, ask your child to apply pressure to their tooth, or apply it yourself with clean hands. If they feel pain, that’s a sign the roots haven’t dissolved enough yet and aren’t ready. If there’s no pain, it may be OK to pull.

To pull safely:

  • Wrap a tissue around the tooth

  • Squeeze gently

  • It should pop out easily.

What to do with a baby tooth when it falls out

  • It may bleed at first: This is normal! It’s very common for the gums to bleed a little when a baby tooth falls out. Ask your child to rinse their mouth with water and, if it keeps bleeding, bite down on either a piece of gauze or a clean towel. It should stop within an hour or so.

  • Clean the mouth: A quick saltwater rinse could go far here to ensure your child’s gums are nice and clean now that the tooth has come out (and there’s a small open wound). Add a small amount of salt to lukewarm water (half a teaspoon per cup of water) and have your child swirl it around their mouth. It might be uncomfortable, but it can help.

  • Is it swollen? In some situations the remaining gums may be swollen as a result of the lost tooth, perhaps if it came out before it was ready. Children’s ibuprofen can help here, but make sure to talk to your pharmacist or dentist before giving your child any medication for their mouth. You’ll need to get the dosage right and ensure you’re giving them the right thing. If you’re ever worried about swelling, see a dentist.

  • Celebrate! This is a fun milestone in the development of your child’s mouth and is worth celebrating. Some children feel scared when their first tooth falls out, so making it a happy occasion could go far to making them feel comfortable and happy, and ready for the rest of their baby teeth to follow suit.

Oral health care tips for new adult teeth

As children get into the six-seven years old age group, it’s time to start getting them to brush their own teeth (if they aren’t already). You’ll need to supervise them at first to make sure they do it right, but if you’ve been keeping up with their oral health care and especially if you’ve been explaining some of what you’re doing, at this point they should have a good idea of what to do and why.

However, here’s a quick checklist to make sure you know what they should be doing to keep their outgoing baby teeth and incoming adult teeth nice and healthy!

  • Brush twice a day for two minutes each time. Usually this would be in the morning and right before bed.

  • Use a toothpaste containing fluoride. There’s plenty of children’s toothpastes out there that contain fluoride and also have interesting flavours to keep it interesting for your child.

  • Don’t forget the backs of the teeth as well as the front!

  • Encourage your child to also brush their gums, using little side to side (vibrating) motions along the gum line, holding the brush at about 45°.

  • They should also brush their tongue gently, as bacteria can build up here too.

  • It’s OK for children to floss, and this can be a great way to remove hard-to-reach debris and inhibit the growth of bacteria. You’ll need to help them at first with this, and possibly for a few years more until they get the knack.

  • If your child is over the age of six or seven, they can usually start to use mouthwash – supervised, of course, to ensure they rinse and spit correctly, and don’t ingest any of the liquid. Look for an antibacterial mouthwash for kids that is alcohol free.

Should my kids get a fissure sealant?

What is a fissure sealant?

A fissure sealant is a special plastic coating that can be applied to your child’s teeth, usually the molars, to help protect them from decay.

The chewing surfaces of these teeth have lots of grooves that can be a little tricky to brush, especially as some of them extend down right into the tooth. If any food particles get stuck in here and bacteria grows, this can cause tooth decay.

Fissure sealants do what they say! They seal these grooves up to protect the teeth and make them easier to brush.


Does my child need one?

Not every child needs fissure sealants. Typically they are applied to children with teeth that contain particularly large grooves, or grooves a dentist feels may be more susceptible to decay.

The procedure itself is quite easy! It requires no anaesthetic and causes no pain, in fact it’s actually quite quick - like painting the tooth with the sealing plastic.


Where do they get one?

If you’re worried about your child’s oral health, their risk of tooth decay, or you're just curious, talk to your dentist about fissure sealants.

That said, if you’re taking your child in for a regular dental check-up chances are your dentist may recommend such a procedure even before you ask – because they’ll be watching your child’s development and keeping an eye out for risks such as large grooves.

Is dental care free for kids?

In New Zealand, basic dental care may indeed be free for your children.

Kids up to the age of 17 can often access certain dental treatments without cost, such as check-ups, x-rays and minor procedures (including fissure sealants). Anything more complicated would come with a cost, such as orthodontics.

But, not all dentists are funded by the government to provide free children's dental care. If the dentist near you isn’t in such a position, that may charge for basic services (depending on the age of your child and the funding they do/don’t receive).

That said, even if they aren’t funded some dentists still try to offer low-cost children's dentistry, or payment plans and credit card deals to help parents pay off these important bills.

Learn more: 
— Our prices here at Kowhai Dental
— Affording the dentist on a budget

Need a dentist in Whangarei? We’re here for you

Kowhai Dental is located on Maunu Road here in Whangarei and we’re open five days a week (Mon-Fri) and ready to help you and your child.


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