It’s a major milestone in a baby’s development during that first year of life when that first baby tooth starts to peek through the gum, a jagged white lump. Every baby book has a spot to record the first tooth alongside the first steps and first words. It can be almost as exciting when those long-awaited baby teeth start to fall out, necessitating the arrival of the tooth fairy. The magic moment when the baby tooth is tucked away for the night and replaced by money or some other small token is a joyful happening for parents and youth alike. But what happens when the tooth comes out too soon? What happens when losing a tooth causes anxiety instead of joy? What’s to be done then?
It’s helpful to understand the process of losing teeth to know if the baby tooth is actually coming out too early or not. Babies start to develop their first teeth well before they are born, at about 6 weeks of development in utero, and develop the hard enamel layer somewhere around 12-16 weeks of development. After the baby is born, those eagerly awaited pearly whites start to peek through the gums at some point between 4 and 12 months, starting with the bottom front teeth. When it’s time for a child to lose their teeth, those bottom front teeth that were the first to arrive will probably also be the first to make an exit.
What Causes Teeth to Fall Out?
In the natural scheme of things, a child’s permanent teeth grow in behind the baby teeth. Eventually, the permanent teeth grow behind the baby teeth, pushing on the roots of the baby tooth. This pressure and a biological cue tell the root to dissolve, causing a loose tooth. After some wiggling, the tooth will fall out, with a permanent tooth growing in shortly after.
Of course, sometimes teeth are lost in other than the natural way. A fall, a collision, a sporting mishap, or another type of accident can lead to an injury that causes a tooth to fall out too soon. In fact, almost half of children will have a tooth injury, so if it’s happened to your child you can take comfort in knowing your dentist has probably seen it all before and will definitely know what to do. Untreated decay in a baby tooth can also cause a baby tooth to become so damaged it needs to be removed to prevent serious complications, prevent further infection, or treat pain in the child’s mouth.
So What’s the Time Frame?
Did you wait a long time to see your baby’s first tooth? Was your little sweetie’s first tooth the first in your baby playgroup (library story hour, daycare center)? You may remember that there is a range of normal, from about 4 months old to 12 months old, for the first baby tooth to make its appearance. Similarly, there is a range of normal for the first teeth to start falling out. While most children start losing teeth around age 6, that’s not an absolute time for all children to start losing teeth. A child who started teething at a younger age is more likely to lose teeth at an earlier age, much like children who start teething later may not start to lose teeth for another year or so after age 6.
In the event that a child loses a baby tooth before the permanent tooth is likely to make a timely appearance (an x-ray done in your dentist’s office can show if a permanent tooth is nearby), it’s incredibly important to have your child evaluated by a dental professional. Early tooth loss can cause shifting in the teeth that remain. If the teeth block the space that the permanent tooth needs to grow in, it can block the permanent tooth from growing in properly, leading to expensive orthodontic issues and/or impacted teeth—teeth that grow into the bone instead of out the gums properly. Bite problems are also possible when a child loses a tooth early.
If your dental team sees a possible problem from the early tooth loss, they may recommend a space preserver to keep the opening until the permanent tooth is able to grow in. A consultation with an orthodontist may also be recommended to help correct a shift in the bite before it causes jaw problems or discomfort.
Homecare is incredibly important for all children who are losing their baby teeth regardless of the reason the teeth have been lost. Encourage children to brush at least twice a day with a high-quality toothpaste to preserve the health of the remaining teeth and to take excellent care of the newly arriving permanent teeth. With a little attention and the right care, your child can build habits that will help those new teeth properly last a lifetime.