What do you do when your child loses their first tooth?

The loss of your child’s first tooth is one of the many milestones to be remembered and celebrated. While losing primary (baby) teeth is natural, it is very common for parents to have questions about the process. Here are some of the most commonly asked questions around losing baby teeth:

• What age does my child start losing teeth?
• Does it hurt to lose baby teeth? 
• Is bleeding normal?
• When will the permanent tooth replace the baby tooth lost?
• What happens if a baby tooth is lost due to trauma or decay?

What age does my child start losing teeth?

Baby teeth are naturally lost because of the resorption process. Resorption occurs when the unerupted permanent tooth begins to resorb the primary tooth's roots. This leads to pushing the baby tooth out. 

Children typically begin to lose teeth around the age of 6 and last through the early teen years (ages 10-13). It is important to remember every child's growth and development is different; therefore, tooth eruption and exfoliation charts are based on ranges. Often the bottom front two teeth (central incisors) are the first to naturally become loose and exfoliate (fall out), with the primary second molars being the last to fall out. 

Does it hurt to lose baby teeth? Is bleeding normal?

As your child grows and develops, baby teeth will begin to loosen naturally. Some children are eager to remove a loose tooth, while others prefer to let it stay in the mouth as long as possible. If a tooth is pulled before it is ready, there may be some discomfort present, along with greater bleeding and the potential for infection. It is best to let the tooth loosen as much as possible before wiggling it out. You may assist your child in wiggling out a baby tooth once it has become very loose by placing a tissue or gauze around the tooth and either squeezing or twisting it back and forth if your child is comfortable with this. If a loose tooth is causing difficulty with eating or brushing, consider scheduling an exam with your dentist. 

If a baby tooth has become loose enough, there will likely be minimal bleeding associated with its loss. Some bleeding is normal and can be minimized by having your child bite down on a damp cloth covering the empty socket from the missing tooth. A warm salt water rinse can help soothe and heal the gum tissue from where the tooth has been lost. It is important to keep the socket clean with gentle brushing. If your child has a bleeding condition, be sure to speak with your medical and dental providers before assisting with removing any teeth. 

The gum tissue surrounding a loose or recently lost baby tooth may become swollen and tender, especially if plaque buildup is present. If there is swelling or discomfort, you may try an over-the-counter anti-inflammatory medication, such as Ibuprofen. Be sure to contact your dentist if the swelling persists, your child is uncomfortable or avoids eating or brushing in that area.

When will the permanent tooth replace the tooth lost?

Sometimes a permanent tooth may begin erupting before the baby tooth falls out. This is especially common for the bottom front teeth (central incisors), and it may appear that your child has two rows of teeth. If this occurs, once the baby tooth falls out, oftentimes, the tongue will naturally force the permanent tooth to move forward. This may not happen if there is limited spacing and crowding of the teeth. If a baby tooth does not become loose despite the permanent tooth erupting, be sure to contact your dentist.

As mentioned earlier, each child’s growth and development are unique. There is no set schedule for when a baby tooth is lost or when the permanent tooth erupts. If you are concerned about your child’s dental eruption, it is best to schedule a dental exam. Certain types of growth and development dental x-rays, such as a panoramic radiograph, allow you to see what teeth are present and where they are positioned.

There are certain cases when a permanent tooth will not replace the baby tooth, such as a congenitally missing tooth. Congenitally missing teeth are not uncommon, and genetics do play a factor. Baby teeth without a permanent counterpart may stay in the mouth much longer or never loosen. Your dental provider may recommend an orthodontic consultation if your child is missing permanent teeth.

What happens if a baby tooth is lost due to trauma or decay?

Baby teeth may become loose or lost due to other factors outside of the natural process. Research has shown that 18% of the physical injuries in children under the age of six are considered to be traumatic dental injuries. The mouth is considered the second most common site of injury in children. If your child encounters an injury to the mouth, it is best to seek care from your dental provider to ensure the tooth is cared for properly.

It is important to remember that baby teeth are the placeholders for permanent teeth. Baby teeth affected by decay (cavities) may need to be removed prematurely, especially if there is a risk of infection or the cavity is too large to restore with a dental material. If this occurs, your dental provider may discuss options to maintain the space from the lost tooth until the permanent tooth has developed fully and erupts into the mouth. Additionally, losing a baby tooth too soon can result in teeth shifting. If your child loses a tooth prematurely, it is important to consult with your dental provider.

Remember to celebrate losing baby teeth!

Did you know the legend of the tooth fairy dates way back to the European Middle Ages and has been recognized modernly since the 1920s. The tooth fairy plays a big role in recognizing this big step in your child’s life, enough that the tooth fairy is given their own national holiday twice each year.  “National Tooth Fairy Day” is celebrated annually on February 28th and August 22nd. 

You may be wondering why is the tooth fairy celebrated twice during the year? The tooth fairy helps promote good oral hygiene and dental health. Dental exams and cleanings are recommended twice annually, averaging six months apart from each other. National Tooth Fairy Day is a reminder to schedule your child’s bi-annual routine dental check up. 

Once your child begins losing baby teeth, it is important to reinforce the importance of good oral hygiene for those permanent teeth. Remind your child that permanent teeth will be with them forever. This means brushing, flossing, maintaining a diet low in sugar, and seeking routine dental care is that much more important! Remember to seek out oral care products that are age and size appropriate. This extra soft bristled kids toothbrush has a brush head sized appropriate for baby teeth and gentle enough on the gums for those newly erupting permanent teeth. 

About the author: Kristen Cockrell, MS, RDH

Kristen Cockrell is a mother to two boys and a Registered Dental Hygienist with a passion for preventive pediatric dentistry and oral health education. Kristen recently completed a master’s degree in dental hygiene education at the University of North Carolina at Chapel Hill.

References:

1. Petersson EE, Andersson L, Sorensen S. Traumatic oral vs non-oral injuries. Swed Dent J. 1997;21:55–68.

Photo credits to our beautiful Grin mama @_thestraightupmama