The process of losing primary, or deciduous, teeth is a predictable and natural stage of childhood development. These first teeth, which typically number 20 in total, serve the important functions of chewing, aiding in speech development, and holding the necessary space in the jaw for the underlying adult teeth. The shedding of these teeth marks the transition from a childhood dentition to a permanent one, preparing the mouth for the complete set of 32 adult teeth. This transition is a gradual process that unfolds over several years.
The Typical Timeline for Tooth Loss
Children generally begin the process of losing their first primary teeth around the age of six, a time that often coincides with the eruption of the first permanent molars at the very back of the mouth. This initial age is an average, and some children may begin shedding teeth as early as age four or as late as age seven without cause for concern. The entire process of replacing the 20 primary teeth with their permanent successors usually spans about six years, completing around the age of 12.
The lower central incisors, the two front teeth on the bottom jaw, are most frequently the first to become loose and fall out. The timing of when a child first got their primary teeth can often influence the timeline for when they lose them later. A child who got their first baby tooth later may also start losing them later.
The Sequence of Shedding
The order in which primary teeth are lost generally follows the same sequence in which they first emerged in infancy. After the initial loss of the lower central incisors, the upper central incisors are typically the next to be shed within the following year, followed by the lateral incisors around seven to eight years of age.
The teeth toward the back of the mouth are lost later in the process. The first molars and canines are generally shed between the ages of nine and twelve. The last primary teeth to be lost are the second molars, which fall out between the ages of ten and twelve, marking the end of the mixed dentition phase. This specific order ensures that space is maintained correctly for the developing permanent teeth beneath.
The Science Behind Tooth Loss
The loosening and eventual shedding of a primary tooth is a biological event initiated by the permanent tooth developing directly beneath it. As the permanent tooth begins its eruption, it applies pressure to the root of the primary tooth above it. This pressure triggers a natural process known as root resorption, where specialized cells called odontoclasts dissolve the primary tooth’s root structure.
The dental follicle surrounding the erupting permanent tooth is thought to release signaling molecules which stimulate this resorption process. As the root is dissolved, the primary tooth loses its anchor in the jawbone, causing it to become loose and eventually fall out without pain or significant bleeding.
When to Consult a Dentist
While the process of tooth loss is generally smooth, certain variations or issues may require a professional dental evaluation. If a child has not lost any primary teeth by the age of seven, or if they begin losing teeth significantly early (before age four), a dentist should be consulted. Early loss, often due to decay or injury, can cause adjacent teeth to shift, which may block the path of the permanent tooth.
A common concern is when a permanent tooth erupts before the primary tooth has fallen out, a situation sometimes nicknamed “shark teeth.” This usually happens when the permanent tooth emerges slightly behind the primary tooth, failing to fully dissolve its root. If a primary tooth remains firmly in place for several months after the permanent tooth is visible, a dentist may need to perform a simple extraction to prevent misalignment. Furthermore, if a primary tooth falls out and no permanent tooth emerges to replace it after a few months, or if a child experiences excessive pain, swelling, or signs of infection, it warrants a prompt dental visit.