What if my Child’s Baby Teeth Aren’t Falling Out?
Children do not all lose their baby teeth on the same schedule. Most begin losing their first primary teeth at around age six, but starting somewhat earlier or later can still be normal. The sequence of tooth loss and whether permanent teeth are developing properly are often more informative than one particular birthday.
If your child’s baby teeth are not falling out when expected, there may be no cause for concern. However, retained baby teeth can sometimes be related to the position of the permanent teeth, crowding, a missing permanent tooth or another developmental issue. A visit for family and children’s dentistry in Oakville can help determine whether your child simply needs more time or should be monitored more closely.
A baby tooth that stays in place longer than expected does not automatically need to be removed. The appropriate next step depends on the child’s age, the tooth involved and what is happening beneath the gums.
When Do Children Normally Lose Their Baby Teeth?
Children generally begin losing their baby teeth at around five to seven years of age. The lower front teeth are often among the first to loosen and fall out, followed by the upper front teeth.
The process continues gradually throughout childhood. From approximately age six through 12 or 13, most children have a combination of baby teeth and permanent teeth. This stage is known as mixed dentition.
The canine teeth and primary molars are usually lost later than the front teeth. By around age 12, many children have lost most or all of their baby teeth, although the timing can vary.
The order and pattern matter. A child who started getting baby teeth later than average may also begin losing them later. It is also possible for a child to lose several teeth close together and then go through a period with little visible change.
The Government of Canada provides a helpful guide to the development and loss of children’s teeth. Tooth charts provide general ranges, but they are not deadlines that every child must follow exactly.
Why Baby Teeth May Not Fall Out
A baby tooth normally loosens as the developing permanent tooth resorbs, or gradually dissolves, its roots. Once there is very little root structure remaining, the baby tooth becomes loose and eventually falls out.
If that normal process does not occur, one of the following factors may be involved.
1. The Permanent Tooth Is Erupting in a Different Position
Sometimes a permanent tooth begins erupting behind or in front of the baby tooth instead of directly beneath it. Parents often call this appearance “shark teeth,” particularly when it happens behind the lower front teeth.
Because the permanent tooth is not directly beneath the baby tooth, the primary root may not dissolve as quickly. The baby tooth can remain in place while the adult tooth becomes visible in a second row.
This situation does not always require immediate treatment. If the baby tooth is becoming increasingly loose, it may still fall out naturally. A dentist should assess it if the baby tooth remains firm, the permanent tooth continues to erupt, or there does not appear to be enough room.
2. There Is Not Enough Space for the Permanent Tooth
Crowding can affect the path a permanent tooth takes as it comes into the mouth. If there is limited space, the tooth may erupt at an angle, remain partially trapped or appear outside the usual dental arch.
Crowding does not necessarily mean that a child will need braces immediately. The dentist will consider the child’s age, jaw growth, eruption pattern and available space. When appropriate, the child may be monitored or referred for an orthodontic assessment.
3. The Permanent Tooth Is Missing or Delayed
Some children are born without one or more permanent teeth. When there is no permanent tooth developing beneath a baby tooth, the usual root resorption process may not occur, allowing the baby tooth to remain in place much longer.
A permanent tooth may also be present but delayed, impacted or following an unusual eruption path. Dental X-rays may be recommended when clinically appropriate to confirm whether the permanent tooth is developing and where it is positioned.
4. The Baby Tooth Is Ankylosed
An ankylosed baby tooth has become fused to the surrounding bone. It may not loosen normally and can appear lower than the neighbouring teeth as the jaw and surrounding teeth continue to develop.
Ankylosed teeth need professional monitoring because they can affect the available space or the eruption of the permanent tooth. Treatment depends on the child’s development, the tooth’s position and whether a permanent replacement is present.
What Should Parents Do?
If your child’s baby teeth seem late to fall out, start by looking at the overall pattern rather than focusing only on age.
Check Whether the Tooth Is Loose
A loose baby tooth is usually a sign that the natural shedding process is underway. Your child can gently wiggle it with a clean finger or tongue, but there is no need to force it.
A tooth that is still firmly attached should not be pulled at home. Avoid tying the tooth to string or using other methods that could cause pain, bleeding, root fracture or injury to the gums.
Look for a Permanent Tooth Coming Through
Check whether another tooth is appearing behind, in front of or beside the baby tooth. If the baby tooth is loose, the situation may resolve naturally. If it remains firm while the permanent tooth continues to erupt, arrange a dental examination.
Continue Regular Dental Visits
Regular examinations allow the dentist to follow your child’s eruption pattern over time. Comparing current findings with previous visits is often more useful than assessing one tooth in isolation.
If needed, dental X-rays can show whether permanent teeth are present, how they are positioned and whether crowding or another obstruction may be affecting eruption.
When Should You Contact a Dentist?
Consider arranging a dental assessment if:
- Your child is around seven and no baby teeth have started to loosen.
- A permanent tooth is erupting behind or in front of a baby tooth that remains firm.
- One side of the mouth is developing very differently from the other.
- A baby tooth remains long after the matching tooth on the opposite side has fallen out.
- The tooth appears sunken or lower than the surrounding teeth.
- There is significant crowding or too little space for an incoming tooth.
- Your child has pain, swelling, bleeding or signs of infection.
- A tooth became dark or stopped developing normally after an injury.
- You are concerned about your child’s overall eruption pattern.
These signs do not necessarily mean something is seriously wrong. They indicate that a dentist should examine the area and determine whether monitoring or treatment is appropriate.
Does a Retained Baby Tooth Need to Be Pulled?
Not every retained baby tooth needs to be extracted. If the tooth is healthy, functional and not interfering with the permanent teeth, the dentist may recommend monitoring it.
Removal may be considered when the baby tooth is blocking a permanent tooth, contributing to crowding, causing discomfort, affected by decay or interfering with an orthodontic treatment plan. If the permanent replacement is missing, keeping a healthy baby tooth may sometimes be beneficial.
The decision should be based on an examination and, where appropriate, dental X-rays. Parents should not attempt to remove a firm baby tooth at home.
Children’s Dental Care in Oakville
If your child’s baby teeth are not falling out as expected, Reflections Dental can assess their tooth development, available space and permanent-tooth eruption. Depending on the findings, we may recommend continued monitoring, an X-ray, removal of a retained tooth or an orthodontic assessment.
Our North Oakville dental office welcomes children and families from Oakville, Burlington, Milton and surrounding communities. If you have questions about your child’s teeth, request an appointment with Reflections Dental.
Frequently Asked Questions About Baby Teeth
Should I worry if my seven-year-old has not lost any teeth?
Some children begin losing teeth later than others, particularly if their baby teeth also appeared later. However, if no teeth have started to loosen by around age seven, it is reasonable to mention it to your dentist. An examination can confirm whether the permanent teeth are developing and following an appropriate eruption path.
Is it normal for an eight-year-old to have lost only a few teeth?
Yes, this can fall within normal variation. Tooth loss does not always happen at a steady rate. The dentist will consider which teeth have been lost, whether the corresponding permanent teeth have appeared and whether the overall development is reasonably symmetrical.
What should I do if a permanent tooth is growing behind a baby tooth?
Check whether the baby tooth is becoming loose. If it is, it may still fall out naturally. If the baby tooth remains firm or the permanent tooth continues to erupt behind it, book a dental examination so the position and available space can be assessed.
Should I pull my child’s loose tooth?
It is usually best to let a loose baby tooth fall out naturally. Gentle wiggling is generally fine, but do not force a tooth that is painful or still firmly attached. Contact your dentist if the tooth is causing ongoing discomfort or interfering with eating.
What happens if there is no permanent tooth underneath?
The baby tooth may remain in place because there is no permanent tooth to trigger normal root resorption. If the retained tooth is healthy, it may continue functioning for years. The dentist will monitor its condition and discuss longer-term options based on the child’s development.
