Dr. Greg Jorgensen
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1401 Barbara Loop SE
Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

Why Aren’t My Child’s Baby Teeth Falling Out?

Posted by Dr. Jorgensen on October 20th, 2011

Missing front toothParents often worry that something is wrong when a child’s baby teeth do not fall out as expected. Although there are some developmental issues which require professional attention, most of the time everything is just fine. What should parents expect when it comes to their children losing baby teeth?

Baby teeth serve several purposes besides chewing. Primary teeth give rise to the permanent teeth and preserve space for them until they are developed enough to come in. If the baby teeth come out too early, space can be lost causing crowding of the underlying permanent ones. At the other extreme, baby teeth that are not lost on time can force the permanent ones to come in crooked creating a more difficult orthodontic condition.

The most common reasons for primary teeth to be lost early are decay, trauma, and crowding. If a tooth has to be pulled because of disease or is lost due to trauma, your dentist is usually already involved. If the teeth are crowded, your child may lose two primary teeth naturally to accommodate the eruption of a single larger permanent tooth. If baby teeth are lost prematurely, an orthodontist should be consulted to see if a space maintainer is needed.

There are several conditions which prevent the baby teeth from falling out on schedule. If the underlying teeth are crowded, they may not be able to push out the overlying baby teeth. Baby teeth with no underlying permanent replacements may be retained indefinitely. Extra teeth can block the normal eruption of the regular permanent ones. With a simple x-ray, your orthodontist can tell you if there really is a problem or if your child is just developing slowly.

The most common reason for parents’ concern however is just misunderstanding the normal sequence of tooth loss in their developing child. The first baby teeth are usually lost at about six years of age. Some children may lose theirs as early as five or as late as seven and neither variation is a problem. By age eight, the average child will have lost eight baby teeth; four front teeth on top and four front teeth on the bottom. Again, a variation of a year in either direction is nothing to worry about. Between the ages of eight and ten there is not much change in the number of teeth. In other words, it is normal for a child to lose eight teeth in a row and then stop for about two years! (It is during this two-year “break” that it is best to provide interceptive orthodontic treatment if it is needed.) Around ten years of age the remaining teeth begin to loosen and fall out. The average adolescent loses their last primary tooth before they are 13 years old. The 12-year-molars also make their appearance during that 12th year (hence the name).

Most questions about delayed tooth loss come during that two year span between eight and ten where no teeth are lost. Such inactivity is unexpected by parents but completely normal. In my practice I don’t worry about delayed tooth loss unless I can see that 1) the retained primary teeth are causing problems for the incoming permanent ones, 2) the 12-year molars are already erupted, or 3) the delayed tooth loss will cause orthodontic treatment to be started at an awkward age (i.e. the junior and senior years of high school). An important service that your orthodontist can provide is monitoring the dental development of your child and counseling with you about the need to have primary teeth removed if that should be necessary.

213 comments so far in response to “Why Aren’t My Child’s Baby Teeth Falling Out?”

  1. Carson says:

    Hello, I’m currently about 13 1/2 and I got a cavity in my left side second miller and I’m not sure if It’s permanent or not I can not remember but should I just let it fall out. Or go to the dentist?

  2. Alexis says:

    Hello, I’m about four months shy of 14, and I have 8 baby teeth left, and I NEED braces. I haven’t lost a tooth in six months, and before that one was about a year. What can I do to lose my teeth? None of them are loose, seriously. I brush twice a day and floss before bed. I have a lingual holding arch on the bottom of my mouth because I was getting adult teeth growing behind my baby teeth that I should have lost so the said adult teeth could have grown there. I just went to the orthodontist and he seemed quite puzzled as to why I haven’t lost more teeth. My brother is 11 and he only has four teeth left to lose. Is this simply because everyone is different, or could there be an issue? Also, I was born about nine weeks early. Thank you :)

    • Everyone is different and it sounds like you are under the care of a doctor who is keeping his eye on you. If you want to hurry things along a little more, you could ask your orthodontist to refer you to get the remaining baby teeth removed. It may not be necessary, but it could save you a year or two of waiting to get your braces started. Even if you start next year, you’ll be 17 before you get your braces off as it is!

  3. Anna says:

    Hi. My daughter is 5 years old, her teeth are looking good so far, no cavity, last time we took her to a clinic she went and had her teeth checked, the dentist was not sure but suspected that she has deep cut but this was to be confirmed by a specialist dealing with deep cuts. should i be worried? what is deep cut?

  4. stella says:

    i am over 40 and i haven’t lost my milk teeth, but my teeth still goes strong , never had a teeth problem , should i be worried ?

    • Hi Stella. Not loosing your primary teeth is not dangerous or anything, but it is interesting. I would love to see and xray (speaking figuratively) of you to see why you haven’t lost them. I one had a patient that was missing all but 6 of his permanent teeth. It is possible that you never developed any permanent teeth.

      • Phillip T. says:

        I to am over 40 and still have all but a couple of milk teeth. I had xrays around 12-13 yo. and there were no more permanent teeth in there. For a long time I thought I might be the only one, but turns out my wife was the same way and our daughter turned out that way too. I found this site as I was searching to see if there was a name for this condition.

  5. Rajan Nanda says:

    Hi Dr. Greg.

    My child is 7.5 years old now. The two top milk teeth of his are not falling out even though the permanent primary tooth have already come out considerably. One of the permanent top tooth which has erupted has thrown the milk tooth protrude outwards to the extent that it is hurting his upper lip. However the local orthodontics have recommended that the milk teeth will fall on its own and we should not take it out surgically. Kindly please advise.

    Regards

  6. Bri says:

    Im 11 and my adult teeth are growing behind my baby teeth and the baby teeth are a little loose but wont budge. I think I may need braces but they said I have o wait until I loose enough teeth. What do I do?

    • If you have baby teeth and permanent teeth next to each other, you’ll probably need some help getting the baby ones out. I would get into see an orthodontist so he can help you devise a plan.

  7. Mariano says:

    This might be different and feel regrets the more I read about this, but I’m 20 now and have permanent behind two baby teeth still. Growing up my family didn’t grow with much money so I got my situation checked and was told to wait for the teeth to loosen then come back but we assumed I can lose the baby teeth and naturally push the permanent teeth forward. We’ll time passed and nothing happened, the fact that I had teeth behind others never bothered me and never saw it as an issue (basically forgot or learned to live with them). This just changed when I was having dinner (nothing hard or chewy), I heard a snap and my baby tooth was bleeding a little. The tooth wiggles a little but feels like effort will be required to be taken out. My other baby tooth still feels as solid as the rest. Now my question is, can I still fix this or did my adaptation hurt my teeth permanently?

    • There is very little than cannot be fixed at your age Mariano. It sounds like one of your remaining baby teeth just snapped. An orthodontist can help you devise a plan that would include the removal of the remaining baby teeth and shifting the appropriate ones froward to where they should be.

  8. Maggie says:

    Hi! I’m 13 and I have only lost one or two molars, I’ve lost all my front teeth but nothing else really. None of them feel loose either. Is this something I should be worried about?

  9. Alisa says:

    Hi! I’m Alisa and I’m 14. For some reason, I still have quite a lot baby teeth left. Also, one of my teeth fell out about a year ago and the new tooth grew a little, and then it stopped growing at all. Now, a year later, it is still just a tiny little tooth. By this time, normally a tooth should have probably completely developed, but this one isn’t even nearly developed. Do you know what is the problem here with my strange teeth?? Thank you so much!! :)

    • What you are describing sounds like crowding that is preventing the eruption of the underlying teeth, even when the primary ones are removed. Only a dentist with an x-ray can tell you what is actually happening in your mouth.

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