Dr. Greg Jorgensen
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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.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

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

  1. shaminah says:

    i am 17 and i still have 4 baby tooth. i also have an extra tooth growing in my top gum. my dentist in school suggested that i should go for a X-ray and get braces as my other adult tooth are irregular too :-( what am i supposed to do?

  2. jomhel says:

    Hi!im jomhel and iam 14 years old now.my problem is a have still 4 remaining milktooth and i go to the dentist and xray it the result is no one is developt to replace the remaining tooth and my wisdom tooth. does not also developt.Thank you..what is the best thing that i will you.

    • Orthodontists work with dentists to put the teeth in the best location so that missing ones can be replaced. I would visit with an orthodontist so that he can help you develop a treatment plan for how to replace your missing teeth.

  3. Andrea says:

    My 10year old has only lost 2 milk teeth and the others are showing no sign of moving! We have had two X-rays and all the secondary teeth are there but not moving. Our dentist says it’s very unusual but that we should not look to pull them out yet. The two secondary teeth which have grown are very crooked and set quite far back. Should we be worried?

  4. 12-23-34 says:

    I have all my back baby teeth and two k-9 teeth left im almost 13!! Is it good or not?

  5. Julia says:

    My son is nearly nine and has all his milk teeth. One is wobbly in the front. Dentist was not concerned but I am- it has been wobbly for four months and has not fallen yet. Shall I ask for an xray? Thanks.

  6. Cate says:

    Help!! I am 14 and I lost my canine tooth 2 months ago and The adult tooth hasn’t grown in at all. It’s embarrisig because my 8 year old sister just lost the same tooth. Everyone at schools makes fun of me. When will it grow in?

    • Only a dentist with an x-ray in his hand can answer that question. It may be that the adjacent teeth are too close together and they are preventing the eruption of the permanent canine.

  7. Aza mohammed says:

    Hi there
    My son is 6 years old and his primary teeth are intact and there are no signs any of them are falling. Should I be worried

    Many thanks

    • You should not worry yet, but I would plan on taking him to see an orthodontist at age 7 as recommended by the American Association of Orthodontists just to make sure everything is OK.

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