Dr. Greg Jorgensen
(505) 891-9440
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.

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.

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

  1. Matthew says:

    Hi. I am 15 years old now and I still haven’t lost all my baby teeth. I have about six left to loose. I just lost one because the permanent tooth started to come in up under it. Other than that I haven’t lost a tooth in about 3-4 years. What should I do? Should I be worried?

  2. Shiny says:

    Hi.I am 18 years old.I have only 8 permanent teeth,the rest are baby teeth.Is it anything to worry? What should I do?

    • There definitely is a problem here. I would recommend getting an evaluation by an orthodontist who has an x-ray of you in his hand. By age 18, it is normal to have 28 permanent teeth

  3. Linda says:

    Hi, my daughter is 5.5. She lost 2 bottom central incisors 2 months ago. She didn’t have gap in her mouth before losing baby teeth. Her new permanent teeth came out and pushed the bottom lateral incisors. She lost her right bottom lateral incisor and the left one is wiggling. I brought her to dentist and x ray showed her lateral incisor root is still inside. The same with the wiggling tooth, the root is still inside but the crown is coming out soon. Permanent lateral incisors won’t come out until she is 6.5 or 7 and she will have 2 missing teeth for a long time. Should something be done? Should I bring her to orthodontist? Thank you.

  4. Sharon O'Beirne says:

    My eleven year old son who has Autism has just had seven baby teeth removed because of overcrowding. He hasn’t lost a tooth in years and still has his main front two teeth. How concerned should I be. He does not eat any chewy foods that would help loosen a tooth if he had one.

    • It sounds like your son is already in the care of someone monitoring his tooth loss (hence the reason that seven were removed). Continue having him evaluated regularly and don’t worry about the kinds of foods he eats being a factor. The foods don’t matter

  5. Harry says:

    I’m 12, and I’ve only lost 12 teeth; the 12th just a few minutes ago. Is this normal?

    • You are a little behind average. The best way to know what is going on with you specifically is to see an orthodontist who can take an x-ray and give you the best answer for you

  6. preeti says:

    My daughter is nearabout 8 yrs. and she has not lost a single tooth so far, however two tooth have started appearing at bottom just behind baby tooth . I am getting nervous if this is really worrisome. Please let me know what to do. I am planning for a dental visit soon. Thanks

  7. Lily says:

    Hi! I’m 13 years old, and I turn 14 in about 4 months. I still have seven baby teeth (I lost one just some minutes ago). I’m a little bit worried if I should go to the dentist to get an X-ray. Is it normal?

  8. Riley Mock says:

    Hi, i’m 12 years old and have only lost 12 of my teeth (4 on top and 8 on bottom) and two more are growing in now, and I only have one 12 year molar coming in. Am I behind at all?

  9. Nicole says:

    Hello. My daughter is six and hasn’t lost a tooth yet and there are no signs of any of them being loose.. I do know she is missing at least two permanent teeth from her dentist appointment. Do I need to take her to a orthodontist or just wait and see if they become lose on their own?

    • I would recommend that she be evaluated by an orthodontist after her 6-year-molars are fully erupted (usually about age 7). That is a good time for an orthodontist to begin monitoring her dental development.

  10. Nicole says:

    My son is 10 & has only lost 6 teeth, 4 bottom, 2 top. It’s been over a year since he lost a tooth. His dentist insists that it’s nothing to worry about, however his teeth are showing signs of heavy wear and tear,in cavities & grinding down. His dentist is the type that says leave the cavities alone in a baby tooth unless they are causing him pain, because they will fall out eventually. I don’t feel like losing his teeth at this slow of a rate is normal. Suggestions?

    • Your son is behind. He should have lost 8 by age 8. At this rate, he’ll be in high school before he loses his last baby tooth. I would consult with an orthodontist who can help “make the call” with (or for) your dentist to get his back on schedule.

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