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.

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

  1. Brienne says:

    My 9 1/2 year old son has lost his two front teeth and his four front bottom teeth. He has no additional loose teeth and a rather small mouth. His last dentist checkup we were informed that he was likely to need braces (which we expected since both my husband and myself needed them). I am concerned that he isn’t losing any additional teeth. Is it normal?

    • Your son is behind. What you are describing usually means that he is crowded and that is preventing the eruption of the permanent teeth. I think your dentist was right about braces in his future.

  2. Manali says:

    My daughter is 6 yrs 6 months old now. She got her first baby tooth at 13 months.I wanted to know when can I expect her baby tooth to fall off as there are no signs of it.please inform me if I need to consult a dentist for this problem or wait for her some days.

    • I would recommend that you start having your daughter examined by an orthodontist at age 7. By that time the orthodontist will be able to see what is going on and give you good counsel on how to best care for your daughter.

  3. betty says:

    My son is 8yrs 3 months and has not lost a tooth. The dentist says not to worry as he has 2 rows of shark teeth and they will fix his teeth in one go when he gets braces.

    I am worried though

    • If you’re dentist is not worried about your 8-year-old son who has not lost a single baby tooth, you need to get your son to a specialist. The presence of two rows of teeth is a clear indicator that there is a problem that needs help now. Get your son to an orthodontist. You don’t need a referral from your dentist.

  4. Heidi says:

    My son is 15. His 12 year molars have not come in. All of his baby teeth were pulled by a dentist starting when he was 9, except one that I pulled The front teeth and eye teeth came in inside of the baby teeth, and the premolars they finally pulled between his Freshman and sophomore year of highschool. He is clearly going to need braces as his bottom front teeth are turning sideways due to crowding. The dentist says they can’t do anything until the 12 year molars come in. As he is 15 is it possible that there is some reason that the molars have not come in, maybe they won’t, can they get stuck like wisdom teeth?

    • The eruption of any tooth in the mouth can be delayed or prevented by crowding. If your son doesn’t have enough room for the 12-year-molars, they may never come in. Only your doctor with an x-ray can counsel you.

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