Children lose 20 baby teeth in total. Every primary tooth that grows in during infancy and toddlerhood will eventually fall out and be replaced by a permanent adult tooth. This process starts around age 6 and typically finishes by age 12 or 13.
The 20 Baby Teeth and Where They Are
A child’s 20 primary teeth come in as a matched set: 10 on the top jaw and 10 on the bottom. Each jaw holds four incisors (the flat front teeth), two canines (the pointed teeth next to the incisors), and four molars (the wider chewing teeth in the back). All 20 usually finish coming in by about age 2 to 3, and every single one of them will be lost over the following decade.
Adults end up with 32 permanent teeth, so the mouth gains 12 additional teeth during the transition. These extras include premolars that didn’t have baby tooth predecessors and the wisdom teeth that arrive in the late teens or early twenties.
When Each Tooth Falls Out
Baby teeth fall out in roughly the same order they arrived. The lower central incisors, those two bottom front teeth, are almost always the first to go, usually between ages 6 and 7. The upper central incisors follow shortly after. The lateral incisors (the teeth flanking the front two) come out next, typically by age 8.
After a brief pause, the canines and molars start loosening. The first molars and lower canines tend to fall out between ages 9 and 11, while the upper canines and second molars are the last to go, often between ages 11 and 13. By age 13, most children have a full set of permanent teeth in place.
Keep in mind this timeline varies. Some children lose their first tooth at 5, others not until 7, and both are perfectly normal. Girls tend to lose teeth slightly earlier than boys. The most reliable pattern isn’t the exact age but the sequence: front teeth first, back teeth last.
What Happens When a Tooth Falls Out Too Early
When a baby tooth is lost on schedule, the permanent tooth beneath it is already pushing upward and fills the gap within weeks or months. But when a baby tooth is knocked out in an accident or pulled due to decay well before its replacement is ready, problems can develop.
Neighboring teeth tend to shift or tilt into the empty space. By the time the permanent tooth is ready to come in, it may not have enough room, leading to crowding or misalignment. Premature loss can also disrupt the natural sequence of dental development, sometimes creating orthodontic issues that wouldn’t have occurred otherwise. In these situations, a dentist may place a small device called a space maintainer to hold the gap open until the adult tooth arrives.
When Baby Teeth Don’t Fall Out on Time
A baby tooth that lingers past its expected window isn’t always a concern, but a few things can cause delays. The most common reason is simply that the permanent tooth underneath hasn’t developed enough yet to push the baby tooth out. This is often genetic, and some families just run late.
In other cases, the roots of the baby tooth don’t dissolve the way they should. Normally, as a permanent tooth grows upward, it gradually breaks down the root of the baby tooth above it until the baby tooth gets so loose it falls out. If the permanent tooth is growing in at an angle or is slightly off course, it may not apply enough pressure to trigger that process, and the baby tooth stays firmly rooted.
Crowding can also play a role. When there isn’t enough space in the jaw for the adult tooth, the baby tooth can get stuck in place. The permanent tooth may then erupt behind or beside the baby tooth rather than replacing it directly. Occasionally, the permanent tooth is congenitally missing entirely, meaning it never formed, and the baby tooth has nothing pushing it out from below. A dental X-ray can quickly clarify what’s happening beneath the surface if a tooth seems significantly overdue.
Helping Your Child Through the Process
A loose baby tooth rarely needs any help coming out. Encourage your child to wiggle it gently with their tongue. Pulling a tooth before it’s truly ready can cause unnecessary pain and bleeding, and it removes the tooth before the permanent one is close enough to fill the gap efficiently.
Once a tooth falls out, light bleeding is normal and usually stops within a few minutes with gentle pressure from a piece of gauze or a damp washcloth. The new tooth may take anywhere from a few weeks to several months to fully emerge, and it will look noticeably larger than the baby tooth it replaced. This is normal. Adult teeth look oversized in a child’s face but will appear proportional as the jaw grows.
Throughout the years of mixed dentition, when your child has both baby teeth and permanent teeth at the same time, the new permanent teeth are especially vulnerable to cavities. Their enamel is still hardening, and the uneven tooth surfaces in a transitioning mouth can trap food more easily. Consistent brushing matters more during this stage than almost any other.