Kids lose 20 baby teeth in total, 10 on the top and 10 on the bottom. This process starts around age 6 and typically wraps up by age 12 or 13, meaning most children spend about six or seven years cycling through loose teeth one by one.
Why 20 Baby Teeth and 32 Adult Teeth
A child’s full set of baby teeth includes eight incisors (the four front teeth on top and bottom), four canines (the pointed teeth next to the incisors), and eight molars (the flat chewing teeth in the back). Every single one of these 20 teeth will eventually fall out and be replaced by a permanent tooth.
Adults end up with 32 teeth because the permanent set includes 12 extra teeth that never had baby versions. Eight of these are premolars, which fill in the space between the canines and molars as a child’s jaw grows. The other four are wisdom teeth, a third set of molars that often don’t appear until the late teens or early twenties, and are frequently removed.
The Order Teeth Fall Out
Baby teeth generally fall out in roughly the same order they came in. The lower central incisors, the two front teeth on the bottom, are almost always first. They loosen around age 6, followed closely by the upper central incisors. Most kids lose all four front teeth between ages 6 and 8, which is why gap-toothed smiles are so common in early elementary school.
The lateral incisors (the teeth flanking the front four) typically come out between ages 7 and 8. After that there’s often a pause. The canines and molars tend to hold on longer, shedding between ages 9 and 12. The second molars, the farthest back in a child’s mouth, are usually the last to go, often around age 11 or 12.
This timeline varies quite a bit from child to child. Girls tend to lose teeth slightly earlier than boys. A child who got their baby teeth early will often lose them early too. Being a few months ahead or behind the typical schedule is completely normal.
What Happens When a Tooth Gets Loose
A baby tooth loosens because the permanent tooth beneath it is pushing upward, gradually dissolving the baby tooth’s root. By the time the tooth feels wiggly, most of that root is already gone, which is why baby teeth that fall out naturally look hollow at the base.
Most kids handle loose teeth on their own, wiggling them with their tongue or fingers until the tooth pops free. If your child asks you to pull a tooth that’s already very loose, the American Academy of Pediatrics suggests grasping it firmly with a piece of tissue or gauze and removing it with a quick twist. Teeth that are only slightly loose should be left alone. Pulling too early can cause unnecessary pain and bleeding because the root hasn’t fully dissolved yet.
Occasionally a baby tooth stays stubbornly in place even when the permanent tooth is ready. A dentist may recommend extracting it if the tooth hasn’t loosened on its own after several weeks or if it’s causing pain or swelling.
“Shark Teeth” and Double Rows
Sometimes a permanent tooth erupts behind the baby tooth instead of directly beneath it, creating a double row that looks a bit like shark teeth. This happens most often with the lower front teeth around age 6 or 7. In many cases it resolves on its own: once the baby tooth falls out, the tongue naturally pushes the new tooth forward into its correct position.
A dentist visit is a good idea if the double row persists past about age 7½, if the permanent tooth is growing in at a sharp angle, or if the baby tooth shows no signs of loosening at all. Removing the stubborn baby tooth gives the permanent tooth room to shift into place and helps prevent crowding.
When a Permanent Tooth Never Shows Up
A small percentage of children are congenitally missing one or more permanent teeth, meaning those teeth simply never developed. Studies estimate this affects roughly 5 to 13 percent of the population, depending on the group studied. The most commonly missing teeth are the second premolars and the upper lateral incisors.
When there’s no permanent tooth underneath to dissolve the root, the baby tooth may never loosen. Some people keep a retained baby tooth well into adulthood. If the baby tooth is healthy and functional, dentists often leave it in place. If it eventually weakens or falls out, options like a bridge or implant can fill the gap.
Taking Care of Gaps Between Teeth
After a baby tooth falls out, the empty socket usually stops bleeding within a few minutes. Having your child bite gently on a piece of gauze or a damp tea bag speeds this along. The permanent tooth may take anywhere from a few weeks to several months to fully emerge, so a gap in the smile is perfectly normal for a while.
The transitional period between baby and adult teeth is actually one of the most important times for dental hygiene. Newly erupted permanent teeth have thinner enamel than mature adult teeth, making them more vulnerable to cavities. Brushing twice a day with fluoride toothpaste protects these new teeth while they’re still hardening. Flossing becomes especially useful once the permanent molars come in and sit tightly against their neighbors.