Children lose 20 baby teeth in total. Every child is born with a full set of 20 primary teeth hidden beneath the gums, and each one will eventually fall out and be replaced by a permanent tooth. This process starts around age 6 and typically wraps up by age 12, spanning a six-year window that covers most of elementary and middle school.
Which Teeth Fall Out and When
The 20 baby teeth fall out in a roughly predictable order, generally mirroring the sequence they first appeared. The front teeth go first, and the teeth further back in the mouth follow over the next several years. According to the American Dental Association, the timeline looks like this:
- Central incisors (front teeth): 6 to 7 years old, both upper and lower
- Lateral incisors (next to the front teeth): 7 to 8 years old
- First molars: 9 to 11 years old
- Canines (the pointed teeth): 9 to 12 years old
- Second molars: 10 to 12 years old
Lower teeth tend to loosen slightly before their upper counterparts. Most kids lose their first tooth around age 6, though some start as early as 4 or as late as 7. The last baby teeth, usually the second molars or canines, hang on until age 11 or 12. If your child seems ahead or behind this schedule by a year or so, that’s still within the normal range.
Why Baby Teeth Fall Out
Baby teeth don’t just loosen randomly. Underneath each one, a permanent tooth is slowly pushing upward through the jawbone. As it rises, specialized cells break down the root of the baby tooth above it, dissolving it from the bottom up. This is why a baby tooth that falls out looks like it barely has a root at all compared to the long root it originally had.
Chewing forces play a role too. As a child’s face grows, the mechanical stress on baby teeth increases. The tissue connecting the tooth to the bone responds to this pressure by triggering more of those root-dissolving cells. Eventually, so little root remains that the tooth becomes loose and falls out on its own, often with minimal bleeding.
From 20 Baby Teeth to 32 Adult Teeth
The 20 baby teeth are replaced one-for-one by 20 permanent teeth: 8 incisors, 4 canines, and 8 premolars. But the adult mouth doesn’t stop there. Twelve additional molars grow in behind the baby teeth in spots where no baby tooth ever existed. The first adult molars arrive around age 6 (often before any baby teeth have fallen out), the second molars come in around age 12, and the wisdom teeth, if they appear at all, show up between 17 and 21. The full adult set totals 32 teeth, though many people have their four wisdom teeth removed, leaving a functional set of 28.
What to Do With a Loose Tooth
The safest approach is to let a loose tooth fall out on its own. Encourage your child to wiggle it gently with their tongue or clean fingers, but don’t force it. If the tooth moves freely in every direction without pain, it’s close to ready. You can help by wrapping it in a clean tissue and giving a gentle twist.
If there’s any resistance or pain when you try, stop. That means the root hasn’t fully dissolved yet, and pulling prematurely can cause unnecessary bleeding and damage to the gums. The old doorknob-and-string trick is not recommended for the same reason. Give it a few more days and try again.
When a Baby Tooth Won’t Fall Out
Sometimes a baby tooth stays put longer than expected. The most common reason is that the permanent tooth underneath is coming in at a slight angle, so it isn’t pressing directly against the baby tooth’s root. In these cases, the tooth usually loosens on its own within a few months.
A less common but notable cause is a missing permanent tooth. Roughly 5 to 8 percent of people are congenitally missing at least one permanent tooth, with the second premolars and upper lateral incisors being the most frequently absent. When there’s no permanent tooth pushing from below, the baby tooth may never get the signal to dissolve its root, and it can remain in place well into adulthood. A dental X-ray, typically taken around age 7 or 8, can confirm whether all the permanent teeth are developing on schedule.
Losing a Baby Tooth Too Early
When a baby tooth is knocked out by an injury or pulled early due to decay, the empty space can become a problem. Neighboring teeth tend to drift into the gap over time, which can crowd out the permanent tooth that’s supposed to fill that spot later. This is especially concerning for molars lost before age 7 or 8, since those teeth act as placeholders for years before their permanent replacements arrive.
In some cases, a dentist will place a small device called a space maintainer to hold the gap open until the permanent tooth is ready to come in. Not every early loss requires one. The decision depends on which tooth was lost, how much space remains, and how close the permanent tooth is to erupting. For teeth lost after age 8, particularly the first baby molars, the permanent tooth is often close enough to the surface that a space maintainer isn’t necessary.
A Quick Reference by Age
Here’s what to roughly expect at each stage:
- Ages 5 to 7: The first 4 to 8 teeth fall out, starting with the lower and upper front teeth. Your child may also get their first permanent molars in the back of the mouth.
- Ages 8 to 9: A brief lull for many kids. The front 8 teeth are usually gone, and the side and back teeth haven’t started loosening yet.
- Ages 9 to 12: The remaining 12 baby teeth (canines, first molars, and second molars) fall out. By the end of this phase, your child has a full set of permanent teeth aside from wisdom teeth.
Every child’s timing varies. Girls tend to lose teeth slightly earlier than boys, and genetics plays a strong role. If a parent was a late bloomer with tooth loss, their child often follows the same pattern. The total count, though, is always the same: 20 baby teeth in, 20 baby teeth out.