Most children lose their first baby tooth around age 6, though it’s completely normal for the process to start up to a year later. The two bottom front teeth are almost always the first to go, followed by the two top front teeth. From there, the remaining baby teeth fall out gradually over the next several years, with most kids losing their last one by age 12 or 13.
The Typical Timeline
Baby teeth tend to fall out in roughly the same order they came in. After the lower front teeth loosen around age 6 or 7, the upper front teeth usually follow within a few months. The lateral incisors (the teeth on either side of the front ones) typically come out between ages 7 and 8. First molars and canines follow between ages 9 and 12, and the second molars are the last to go, usually between ages 10 and 13.
Some children lose their first tooth as early as 4, and others don’t start until closer to 8. Girls tend to lose their teeth slightly earlier than boys. If your child hasn’t lost any teeth by age 8, it’s worth mentioning to a dentist, but in most cases a late start is simply a variation of normal.
Why Baby Teeth Fall Out
Baby teeth don’t just fall out on their own for no reason. The process starts when a permanent tooth developing beneath the gum begins pushing upward. As it rises, specialized cells break down the root of the baby tooth above it. These cells work similarly to the ones that remodel bone throughout your body, dissolving the root gradually from the bottom up.
Everyday chewing also plays a role. The mechanical stress of biting and chewing sends signals to the tissue surrounding the baby tooth’s root, accelerating the breakdown process. Over weeks or months, the root gets shorter and shorter until the tooth is held in place by little more than a thin strip of gum tissue. That’s when it starts to feel loose.
What “Shark Teeth” Look Like
Sometimes a permanent tooth pushes through the gum before the baby tooth has fallen out, creating what looks like a second row of teeth behind the first. This is commonly called “shark teeth,” and it’s one of the things that catches parents off guard the most. It happens frequently with the lower front teeth.
In most cases, shark teeth resolve on their own. Encouraging your child to gently wiggle the baby tooth can help speed things along. Once the baby tooth falls out, the tongue naturally pushes the permanent tooth forward into its correct position over the following weeks. If the baby tooth stays firmly rooted after several weeks, or if the permanent tooth is almost fully grown in behind it, a dentist can evaluate whether the baby tooth needs to be removed.
How to Handle a Loose Tooth
The best approach to a loose tooth is patience. Encourage your child to wiggle it gently with their tongue or a clean finger, but let them set the pace. A tooth that’s truly ready to come out will move freely in all directions and may hang by a thin thread of tissue. Forcing a tooth that still has significant root attached can cause unnecessary pain and bleeding.
When the tooth is clearly dangling and your child is ready, you can help it along at home. Wash your hands and your child’s hands first. Grip the tooth with a piece of wet sterile gauze, give it a slight turn, and pull quickly. The whole thing should take a second. Have another piece of gauze ready for your child to bite down on, since there will be a small amount of bleeding. Light bleeding for 10 to 15 minutes is normal. Check afterward to make sure the whole tooth came out cleanly and no fragments were left behind.
If the tooth won’t budge easily, don’t force it. You can try sliding a piece of dental floss around both sides of the tooth and gently pressing it between the tooth and gum to loosen things up. But if it still resists, leave it alone and try again in a few days.
Permanent Teeth Coming In
Permanent teeth look noticeably different from baby teeth, and this catches some parents by surprise. They’re larger, slightly more yellow, and often have ridged edges (called mamelons) that smooth out naturally over time with chewing. The color difference is especially obvious when new permanent teeth sit next to remaining baby teeth.
The order of arrival roughly mirrors the order baby teeth were lost. The first permanent molars, which come in behind the last baby teeth rather than replacing them, often appear around age 6 as well. These are easy to miss because no baby tooth falls out to signal their arrival. By age 13, most children have 28 permanent teeth in place, with wisdom teeth potentially arriving in the late teens or early twenties.
Signs Something May Be Off
Most of the time, losing baby teeth is completely uneventful. But a few situations are worth paying attention to. Losing a tooth before age 4, especially from an impact or injury, can create spacing issues for the permanent tooth developing below. A baby tooth that falls out and isn’t followed by a permanent tooth within six months may indicate the permanent tooth is delayed, missing, or blocked. Persistent pain, swelling, or significant bleeding around a loose tooth can signal infection rather than normal loosening.
Teeth that loosen out of the expected order aren’t usually a concern on their own, but if multiple teeth loosen at once or your child complains of pain in teeth that shouldn’t be loose yet, a dental X-ray can clarify what’s happening beneath the surface.