When to worry about baby teeth not falling out

When to worry about baby teeth not falling out

Aug 22, 2021

At your child’s First Visit to Perfect Smiles Orthodontics, we will do a count of all your child’s teeth. If they are not ready for treatment, we usually keep your child under recall and bring them back for review visits.

At each review visit, he will be asked whether any baby teeth have fallen out.

This is to make sure that the permanent teeth are coming through as planned, and we need to keep a lookout for any potential problems.

A child will begin losing their baby teeth from age 6 or 7 onwards, and this continues on until the age of 12-13, when they will get a full set of permanent teeth. A child will generally lose their lower central incisors first, as they are the first teeth that come on the scene when the child is a toddler. Between ages 7- 12, your child may have a set of mixed baby and permanent teeth, and this is called mixed dentition.

By age 12-13, your child should have a full set of permanent teeth – 32 in all, and these teeth will serve them for the rest of their life. Generally, girls will attain their full set of permanent teeth earlier than boys.

The importance of baby teeth

Baby teeth, also known as primary teeth or deciduous teeth, play a crucial role in your child’s overall oral health and development. Although they are temporary, these little teeth serve several important functions.

First, baby teeth help your child chew and digest food properly, ensuring that they receive the necessary nutrients for growth and development. Additionally, baby teeth play a significant role in speech development, enabling your child to articulate sounds and form words correctly.

Baby teeth act as placeholders for permanent teeth, guiding their eruption into the correct positions. Without a healthy set of baby teeth, your child’s permanent teeth may not have enough space to come in properly, potentially leading to orthodontic issues in the future. Therefore, it is essential to take care of your child’s baby teeth and monitor their eruption and shedding.

When do baby teeth typically start falling out?

A child will begin losing their baby teeth from age 6 or 7 onwards, and this continues until the age of 12-13, when they will get a full set of permanent teeth.

A child will lose their lower central incisors first, as they are the first teeth that come on the scene when the child is a toddler. Between ages 7- 12, your child may have a set of mixed baby and permanent teeth, and this is called mixed dentition.

Signs that baby teeth may not be falling out on time

While the timeline for baby tooth loss can vary, there are some signs that may indicate a delay or issue with the natural shedding process. If your child’s baby teeth are not falling out as expected, you may notice the following signs:

  • Persistent loose teeth
    If your child’s baby teeth remain loose for an extended period without falling out naturally, it could be a sign that they are not shedding properly.
  • Double row of teeth
    One of the most noticeable signs of retained baby teeth is the presence of two rows of teeth. This occurs when the permanent teeth start to erupt behind the baby teeth without displacing them.
  • Delayed eruption of permanent teeth
    If your child’s permanent teeth are not coming in after their baby teeth have fallen out, it could be an indication of a problem.
  • Crowding or misalignment
    Retained baby teeth can disrupt the normal alignment of permanent teeth, leading to crowding or misalignment issues.

If you notice any of these signs, it’s important to consult a pediatric dentist for a thorough evaluation and appropriate treatment if necessary.

Reasons why baby teeth may not be falling out

There can be several reasons why baby teeth may not fall out on their own. Some of the common causes include:

  • Retained Baby Teeth
    If a baby tooth or teeth does not fall out within the predicted time, this may cause problems for the adult teeth, which still need to come through. In most instances, we would advise the child to “wobble” the tooth continuously so that it falls off by itself. This usually does the trick, however, after a certain time, if the tooth is still retained, we may advise for the dental extraction of the tooth, to enable the adult tooth to come through.
  • Impacted Adult Teeth
    Some adult teeth may become impacted, either from the baby teeth being retained and not falling, or from the angle of the (adult) teeth’s growth. Xray’s need to be taken to check if a tooth is impacted or potentially impacted. If a tooth is impacted due to retain a baby tooth, the removal of the baby tooth will usually resolve the problem over time, and the adult tooth will move into its rightful position.However, there are some adult teeth (usually upper canines) that, due to their angle of growth, have a disposition for impaction. Your orthodontist will advise you when is the best time to deal with these impacted teeth. Usually, it will require orthodontics and surgical exposure to ensure that the impacted tooth is brought down to its correct position.
  • Lack of space
    If your child’s mouth is overcrowded or there is not enough space for the permanent teeth to come in, the baby teeth may not fall out as expected.
  • Premature loss of baby teeth
    If a baby tooth is lost prematurely due to trauma or decay, neighboring teeth may shift positions, blocking the eruption path for the permanent teeth.
  • Genetic factors
    Some children may have a genetic predisposition to retain baby teeth.
  • Missing Adult Teeth
    Some children are born with missing adult teeth. So, when the baby tooth falls off, there is no adult tooth to take its place. This leaves a gap where the adult tooth should be. This is the time to visit the orthodontist to discuss treatment options to close the gap.To monitor your child’s developing teeth, please visit your orthodontist at allotted intervals. Most times a physical examination will not be enough to find out what is happening with their teeth. Even if you have finished Phase 1 treatment, you should still visit your orthodontist to monitor the development of the rest of the permanent teeth.

    X-Rays will need to be taken to see if the permanent teeth are present, absent, impacted or developing normally.

It’s important to remember that every child is unique, and the reasons for retaining baby teeth may vary. A pediatric dentist can help determine the underlying cause and recommend appropriate treatment options.

Common myths about retained baby teeth

There are several myths and misconceptions surrounding retained baby teeth. Let’s address some of the most common ones:

  • “Retained baby teeth are not a concern since they will eventually fall out.” While it’s true that baby teeth are temporary, retained baby teeth can lead to various complications, including orthodontic issues and improper eruption of permanent teeth. It’s essential to address retained baby teeth to ensure proper oral development.
  • “You should pull out your child’s loose baby teeth to make room for permanent teeth.” It’s important to allow baby teeth to fall out naturally. Pulling out loose baby teeth prematurely can cause trauma and damage to the surrounding tissues.
  • “Retained baby teeth are a sign of late blooming and will resolve on their own.” While some cases of retained baby teeth may resolve without intervention, it’s crucial to consult a pediatric dentist for a proper evaluation. Delayed eruption or retention of baby teeth can indicate underlying issues that may require treatment.
  • “Baby teeth don’t need to be cared for since they will be replaced by permanent teeth.” Baby teeth are just as susceptible to decay and cavities as permanent teeth. Proper oral hygiene and regular dental check-ups are essential to maintain healthy baby teeth and promote optimal oral health.

It’s important to rely on accurate information and seek professional advice from a pediatric dentist when it comes to your child’s dental health.

Transitioning to permanent teeth

As your child’s baby teeth fall out, it’s important to support the transition to their permanent teeth. Here’s what you can expect during this phase:

  • Mixed dentition: During the transition phase, your child will have a mix of baby teeth and permanent teeth. This is known as mixed dentition. The baby teeth that have fallen out will be gradually replaced by permanent teeth.
  • Care for permanent teeth: Once your child’s permanent teeth have fully erupted, it’s important to continue practicing good oral hygiene. Encourage regular brushing, flossing, and dental check-ups to maintain the health of their permanent teeth.
  • Orthodontic evaluation: Around the age of seven, it’s recommended to have an orthodontic evaluation to assess your child’s dental development. Early interventions, if necessary, can help guide the permanent teeth into their correct positions and prevent potential orthodontic problems in the future.

By providing proper care and attention during the transition to permanent teeth, you can ensure your child’s smile remains healthy and beautiful.


Understanding the timeline of tooth loss in children and knowing what to do if baby teeth don’t fall out is essential for parents.

By recognising signs of retained baby teeth, seeking professional dental care, and orthodontic advice, you can help ensure your child’s oral health remains optimal. Remember, every child’s dental journey is unique.