Dr Liisbet Palm: children’s tooth-change timeline varies widely
When children's baby teeth start wobbling and falling out, it's often a moment of excitement and joy — but it can raise plenty of questions for parents too. Meliva dentist Dr Liisbet Palm answers the most common ones.
1. At what age should a child’s teeth start changing? Is it true that once teeth start changing, the child is “school-ready”?
Baby teeth usually start being replaced by permanent teeth around age 5-6, though quite a few children lose their first tooth as early as 4, or as late as 7. The old belief that tooth-changing marks a sign of school readiness holds up only partly. Every child develops a little differently, so it can’t be said to apply universally.
2. Should you worry if a baby tooth stays loose for a long time without falling out?
If a baby tooth stays loose for a long time without coming out, it’s often because the permanent tooth underneath hasn’t developed enough yet to push it out. In that case, giving the child harder foods — like carrot or apple — can help speed things along. It’s also worth encouraging the child to gently wiggle the tooth with their tongue or clean fingers. A tooth tends to come out most easily with a gentle twisting motion. There’s no need to worry about a child “over-wiggling” a tooth — children naturally stop wiggling it themselves once it starts to hurt.
If a loose baby tooth is interfering with eating and/or brushing, or if the permanent tooth has already erupted before the baby tooth has come out, it’s worth seeing a dentist, who can remove the baby tooth if needed.
3. Can a baby tooth come out “the wrong way,” and when should you ask a dentist for advice?
Baby teeth coming out “the wrong way” is very rare. Occasionally, a baby tooth can break and only partially come loose. If the child complains of pain or there’s swelling, it’s worth seeing a dentist, who can remove the remaining tooth fragment if needed. Mild bleeding when a tooth comes out is normal.
Sometimes a permanent tooth erupts before the baby tooth has come out, leaving two teeth in the same spot. This most often happens with the lower front teeth. In that case, I’d recommend seeing a dentist, who can assess the situation and remove the baby tooth if needed.
4. Once a baby tooth has come out, how quickly should the permanent tooth appear?
The timeline for tooth replacement varies a great deal between children. Once a baby tooth falls out, the permanent tooth often erupts within less than a month — but sometimes it can take as long as six months.
The order in which baby teeth are replaced is fairly consistent: usually the lower and upper front teeth go first, followed a little later by the baby molars and canines. Small variations from this pattern can occur and aren’t necessarily a cause for concern.
5. How much time usually passes between two baby teeth falling out?
This also varies. Sometimes several baby teeth fall out within days or weeks of each other, but sometimes years can pass between the loss of two teeth.
6. What should be done if a permanent tooth doesn’t fit into the space left by a baby tooth?
It’s fairly difficult for parents to judge on their own how large or small a permanent tooth is, and whether it will fit into the space left by a baby tooth. In addition, children’s jawbones are constantly developing and usually grow enough to accommodate all the permanent teeth. If in doubt, it’s still worth raising the concern with your dentist. If permanent teeth genuinely don’t fit, this points to a lack of space — in which case the dentist can refer the child to an orthodontist.
7. What should you pay attention to when it comes to hygiene for teeth that are changing or loose?
Dentists often notice that the quality of toothbrushing declines while teeth are changing. Loose baby teeth can cause discomfort, leading children to avoid brushing certain areas of the mouth. Newly erupted permanent teeth also often don’t get enough attention when it comes to cleaning. In these situations, parents can help by occasionally brushing their child’s teeth for them and reminding them how important it is to get every tooth properly clean.
This article was first published in the online edition of Pere ja Kodu on 17.03.2025.
