Losing a baby tooth is the ultimate sign of becoming a big kid. In fact, it's probably more important to 5- and 6-year-olds than learning to read, write, or ride a bike. Kids competitively track how many teeth their classmates have lost, open their mouths to show off the progress, and endlessly trade tooth stories. My daughter, Amy, will never forget the day she lost a tooth during a school assembly; the principal held it up, and everyone applauded.
Baby teeth loosen as their roots dissolve, clearing the way for permanent teeth, explains George White, D.D.S., a professor of pediatric dentistry at Tufts University, in Boston. The bottom two front teeth are usually the first to go, followed by the top two in front.
Most kids have their first loose tooth at age 5 or 6, but it can happen when they're as young as 4 or as old as 8. (Children whose baby teeth erupted early usually lose them before late teethers do.) It generally takes a few months from the time a tooth becomes loose until it falls out. Teeth tend to fall out on their own -- becoming stuck in food or even getting swallowed, which dentists say is harmless. But loose teeth can also be stubborn, sometimes hanging by a thread for weeks. Is it okay for kids to wiggle them free?
Absolutely. "It's best to encourage your child to wiggle the tooth out on his own," explains Gerald Ferretti, D.D.S., a professor of pediatric dentistry at the University of Kentucky, in Lexington. "If it's extremely loose, you can take a tissue and try to rotate the tooth," Dr. White adds. If there's no root left, you should be able to pull it out easily. But don't force it, and never tie it to a string and yank -- if the root is only half dissolved, it could break and become infected.
When a baby tooth falls out, the big tooth is usually underneath the gums, waiting to erupt. Your child's permanent teeth will have ridges on the biting edges at first (they haven't been worn down yet through chewing), and they'll be slightly less white than his baby teeth were. "As more adult teeth replace baby teeth, the difference in color becomes less noticeable," says Fred S. Ferguson, D.D.S., a professor of pediatric dentistry at the State University of New York at Stony Brook and founder of aboutsmiles.org.
Don't worry if your child's teeth look a little too big for his face; his head will keep growing, but his teeth won't. However, if the teeth seem crowded, you may want to talk to your dentist about arranging a consultation with an orthodontist.
Some kids develop two rows of teeth -- often called shark's teeth -- when the permanent teeth come through before the baby teeth have fallen out. The new teeth will push forward on the baby teeth, usually causing them to fall out within a few weeks, Dr. Ferretti says. Consult your dentist if the double row lasts for longer than three months.
The process of losing baby teeth is normally painless, but if the edge of a baby tooth cuts into your child's gums, your dentist may encourage him to wiggle it more vigorously. At the same time that your child's baby teeth are becoming loose and falling out, his six-year molars are coming in. The gums can look swollen, and some kids may complain that they hurt. Acetaminophen, ibuprofen, or topical analgesics can help ease the discomfort.
Although your child may insist that it's hard to bite or chew with loose or missing teeth, it's important for her to maintain a healthy diet. If she won't chew, serve her vegetable soup, pureed fruits, and other healthy soft foods, Dr. White suggests. Make sure she continues to brush her teeth twice daily, and help her with flossing.
If your child has not lost any teeth by the time he turns 7, talk to your dentist. Most likely there won't be a problem, but the dentist may suggest taking X rays to make sure that all the teeth are under the gum. In fact, there's actually an advantage to getting permanent teeth late, Dr. White says. "The teeth will be harder as a result of remaining in the jaw longer, and they'll be more resistant to cavities."
That won't matter to your child, though, who may feel like the "baby" in his class. (Some teachers even fuel such anxiety by making a chart of how many teeth students have lost.) You might say to him, "Everyone's different. Just like some kids are taller than others, some kids lose their teeth earlier or later. Your teeth will come out when it's right for your mouth -- and if they come out before, then it's not right for your mouth." Your child might also enjoy reading books such as Tabitha's Terrifically Tough Tooth, by Charlotte Middleton (Penguin Putman, 2001), or Arthur's Tooth, by Marc Brown (Little Brown, 1986).
Sooner or later, though, all kids will get to put a tooth under their pillow. Even if they were a bit skeptical about the Tooth Fairy beforehand, they usually become believers when the time comes-and may even be eager to go to bed early.
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.