Most children start losing their baby teeth around age 6, beginning with the lower and upper front teeth. If your child’s teeth are not falling out, it is often due to normal variation in timing, genetics, or the permanent tooth developing more slowly. Sometimes, however, a retained baby tooth, a missing permanent tooth, crowding, or a condition called dental ankylosis can prevent a baby tooth from falling out naturally. If a permanent tooth is already coming in behind the baby tooth, creating “shark teeth,” or a baby tooth remains long after it should have fallen out, a pediatric dentist should evaluate it.
When Do Baby Teeth Normally Fall Out?
Every child develops at their own pace, but there is a typical pattern.The First Wave (Around Ages 6 to 8)
Most children lose their first baby teeth around age 6. The lower front teeth usually loosen first, followed by the upper front teeth.The Natural Pause (Around Ages 8 to 10)
After the first eight baby teeth are lost, many children experience a natural pause before more teeth begin to loosen. This is completely normal.The Second Wave (Around Ages 10 to 12)
The remaining baby teeth usually fall out between ages 10 and 12 as the permanent premolars and canines erupt.Scenario 1: The Baby Tooth Is Not Loose Yet
A baby tooth that has not started to wobble is not always a cause for concern. Possible reasons include:Genetics
Children often follow a similar tooth-loss pattern to their parents. If you lost your baby teeth later than average, your child may do the same.The Permanent Tooth Is Developing More Slowly
Some permanent teeth simply erupt later than others.A Missing Permanent Tooth
Occasionally, the permanent tooth never develops. This is called a congenitally missing tooth. Without a permanent tooth underneath, the baby tooth’s root does not dissolve, so it may remain in place for many years.Crowding Or Lack Of Space
If there is not enough room in the jaw, the permanent tooth may erupt more slowly or in a different position.Scenario 2: The Permanent Tooth Is Coming In Behind The Baby Tooth
This is commonly known as shark teeth. It happens when the permanent tooth begins erupting before the baby tooth has fallen out, creating a temporary double row of teeth.Why Does This Happen?
Normally, the permanent tooth dissolves the baby tooth’s root as it grows. If root resorption happens more slowly, the permanent tooth may erupt behind the baby tooth instead.Is It Common?
Yes. Shark teeth are most common between ages 6 and 8 and usually affect the lower front teeth.What Can Parents Do?
Encourage your child to gently wiggle the loose baby tooth every day with a clean finger or their tongue. In many cases, the baby tooth falls out naturally within a few weeks, allowing the permanent tooth to move into the correct position.When Should You See A Pediatric Dentist?
Arrange an appointment if:- The baby tooth is not becoming loose after several weeks.
- The permanent tooth appears crowded.
- Your child has pain or swelling.
- You are unsure whether the tooth is developing normally.
Dental Ankylosis: When A Tooth Is Stuck
Sometimes a baby tooth becomes fused directly to the jawbone. This condition is called dental ankylosis. Unlike a normal baby tooth, an ankylosed tooth cannot loosen because its root is attached to the bone. Signs may include:- A tooth that appears lower than the surrounding teeth.
- A baby tooth that never becomes loose.
- Delayed eruption of the permanent tooth.
How Does A Pediatric Dentist Find The Cause?
A dental examination is the first step. If needed, your pediatric dentist may recommend digital X-rays to:- Check whether the permanent tooth is present.
- See how the permanent tooth is positioned.
- Identify crowding or obstruction.
- Detect an ankylosed or over-retained baby tooth.
Treatment Options
Treatment depends on the reason the baby tooth has not fallen out.Watchful Waiting
If development is normal, no treatment may be needed. The tooth may simply need more time.Encouraging Natural Loosening
Children can safely wiggle a loose tooth each day to help it fall out naturally.Baby Tooth Extraction
If the permanent tooth is blocked or the baby tooth remains firmly in place, a simple extraction may be recommended.Space Maintainers
If a baby tooth must be removed much earlier than expected, a space maintainer may be used to preserve room for the permanent tooth.Orthodontic Evaluation
If crowding or lack of space is delaying eruption, an orthodontic assessment may be recommended.Why Dentists Avoid Removing Baby Teeth Too Early
Baby teeth help guide permanent teeth into the correct position. Removing them too early can allow neighbouring teeth to drift into the empty space, increasing the risk of crowding and future orthodontic treatment. That is why pediatric dentists only recommend extraction when it is truly necessary.When Should You Book An Appointment?
Arrange a dental evaluation if:- Your child is over age 7 or 8 and a tooth has not started to loosen.
- A permanent tooth is erupting behind a baby tooth.
- The baby tooth appears lower than the surrounding teeth.
- Your child has pain, swelling, or difficulty chewing.
- One matching tooth has erupted, but the tooth on the opposite side has not appeared after about six months.