When do loose baby teeth require a visit to the dentist?

A child in a dental office
Before falling out, your child's baby teeth go through 3 stages. First, they form and grow inside the jawbone for one year, then they appear in the mouth and stabilize for three years, and finally, the roots begin to shorten, causing them to loosen and be replaced by adult teeth.

Loose baby teeth is a natural and painless process that shouldn't worry you, but some symptoms may indicate something is wrong and require seeing a dentist.

What is a baby tooth?

Baby teeth, also called temporary or deciduous teeth, are the first teeth to appear. As the name suggests, their life span is limited and they are progressively replaced by permanent teeth between 6 and 12 years old.

At 3 years old, the average baby has 20 teeth: 8 incisors, 4 canines, and 8 molars. From 6 years old, the child will experience for the first time the beginning of the loosening of his milk teeth and the appearance of the first permanent teeth.
The replacement of temporary teeth generally follows the following pattern:

  • Between the ages of 6 and 9, the child loses his upper and lower incisors,
  • Around 11 years old, the child loses his 2 lower canines, then his 2 upper canines,
  • Around 12 years old, the child loses first his 2 lower molars, then his 2 upper molars,
  • Between 6 and 13 years old: the 8 permanent molars grow in,
  • From the age of 18: the 4 wisdom teeth grow in.

Although baby teeth are to be replaced, they are essential to the development and growth of the child's jaws. They also make room and guide the appearance of permanent teeth, which could not develop immediately in the child's small jaw.

Temporary teeth also allow the acquisition of oral functions, including chewing, swallowing, and speaking, and define the facial features of the child's face.

How do baby teeth become loose?

The evolution of milk teeth goes through several stages. It starts during pregnancy, stabilizes around 3 years of age when the 20 temporary teeth appear, and ends when the child is about 12 or 13 years old, as the last temporary tooth falls out.

As the temporary teeth fall out, the permanent teeth show up and replace them.

The mechanism that leads to the loosening of deciduous teeth and their subsequent loss is the progressive loss of their roots, also called physiological root resorption. It is genetically programmed and involves pressure exerted on the bottom part of the temporary teeth by the upcoming permanent teeth.

As the permanent teeth develop, they migrate outward and shorten the roots of the baby teeth causing them to loosen and fall out.

By the time the baby tooth falls out, almost two-thirds of the permanent tooth root has formed, and almost nothing remains but the crown of the temporary tooth. Thus, the root of a temporary tooth that has fallen out naturally is not visible.

Once the baby tooth has fallen out, the permanent tooth may already have erupted through the gum. Nevertheless, it will take another 6 to 12 months to complete its eruption.

What to do if your child has loose baby teeth?

A loose baby tooth does not mean that it will fall out immediately. The physiological resorption process is long and takes about 3 years. This time depends on the growth rate of the tooth underneath.

It is therefore useless to force a loose baby tooth. The best thing to do is to let the permanent tooth do the work.

Also, if you want to pull the baby tooth too soon, there is a risk that the root of the baby tooth has not completely disappeared, which can cause gum damage, pain and infection.

On the other hand, if it is too disturbing for the child and the tooth is about to fall out, you can try to pull it out gently.

The best-known technique for getting a baby tooth out is to have your child bite into an apple so that the tooth falls out on its own and doesn't get swallowed.

You can also try to remove it with your fingers, but be sure to apply an ice cube to the gum around the tooth for the child's comfort, and put on gloves to avoid infection. Before pulling a baby tooth, a good rule of thumb is to make sure it's a temporary tooth and not a permanent one.

How to differentiate between a baby and a permanent tooth?

Until the age of 5 or 6, there are only temporary teeth in the mouth. After 12 to 13 years, the child has only permanent teeth. Between 6 and 12 years of age, the child's dentition is composed of both temporary and permanent teeth and is called a mixed dentition.

Permanent teeth are so-called because we keep them forever. They are larger and naturally less white than the baby teeth. The contrast with the temporary teeth is more pronounced when the dentition is mixed. However, it decreases with the eruption of all the permanent teeth.

Another difference is that the permanent incisors have a jagged edge, marked by 3 small lobes when they first appear in the mouth. But, it disappears with the natural wear of the teeth to become a straight edge later on.

If you think one of your child's permanent teeth is loose, you should take him or her to the dentist as soon as possible. Adult teeth are permanent and not meant to be replaced. Any damage or mobility of a permanent tooth should be assessed immediately.

Problems that may be related to loose baby teeth

The loosening of the baby teeth and their replacement by the permanent teeth is a natural and painless process. However, sometimes it is linked to problems whose symptoms should lead you to seek dental advice. Among these situations:

Early loss of baby teeth

On average, children will lose their first baby tooth at about 6 years old. The loss of a temporary tooth 1 to 2 years before its due date should not alarm you as long as the permanent tooth evolves without concern.

But, if the baby tooth has fallen out with its entire roots that have not resorbed or it is not followed by the appearance of the permanent tooth during the first few months, it may be due to decay, infection, trauma, tooth crowding, or general illness. If you are worried, do not hesitate to consult your dentist. He or she may suggest an x-ray to remove any doubt.

Delayed eruption of permanent teeth

Once again, a little delay in eruption after a temporary tooth has fallen out should not overwhelm you.

But, if the delay persists or if the temporary tooth refuses to fall out even years after the average fall date, it may signal an inclusion of the permanent tooth where it gets stuck in the bone, an obstacle that blocks the eruption of the tooth, insufficient space that often results in crowding. Sometimes, the permanent tooth is missing, which is called tooth agenesis.

Painful, discoloration, and bleeding loose baby teeth

If the loosened temporary tooth is associated with painful symptoms or is discolored, it may indicate that it is infected and must be extracted quickly before damaging the succedaneous tooth. Symptoms of an infected baby tooth include:

  • The crown of the tooth is decayed.
  • Abscess or swelling of the gum or cheek around the tooth.
  • The tooth looks gray or brown.
  • Fever and swelling of the lymph nodes under the lower jaw.

If any of these symptoms are present, it is crucial to see a dentist before the infection spreads to the permanent tooth.

Dental crowding

It is often a concern for parents. The growth of a permanent tooth out of its normal eruption direction is a common condition. The baby tooth stays in place, and the permanent tooth grows through the gum underneath: your child ends up with two rows of teeth!

If the baby tooth is loose and ready to fall out, the spontaneous alignment of the teeth is favorable. If not, or if the child is older than 7 years old, the advice of your dentist is essential. To avoid any concern about future alignment and dental malposition, he may decide to extract the baby tooth still in place to promote the growth of the permanent tooth under better conditions. Orthodontic assessment can be done as early as age 6.

How to take care of baby teeth?

The loss of baby teeth is a special moment for children and is illustrated by legends such as that of the tooth fairy.

It is also an opportunity to teach him the rules of oral hygiene to take care of his new teeth.

First, if you notice any signs of infection, including pain, redness, bleeding, and swelling, take your child to the dentist immediately to rule out the risk of contaminating the permanent tooth.

The loosening and falling of baby teeth is the perfect time to educate your child about preventive measures, as this is primarily a time of empowerment and growth as your child enters the adult world.

Teach your child to brush his teeth properly. Teeth should be brushed twice a day for at least two minutes, with vertical motions from the gums to the teeth and from all sides.

To make this moment more fun, offer him a colorful toothbrush, and why not with the effigy of his favorite hero. Toothpaste should be age-appropriate because of its fluoride composition. Excessive fluoride exposure can lead to fluorosis, which appears as white spots on the teeth.

Take your child regularly to the dentist to monitor his baby teeth and the development of adult teeth. A visit as soon as the first tooth appears and at least once a year is essential for the child's oral health and global development. Controlling and detecting cavities and preventing them as early as possible is crucial to avoid complications that will require more complex and traumatic treatments.

Last but not least, teach your child the basics of a healthy diet and balanced snacks to keep his or her natural teeth forever.