Milk Teeth: The Full Timeline, and When to Worry

Children get twenty milk teeth and thirty-two permanent ones. The exchange runs from about six to twelve years, and it is more orderly than most parents expect.

When they fall out

They generally leave in the same order they arrived:

• 6–7 years — lower central incisors, then upper centrals.
• 7–8 years — lateral incisors.
• 9–11 years — first molars.
• 9–12 years — canines.
• 10–12 years — second molars.

Girls typically lose teeth a few months earlier than boys. A variation of a year in either direction is normal.

The tooth most parents miss

At around six, the first permanent molars come through right at the back, behind the last milk tooth. Nothing falls out to make room, so parents frequently assume they are milk teeth and do not worry much about them.

They are permanent, they are meant to last a lifetime, and they arrive with deep grooves in a mouth being brushed by a six-year-old. They are the most commonly decayed teeth in children. A fissure sealant — a thin protective coating flowed into those grooves, painless and requiring no drilling — is one of the most cost-effective things in dentistry.

Shark teeth

Sometimes a permanent tooth erupts behind the milk tooth before that one has fallen, giving a double row at the lower front. It looks alarming and is usually fine. Encourage the child to wiggle the milk tooth; in most cases it comes out within a few weeks and the permanent tooth drifts forward into place. If the milk tooth is still solid after two to three months, or the permanent tooth is fully through, it is worth having the milk tooth removed so the new one can settle correctly.

Loose teeth

Let the child wiggle it themselves with a clean finger. Do not use string or force it out before it is ready — pulling a tooth whose root has not fully resorbed hurts and can leave a fragment behind. A little blood afterwards is normal; a clean gauze pressed for ten minutes settles it.

When to have it checked

• No teeth lost by age eight, or a big departure from the usual order.
• A tooth lost very early, before five. Milk teeth hold space; losing one early lets neighbouring teeth drift and crowd the adult tooth out. A space maintainer may be needed.
• A milk tooth that is decayed. They still need treating — a milk tooth abscess can damage the permanent tooth forming right above it.
• A milk tooth knocked out by injury. Do not replant it, but do get it checked.
• Permanent teeth coming through visibly crowded, which is worth an orthodontic assessment at around seven.

The idea worth abandoning

“They are only milk teeth, they will fall out anyway” is the most expensive sentence in children's dentistry. Milk teeth guide the permanent teeth into position, allow proper chewing and speech, and an infected one can damage the developing tooth above it. Treating them is not optional.

Frequently asked questions

What if my child's permanent tooth comes in behind the milk tooth?

Commonly called shark teeth, and usually self-correcting. Encourage wiggling; the milk tooth normally falls within a few weeks. If it is still firm after two to three months, have it removed.

Do cavities in milk teeth need to be filled?

Yes. An untreated milk tooth can abscess and damage the permanent tooth developing above it, and early loss lets neighbouring teeth drift into the space the adult tooth needs.

At what age should a child first see an orthodontist?

Around seven. Enough permanent teeth are through to spot crowding, crossbites and jaw growth problems, while growth can still be used to help correct them.

My child is eight and has lost no teeth. Should I worry?

It is worth a check, mostly to confirm the permanent teeth are present and developing. An X-ray settles it quickly. Late exchange often simply runs in families.

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