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July 6, 2016

When Do Teeth Come In / Fall Out?

Dr. McPherson

child-girl-face-towel-37924-largeKids seem to be constantly getting teeth in or losing them for about the first twelve years of life! For first time parents this can be a really confusing and stressful process. In my experience, parents who have already been through it with an older child tend to worry quite a bit less! The important thing to remember is that this is an entirely normal and natural process that happens! Some discomfort is perfectly normal and no matter what you do, the process usually takes care of itself (with some exceptions).

Lets talk first about getting those initial teeth in. The rule of thumb is the first teeth start coming in around age 7 months and they’ll get another 4 teeth in every 4 months for a total of 20 teeth when they’re done right around 2 to 2 1/2 years old. While these are averages, there is a huge amount of variation between kids, not only in when the teeth come in, but also the order. Don’t worry if your child is getting them in faster / slower than other kids. This doesn’t necessarily mean there is any problem. The usual order is the front four teeth will come in first, then their first molars, then canines / eye teeth, and lastly their second molars. Good thing those second molars come in last because they are the biggest and most uncomfortable to break through! Once they’re all in you don’t have to worry about teeth coming in / out for about 3 more years! No more drooling, biting things, and general crankiness! Yay! Baby orajel and the occasional use of Tylenol for pain is just about all you need for these years.

Your next milestone is right around 6 years old. Again this is wildly variable. I’ve seen kids as young as 5 starting the process and some kids don’t have anything happen until age 7. This will usually start with the two bottom front teeth starting to get loose and some new (really big!) molars coming up right behind their last baby teeth. These new molars (first permanent molars or six year molars) are permanent teeth and you want to make sure they take extra special care of them because they are some of the most important teeth they will get! Oftentimes the permanent teeth in front will come in behind the baby teeth and for a while they’ll have a double row of “shark teeth”. Again this is totally normal! I literally can’t count how many times I’ve seen this. I tell the kids they look awesome with their “shark teeth” and send them off and invariably they end up losing them in next couple of weeks and the permanent teeth move into the right spot. In pretty quick succession they’ll lose the front four teeth on the top and the bottom and then they’ll have another break for a couple of years.

Right around age 10 they’ll start losing teeth again and this will continue until around age 12 when all the baby teeth are gone and they get their second molars (twelve year molars) in the very back. Hooray! You’ve got another 6 year break!

Around age 18, if they have wisdom teeth, they’ll start to come in. Many people’s wisdom teeth will be partially impacted and won’t come in all the way. If there is any concern as to their positioning or space available for them I’d highly recommend they are taken out. Wisdom teeth are one of the most common problem areas for adults who haven’t had them out.

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