Baby teeth or milk teeth: what are they and when do they fall out?

Just because baby teeth are not for life does not mean they are not important for the development of your child's oral health. In fact, it’s the baby teeth that will shape their future smile. In this article, we explain everything you need to know about milk teeth, or baby teeth, as well as when babies start teething and the symptoms, so that your little ones grow up with a healthy smile.

What are milk teeth?

Milk teeth are the first teeth to erupt in a baby's mouth. They remain in the mouth for a limited time, until they are replaced by permanent teeth.

Baby teeth are responsible for making space for adult teeth, which begin to grow in children’s gums. Properly developed milk teeth will benefit the growth of permanent teeth.

Baby teething

When do babies start teething?

When babies get teeth can vary, although babies usually start teething from 4 months onwards.

Generally, the lower incisors are the first 4 deciduous teeth to appear. From 9 months onwards, the upper central incisors usually erupt. At about 15 months, the first upper and lower molars erupt. At around 2 years, the second primary molars begin to erupt.

The process of when babies get their teeth usually lasts until they are two and a half years old. However, the first permanent molars don’t normally begin to appear until the age of six.

Baby teething symptoms

Baby teething symptoms vary from case to case: there are babies who have no symptoms at all, whilst others experience real discomfort.

The following could be symptoms of teething in babies:

• Nervousness and irritability
• Excessive drooling
  
• Swollen gums
  
• Difficulty falling asleep
  
• Loss of appetite
  
• Slight fevers

If the baby's discomfort persists for a prolonged period of time, it is recommended that you visit a paediatric dentist.

Why do we have baby teeth?

Fundamentally, we have baby teeth to assist with three main functions:

• To enable the transition from a liquid to a solid diet.

• To maintain space for the permanent teeth and to contribute to the development of the upper and lower jaws.

• To facilitate pronunciation in the process of learning to speak.

How many teeth do babies have?

You may be wondering how many baby or milk teeth there are. The answer is 20 in total: 10 teeth in the upper arch and 10 in the lower arch. These 10 teeth in the upper jaw and 10 in the lower jaw maintain the space for your child's future smile.

Once the first milk teeth fall out, the process of mixed dentition begins, in which deciduous and permanent teeth coexist.

Milk teeth falling out

When do baby teeth fall out?

The time when baby teeth fall out is a crucial period in a child’s development.

You may be wondering at what age milk teeth fall out. The answer is between the ages of 5 and 6 and up to the age of 12. During this time, the primary teeth coexist with the permanent teeth. Normally, by the age of 12, children's teeth are complete, going from 20 primary teeth to 28 adult teeth, with the absence of the four wisdom teeth that grow later.

What is the order of milk teeth falling out?

Each child is different, so it is not possible to specify how long the milk teeth will take to erupt, develop or fall out.

Normally, the order in which milk teeth fall out starts with the incisors and ends with the back molars, although this can vary from child to child.

The lower central incisors are the first to fall out at about five and a half or six years of age, followed by the lower lateral incisors and the four upper incisors. The next to fall out are the lower canines and lower molars, usually at aged nine or ten. Finally, a year or two later, the upper canines and second molars are the last to fall out.

When do milk molars fall out?

The first molars fall out at the age of 10 and the second molars fall out at approximately 12 years of age. When the milk molars fall out, they are replaced by permanent teeth at around the age of 13.

Shark teeth: adult teeth coming up behind baby teeth

Shark teeth occur when the baby teeth that have not fallen out are still in place when the new teeth start coming up, resulting in a double alignment of teeth during mixed dentition.

Adult teeth coming in behind baby teeth can occur for different reasons, but the most common are due to a lack of space in the jaw, a simple deviation of the permanent teeth or because the roots of the first teeth have not been absorbed as they should.

Although it is an alteration that usually corrects itself, it is important to visit a paediatric dentist to avoid problems of crowding or dental malocclusion in the future.

Baby teeth in adults

In some cases, adults experience that their baby teeth are not falling out during the period when the rest of the milk teeth are falling out. The most common cause is tooth agenesis, i.e. the absence of the permanent tooth that should replace the baby tooth. Other causes can be trauma, lack of space for the permanent tooth or poor alignment of the teeth.

Although a baby tooth not falling out in adults is not usually a problem, it should be assessed by a dentist to determine if the temporary tooth can be maintained or if it will cause dental problems and should therefore be extracted.

Differences between milk teeth and permanent teeth

The difference between milk teeth and permanent teeth lies mainly in the number of teeth, their anatomy and their composition.

In terms of quantity, as mentioned above, there are 20 baby teeth, whereas there are 32 permanent teeth (if we take into account wisdom teeth).

Another difference between milk and permanent teeth is that the former are smaller because the child's oral cavity is smaller. The roots of baby teeth are also thinner and shorter, which is why they fall out more easily.

Finally, in terms of composition, milk teeth have thinner layers of dentine and tooth enamel, which is why they are whiter.

Baby teeth problems

Although baby teeth are temporary, it is important to be aware of the problems in children’s milk teeth that can emerge, as they could affect the development of the child's oral health. Some of the most common children’s milk teeth problems are cavities, premature decay and necrosis.

Decay in milk teeth

Cavities in children is one of the most frequent problems in milk teeth. The most common causes of decay in milk teeth are:

• Prolonged use of bottles

• Transmission of cavity-causing bacteria, as they are contagious

• Poor feeding

• Lack of oral hygiene

Losing baby teeth early

In some cases, baby teeth can fall out prematurely. Tooth decay, an unbalanced diet - especially due to a lack of calcium - weak roots or strong blows to the mouth are the most common reasons for losing baby teeth early.

What if the baby’s teeth are black?

Milk teeth turning black is a sign of pulp necrosis, which is damage to the teeth’s nerves caused by a strong impact to the jawbone. Pulp necrosis is not visible at the time of the blow, but usually becomes visible months later, when the tooth begins to take on a different colour.

And what happens if a baby’s tooth turns black? If a baby’s teeth are black it is a visible sign which identifies that the nerves of the teeth are dead, but this does not have to be alarming, nor does it have to affect the permanent teeth. However, if your child has a necrotic baby tooth, it is recommended that you visit a paediatric dentist to assess the situation.

Orthodontics with milk teeth

There is widespread doubt as to whether orthodontics can be used with baby teeth, and although the short answer is “yes”, several points must be taken into consideration.

It is always necessary to assess which type of orthodontics is most appropriate for the child's stage of development and the imperfection to be corrected. Depending on the reason for orthodontics, the paediatric dentist will apply one or the other.

Can you get braces with baby teeth?

Corrective orthodontics is used to solve problems mainly related to the position of the teeth. Corrective orthodontic treatments are braces and aligners.

In theory, you can get braces or aligners with baby teeth to change their position. However, as already mentioned, these teeth are temporary and will be replaced. Therefore, if there is any dental malposition, such as crooked teeth or diastema, corrective orthodontic treatment would not be of much use as it will have no effect on the permanent teeth.

Beyond corrective orthodontics: interceptive and orthopaedic orthodontics Impress

While children's teeth are replaced as the child grows, this is not the case for the bony structures of the mouth. If the child's jaws are too narrow or receding, there is a high chance of malocclusion complications or dental malposition once all the permanent teeth erupt.

In these cases, interceptive or orthopaedic orthodontic treatment at an early age can be of great help.

Interceptive or orthopaedic orthodontics can improve a child's physiognomy, prevent severe malocclusion problems, disrupt bad habits and correct functional and speech problems. As the child is still developing, it is easier to act on the bones at this stage and thus avoid more serious problems in the long term.

From age 7, after the eruption of the first molars and while the child is still in the growth phase, interceptive or orthopaedic orthodontic treatments can be started and adapted to the needs of the patient. At Impress we offer various types of interceptive and orthopaedic orthodontic treatments for children that can help correct cases of:

• Receding jaw
• Recessed maxilla
  
• Narrow palate
  
• Open bites
  

Thanks to Impress Kids children's orthodontic treatments, subsequent corrective orthodontic treatments, such as Impress Teens, will be much faster and more effective.

If you want to give your child another reason to smile, at Impress we have the expertise and necessary tools to carry out the most appropriate treatment for your child. To find out which Impress clinics offer Impress Kids services, contact us by making an appointment through our website, phone or WhatsApp on +44 20 3808 1072. We look forward to hearing from you!