Baby teeth 101

Every night in America, countless “tooth fairies”? clock in. Usually disguised as groggy moms and dads, you can spot them counting out cash under a one-watt Cinderella night-light and cursing silently from stepping barefoot on scattered Legos.

Traditions vary across the globe, but practical dental advice is universal when it comes to losing baby teeth. Here are a few details parents need to know before that first loose tooth.

The first little wiggle

Children naturally start to lose their baby teeth (otherwise known as deciduous, milk, temporary or primary teeth) around ages 5 to 6. (Children whose baby teeth erupt early may lose them before late-teethers do.)

“Girls also tend to lose their first baby tooth earlier, and the first tooth to go is usually in the lower front,”? says Gary Badger, DDS, MS, associate professor and chair of pediatric dentistry at The University of Texas Health Science Center at Houston (UTHealth) School of Dentistry.

It’s exciting to discover that first loose tooth. For most little kids, it is a sign of becoming a big kid. “Encourage them to wiggle the tooth every day with clean fingers,”? Badger said, emphasizing the word clean. “Wiggling the tooth will help it to be shed quickly and naturally. Parents should also be aware that permanent teeth will often be crooked as they emerge through the gums. As the teeth grow in they will usually straighten themselves out.”?

Baby teeth 101

A baby tooth becomes loose when its roots begin to dissolve from the pressure exerted upon it by the incoming permanent tooth. Generally, it takes a few months from the time a tooth becomes loose until it falls out. Loose teeth also can be stubborn, sometimes “hanging by a thread”? for several weeks. If this happens it can be quite uncomfortable. They may have
to be helped out by a pediatric dentist.

Eating apples and pears also can help loosen the tooth. “The tough skins on those two fruits can be especially helpful. They might even see their tooth come out by munching down on one of those healthy snack items,” Badger said.

Normal bleeding

A little bleeding may occur when the baby tooth first comes out. Don’t encourage your child to keep spitting out the blood because the spitting action can cause more bleeding. Just take a small piece of moistened gauze or a cooled and wrung-out tea bag and place it where the tooth came out.

“Keep in mind that even a very small amount of blood mixed with saliva can seem like a lot of blood — more than it actually is. It’s important to reassure the child that this is normal,”? Badger said. The bleeding should stop within five to 10 minutes. If it doesn’t, call your dentist.

When to see the dentist

First dental visits should be scheduled about six months after the appearance of the first baby tooth or by age 1, according to guidelines of the American Academy of Pediatric Dentistry.

Badger, program director at the UTHealth School of Dentistry, urges parents to pay close attention to their children’s early dental hygiene.

Dr. Gary Badger


Dr. Gary Badger is associate professor, chair of Department of Pediatric Dentistry and program director of Pediatric Dentistry Residency at UTHealth School of Dentistry.

“You want to keep baby teeth as free from decay as possible to prevent systemic infections that might start from cavities and to prevent any damage to the permanent teeth underneath,” he said. “Children should see their dentist regularly, at least once a year, and more often if they’re at higher risk for cavities. Baby teeth that have a cavity should be restored, because the baby tooth holds the space for its permanent successor.”

Badger likes to allow youngsters, ages 2 to 6, to brush their own teeth with parental supervision.

“But when they’re finished, it’s best for parents to go behind them and re-brush,? especially the back teeth that children often miss, he said. “This is also a good time to notice any concerns, such as a permanent tooth erupting before a baby tooth is gone.”

If a permanent tooth begins to sprout from the gum before the baby tooth falls out, the dentist will pull the baby tooth to help ensure that the permanent tooth can grow straight into the empty spot.

Always visit a dentist if a baby tooth is damaged or knocked out due to trauma to the mouth, Badger said, “to make sure no gum tissue, bone structure or permanent teeth were harmed.”?

A child who hadn’t lost the first baby tooth by age 8 will need a dental evaluation and most likely, an X-ray, he said. By age 12, most children will have lost all 20 of their baby teeth.

As for what to do with those baby teeth, it’s up to each parent. It’s important to reassure the child that losing baby teeth is a normal part of growing up. Many children place them under their pillow for the “tooth fairy”? to replace with cash. It should be a celebration as a sign of growth.?

What to do with those baby teeth?
Scotland has a tooth fairy; Mexico has a mouse

“In many European countries, differing traditions dispose of the baby teeth in many ways. Many of these ways have been adopted by the U.S. culture. The overriding sentiment is that the amusing tradition is a way to signify that the child is advancing in age and the loss is to be celebrated by myth and joy.”?
– Dr. Gary Badger, Chair, Department of Pediatric Dentistry, UTHealth School of Dentistry

“I trained at the University of Iowa where we saw a lot of Mesquaki children from the settlement near Marshalltown, Iowa. In Mesquaki tradition, losing your first tooth means you are beginning to grow up. Mesquaki parents save all of a child’s baby teeth and take the adolescent and his or her baby teeth to sacred ground near the Iowa River where they throw the teeth into the woods as the family sings and prays for the child’s healthy passage to adulthood.”?
– Dr. Jennifer Hill, formerly of UTHealth School of Dentistry

“Growing up in Italy, it was the custom to take the tooth and throw it in a chimney… so it would disappear.”?
– Dr. Giuseppe Colasurdo, pediatrician and UTHealth President

“In Puerto Rico, it is a little mouse that takes the tooth. According to my husband’s family, the mouse collects the teeth to use as keys for a beautiful piano it is building.”
– Dr. Susan Pacheco, pediatric immunologist and allergist, UTHealth

“I kept a letter my daughter wrote about the ‘tooth fairy’ as a child. I have it saved with her keepsakes. Apparently, she felt that the ‘tooth fairy’ and leprechauns (in Irish mythology) had a give-and-take relationship. She thought the tooth fairy got the money to leave under children’s pillows from leprechauns. In exchange, the tooth fairy then gave the teeth to the leprechauns so that they could build their houses out of teeth. Part of this was probably my fault, as I always left gold dollars for her teeth. I guess she connected that with the pot of gold at the end of a rainbow.”?
– Dr. Pamela Berens, obstetrician-gynecologist, UTHealth

“In a desperate attempt to preserve the magic for my children who had heard the ‘no tooth fairy’ rumors at school, I bought a can of spray glitter. I sprayed it on the sill of the slightly cracked-open window and trailed it across the floor to their beds: fairy dust. For one special tooth, I left a butterfly wing behind.”?
– Karen Krakower Kaplan, assistant vice president, chief information officer, UTHealth

“My daughter lost her first tooth while we were visiting my mother. She put her tooth under her pillow that night, but we failed to designate a ‘tooth fairy.’ I crept in and gave her money; her father snuck in and gave her money; so did my mother. She woke up with $20. The next night I tucked her in, and my hand met something sharp under her pillow. I lifted it up and saw my mother’s partial denture. She explained, the tooth fairy gave me $20 for one tooth, think of what she will give me for all of grandma’s teeth.”?
– Shelia Amiot, retired administrative assistant, UTHealth

Customs in other countries

In Austria, you either make the baby tooth into a pendant head, a key ring, or throw the upper tooth under the house and the lower over the roof.

One tradition in England held that if a child’s tooth fell out, that child must drop it into a fire, to avoid having to look for it after death, and this may be the origin of the importance of a lost tooth. This tale was handed down during the Middle Ages to smaller children during the teething stage.

French children puts their baby teeth under a pillow when they go to bed. The fairy takes it while the child is asleep and replaces it with a present, such as a toy, instead of money.

In Hungary, one custom may have been that the baby tooth was put into a bottle with water, and the tooth melted in about two years’ time.

If it is a lower baby tooth, throw it up onto the roof; and if it is an upper tooth, throw it underneath the en-no-shita, which is the lower portion below the floor of a Japanese house. It is done so that the upper tooth grows healthy downwards, while the lower tooth upwards.


This article, which has been updated, originally appeared on HealthLEADER, an online wellness magazine produced by The University of Texas Health Science Center at Houston (UTHealth). Visit HealthLEADER for more articles on a broad array of health and wellness topics.