Fall of the Milk Teeth

When do the teeth fall?

The fall of milk teeth is a physiological phenomenon that starts around the age of 6, with the aim of making room for permanent teeth.

In medical parlance, the fall and subsequent replacement of milk teeth with permanent ones is called a trade-in .

It is not possible to establish with absolute accuracy which is the ideal age for which a milk tooth should fall: while some children lose their first tooth at the age of 5, others show all 20 milk teeth still at the age of 7 years.

Symptoms

The fall of milk teeth is a normally painless process, which however can cause discomfort when a tooth flaunts of falling, remaining semi-tied (and dangling) to the gum. Other times, the edge of the milk tooth may be chipped due to falls or traumas (a fairly frequent occurrence in children): in these circumstances, tooth drop may anticipate standard times, and the exchange process may undergo some temporal variations .

Although, in physiological situations, the fall of milk teeth does not cause particular pain to the child, the gums may appear swollen and inflamed, especially in the days immediately preceding the eruption of the permanent teeth. If, in these cases, the child experiences an annoying perception of gum soreness, it is possible to administer paracetamol (after medical advice) which, in addition to burning, prevents fever. In fact, in some children, the growth of a permanent tooth after the milk tooth has fallen causes a slight rise in temperature.

Fall (or exchange) of milk teeth = replacement of the deciduous (or milk) teeth with the permanent one

Milk teeth

The milk teeth, all destined to fall, are thus subdivided for each dental SEMI-CIRCUIT:

2 incisors (1 central + 1 lateral)
1 canine
2 molars (called respectively "first" and "second" molar)

The premolars and wisdom teeth are absent in the milk dentition

Permanent teeth

The permanent teeth replace the milk teeth after the fall, and are thus divided for each dental semi-arch:

2 incisors (1 central + 1 lateral)
1 canine
2 premolars
3 molars (first, second and third)

Even if they are destined to fall, milk teeth are nonetheless a fundamental task: they allow an effective chewing and an adequate phonation, guide the permanent teeth in their correct position and maintain an adequate space for the subsequent development of the "mature" teeth.

Despite the frequency and the order of fall of the deciduous teeth are not constant parameters in all children, approximately, it is possible to affirm that the milk teeth tend to fall in the order in which they arose. First the lower central incisors arise; subsequently, the two upper central incisors erupt, the first molars, the canines, the second molars and so on.

The reason is not clear yet, but from medical statistics it can be seen that the fall of the teeth starts first in females compared to males.

Age of falling milk teeth

The table shows the approximate ages in which the milk teeth begin to fall to make room for the permanent teeth.

Type of teeth	Approximate age of falling milk teeth	Approximate age of replacement of milk teeth with permanent ones
Central incisors	6-8 years	6-8 years
Lateral incisors	7-9 years	7-9 years
canines	9-12 years	9-12 years
First molars (deciduous)	10-12 years	10-12 years (first premolars)
Second molars (deciduous)	10-13 years	10-13 years (second premolars)
First molars or molars of 6 years	-	6-7 years
Molar seconds or molars of 12 years	-	12-13 years
Third molars (wisdom teeth) or molars of 18 years	-	17-25 years (may or may not appear)

As can be seen in the table, the first, second and third molars do not replace any milk tooth (they do not have a corresponding tooth destined to fall). Let us remember briefly that the milk teeth are 20, while the permanent ones are 32.

Curiosity

In the period between the end of breastfeeding and the fall of milk teeth, the child is much more exposed to the risk of infectious diseases and cooling. This correlation is quickly explained and should not be surprising: in this precise phase of development, the child makes numerous advances, such as the improvement of language, being together with adults, dressing alone, brushing teeth without asking for help, etc. Seen with the eyes of a child, these behaviors - considered habitual for the adult - require an exaggerated effort, such as to heavily reduce the immune defenses and make it susceptible to infections.

What happens if...

... the fall of the teeth is postponed beyond the "standard" time → the deciduous teeth can hinder the correct development of the permanent teeth, laying the foundations for a dental malocclusion
... the fall of milk teeth does not occur → milk teeth must be surgically extracted to avoid future structural tooth anomalies (eg crooked teeth)
... the fall of milk teeth begins early → it is not uncommon that, due to cariogenic processes or traumas, the teeth undergo an early (non-physiological) fall. In such circumstances, permanent teeth that are born tend to undergo structural alterations
... milk teeth fall into old age (compared to the norm) and are affected by inflammation or other pathologies → greater probability that permanent teeth grow with spots on the enamel
... the milk teeth have fallen but the permanent teeth do not grow → the (infrequent) phenomenon is called ankylosis: the permanent teeth become trapped inside the bone, therefore they cannot erupt. In this case, a surgical intervention is often required
... a milk tooth caries → the filling of caries is necessary. In fact, an untreated deciduous tooth can anticipate tooth drop, causing a future misalignment of the teeth
... if a permanent tooth erupts before the fall of the deciduous equivalent → it is advisable to remove the tooth from the tooth if the fall does not occur within three months of the eruption of the permanent tooth
... if the permanent teeth tend to cariare easily → immediately after the fall of the milk teeth and the subsequent replacement with the permanent teeth, it is possible to prevent caries with the correct daily dental hygiene. To obtain further coverage from cariogenic processes, dental sealing is recommended, a procedure which consists in applying a special resin on the tooth, such as to prevent the formation of caries. The sealing of the teeth is particularly indicated for the molars, being more exposed to the risk of caries due to the particular "furrows" structural conformation that favors the accumulation of plaque and tartar on the chewing face of the tooth.
... if a milk tooth tends to fall but does not come off within 15 days → the child can be encouraged to gently move the tooth, to facilitate its fall

Keeping milk teeth healthy is essential to allow the physiological fall of the teeth in the appropriate times, and to favor the correct development of the permanent dentition