Losing A Baby Tooth

Understanding an important process in your child's development

Dear Doctor,
My young son just lost his first baby tooth. The tooth was hollow and a small wound in the gum was left where the tooth had been. What do I do, and is this normal?

Dear Monica,
First of all, you'll be pleased to know that everything sounds quite normal.

Here's the general story. Baby teeth, also known as primary or deciduous teeth, are just like deciduous trees that shed their leaves. These teeth are supposed to be lost to make room for the larger adult or permanent teeth that succeed them. The parts of teeth that you see in the mouth are known as the crowns of the teeth and are rather like the tips of an iceberg with most of the teeth hidden beneath the gums and attached in the bone. These hidden portions are the roots of the teeth.

The adult or permanent teeth develop and grow in the jawbones from tooth “germs” (from “germination” – a center of specialized cells from which specific growth starts) similar to plant bulbs growing new leaves and roots. However, unlike plants, the tops or crowns of permanent teeth grow first, followed by their roots. As the roots develop, the permanent teeth push the baby teeth into the mouth through the gum tissues. This process stimulates the roots of the baby teeth to be resorbed or melted away.

It's also important to make sure that the baby teeth are lost in the right sequence, and if they are lost prematurely, that the space that they formerly occupied is maintained to make proper room for the adult teeth that will replace them.

During this process, specialized cells remove the roots of the baby teeth as part of normal growth. As the roots are the foundations of the baby teeth and are undermined by the melting away process, the effect makes them loose enough that kids are able to wiggle and wobble them until they fall out or come out with the slightest coaxing. All that is left is the crown of the baby tooth with a little tissue that joins it to the gum tissue. That last little tug to the remains of the tooth usually leaves a small wound exposed and sometimes a little bleeding gum tissue that should heal quite readily. So it would appear that part of the answer to your question is, “yes, what you describe seems normal.”

Baby teeth are important; among other things, they are guides for the permanent adult teeth to erupt or come into place properly. It's also important to make sure that the baby teeth are lost in the right sequence and if they are lost prematurely, for example because of decay, that the space that they formerly occupied is maintained to make proper room for the adult teeth that will replace them.

What should you do? Consult with your general dentist or pediatric dentist (a specialist in children's dentistry) to make sure this is exactly what is happening in your son's case and to verify there is no other disease or disorder accounting for your observations and concerns. Remember, it is recommended to visit your dentist at least every six months.