Medical Conditions

Baby Teeth Not Falling Out

The short answer

Baby teeth typically begin falling out around age 6, starting with the lower central incisors, but there is a wide normal range. Some children lose their first tooth as early as age 4 or as late as age 8. Delayed loss of baby teeth can be caused by a late pattern of tooth development, missing permanent teeth underneath, or crowding. If a permanent tooth erupts behind a baby tooth that has not fallen out (sometimes called shark teeth), the baby tooth usually loosens and falls out on its own within weeks.

By Age

What to expect by age

This concern is not applicable at this age. Baby teeth are just beginning to erupt and will remain in place for years. The full set of 20 primary teeth usually comes in by age 2.5 to 3 years.

Baby teeth are erupting during this period. All 20 primary teeth will serve important functions for chewing, speech development, and holding space for permanent teeth. They are not expected to begin falling out until approximately age 6.

The primary teeth are still actively erupting. Parents should focus on oral hygiene and dental visits. The permanent teeth are developing within the jaw below the baby teeth and will not begin pushing them out for several more years.

All baby teeth should be in by age 3. The first baby teeth typically fall out around age 6, though the range of normal extends from about age 4 to 8 for the first lost tooth. If baby teeth have not begun to loosen by age 8, a dental evaluation with X-rays can check whether permanent teeth are developing normally underneath. Some children have congenitally missing permanent teeth, which means the baby tooth above that space may be retained indefinitely.

What Should You Do?

When to take action

Probably normal when...
  • Your child has not lost any baby teeth yet but is under age 7
  • Baby teeth are falling out in a different order than expected
  • A permanent tooth is coming in behind a still-present baby tooth (shark teeth) and the baby tooth is starting to get loose
  • Your child is a late bloomer developmentally and also a late teether, as these patterns often correlate
Mention at your next visit when...
  • Your child is 8 years old and has not lost any baby teeth yet
  • A permanent tooth has erupted behind a baby tooth that shows no sign of loosening after several weeks
  • Baby teeth were lost very early (before age 4) due to decay or trauma, and you want to ensure the permanent teeth will come in correctly
Act now when...
  • A baby tooth was knocked out or is severely damaged from trauma and needs immediate dental evaluation to protect the permanent tooth underneath
  • Your child has significant pain, swelling, or infection around a retained baby tooth

Sources

My Baby's Head Shape Looks Abnormal

Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.

Achondroplasia (Dwarfism) in Babies

Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.

Adenoid Hypertrophy and Breathing

Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.

Air Quality and Baby Health

Babies and young children are more vulnerable to air pollution than adults because they breathe faster, their lungs are still developing, and they spend more time close to the ground where some pollutants concentrate. The EPA recommends keeping babies indoors when the Air Quality Index (AQI) exceeds 100 (orange level). During wildfire smoke events, keep windows closed, use air purifiers with HEPA filters, and monitor your child for coughing, wheezing, or difficulty breathing. Long-term exposure to air pollution can affect lung development.

Altitude Sickness in Babies

Babies and toddlers can experience altitude sickness when traveling above 5,000-8,000 feet (1,500-2,500 meters). Symptoms are harder to recognize in infants because they cannot describe how they feel. Watch for unusual fussiness, poor feeding, disrupted sleep, vomiting, and fast breathing. Gradual ascent is the best prevention. Most pediatricians recommend avoiding sleeping at very high altitudes (above 8,000 feet) with infants when possible, and descending immediately if symptoms appear.

Amblyopia (Lazy Eye) Treatment Timing

Amblyopia (lazy eye) is the most common cause of vision loss in children, affecting 2-3% of the population. It occurs when one eye develops weaker vision because the brain favors the other eye. Early detection and treatment are critical because the visual system is most responsive to treatment during early childhood. Treatment is most effective when started before age 7, though improvement is possible at older ages. Treatment options include patching the stronger eye, atropine eye drops, glasses, or a combination.