The guide to the gappy grin

Shannon Sauve had her first loose tooth when she was six. She wiggled it almost free, but in the end her dad gave the final tug. From then on, says her mom Lynn, Shannon has worked for hours to get her loose teeth out with minimal pain and hopefully no blood.

If you’ve got a school-aged child, chances are the tooth fairy is on permanent standby at your house. Here are the answers to your most pressing wobbly-tooth questions, straight from a dentist’s mouth.

How many baby teeth does a child lose? Kids lose 20 teeth between the ages of 5½ and 12, says Toronto paediatric dentist Barry Rubinoff. The front teeth are often the first to go, but the order can vary from child to child.

When do kids lose their first tooth? The average is between age 5½ and six; most kids are in this range. Some lose their first teeth a bit earlier, around five, while others not until 6½ or seven.

How does it happen? “When it’s time for them to come out, baby teeth get wobbly because the root begins to dissolve — until it’s gone and the tooth falls out. Sometimes, though, the root only partially dissolves, and that’s when the phone calls come into the office,” says Rubinoff.

My son isn’t eating much these days because he’s got a wobbly tooth that’s bugging him. How can I help? Encourage your child to bite on hard apples or carrots and to wiggle that loose tooth with a clean finger. If the tooth doesn’t seem to want to come out, or it’s really bugging your child, take him to the dentist. “Parents shouldn’t try to pull a loose tooth themselves, not only because it’s not always easy to get it out, but it can hurt!” And forgo the time-honoured technique involving the string and the doorknob.

My daughter’s baby teeth are crowding the permanent teeth. Is this a problem? Crowding means there’s not enough room in the dental arch for the permanent teeth. Sometimes kids will have a second row of permanent teeth coming in behind the baby teeth, like a shark. This isn’t necessarily a problem; the tongue pushes the permanent teeth forward and the baby teeth drop out. But sometimes the permanent teeth are too big for the jaw. “What we like to see is little spaces between the baby teeth, which means there will be a better chance for enough space,” explains Rubinoff. If the permanent teeth are crowded, the dentist may shave a bit off the sides of the baby teeth to make room or, in severe cases, extract them. Are there other reasons for loose teeth? Yes, says Rubinoff. Sometimes kids fall or knock their teeth, loosening them. But the parents don’t realize there’s a problem because the kids don’t say anything, and there’s no sign of an injury. If you suspect a tooth is loose because of an accident, see your dentist. “In the case of a primary (baby) tooth, sometimes the approach is to wait and see. If the tooth tightens up and stays healthy, great; if it becomes infected, it will have to be taken out.”

In occasional cases, a child will have loose teeth because of an infection of the tooth. Good dental hygiene is the best way to keep teeth healthy: regular brushing and flossing, limiting sweets and wearing appropriate protection — a mouthguard is essential for any contact sport.

Tooth fairy tales

The going rate, according to our extremely unscientific poll, appears to be a loonie or a toonie for baby teeth. But sometimes the tooth fairy is moved to provide a toy, a special charm, a new book or a toothbrush in lieu of cash payments. If the tooth under the pillow was pulled by a dentist, the rate tends to climb to five or even 10 dollars in recognition of pain and suffering.

It seems that the tooth fairy is notorious for her forgetfulness. One youngster waited three weeks for a visit, while others have been informed that their tooth was lost too late in the evening to be included in that evening’s round.

Often the tooth fairy leaves a little note or letter imploring tiny toothless wonders to brush and floss regularly. Purple ink is standard issue.

And yes, Virginia, the tooth fairy does tend to keep all those little pearls of babyhood tucked into a treasure box in her top drawer.