First Lost Tooth: Tooth Fairy Ideas, Questions Kids Ask and What's Normal

“Mom, it’s wiggling!” Your six-year-old daughter has been checking the same bottom front tooth for a week, in every mirror and every spoon. One evening, halfway through an apple, it’s out. There’s a tiny gap, a little blood and a very proud grin.

A first lost tooth is a milestone a child can see and touch. Excitement and nerves are both normal, and a little preparation helps.

In one minute

• What’s typical: most children lose their first baby tooth around age 6, usually between about 5 and 7. Earlier or later is usually fine. The bottom front teeth usually go first.
• The key insight: children have 20 baby teeth, and losing them takes years, often until about age 12.
• The key action: let each tooth come out when it’s ready, and pick a tradition that fits your family. The tooth fairy is a family choice; there’s no wrong one.

What’s going on

Under each baby tooth, a grown-up tooth grows. As it rises, the roots of the baby tooth slowly dissolve, the tooth gets loose and finally falls out. It rarely hurts much, but many children feel nervous about the wiggling and the blood.

Sometimes a grown-up tooth comes in behind a baby tooth that hasn’t fallen out yet. It looks strange, but it’s common, and the baby tooth often falls out on its own.

Some children are sad to lose “their” tooth, or feel left out because half the class has a gap (“Your teeth have their own calendar” helps). Swallowing a tooth happens too, and is almost always harmless.

Try today

1. Prepare before it falls out. Talk about what will happen: a wiggle, a little blood, a gap. Keep clean gauze and a small envelope for the tooth somewhere easy to find.
2. Let your child wiggle it, and stay calm when it’s out. Gentle wiggling with clean hands or the tongue is fine. Pulling hard before the tooth is ready can hurt. Once it’s out, rinse with water and press clean gauze on the spot for a few minutes. Stay relaxed: children read our faces.
3. Plan the tradition together. A pillow, a little box or an envelope. A tooth fairy letter your child writes or tells you, and a tiny reply. A photo of the gap smile. Some families have a tooth mouse instead (Ratón Pérez or la Petite Souris). Small and personal is enough.

In calm moments, talk about the new teeth: they’re for keeps, so brushing twice a day with fluoride toothpaste matters more than ever. Most children need a grown-up to help or check until about 7 or 8.

What to say

In the moment, when a loose tooth makes them nervous:

“You’re nervous about the wiggly tooth. It feels strange. Your body is making room for a grown-up tooth. You can say: I’ll wiggle it with my tongue.”

Afterwards, when it comes out:

“You lost your first tooth! How does the gap feel with your tongue? You stayed calm when you saw the blood. That was brave.”

The hardest version, when they ask if the tooth fairy is real:

“What do you think?”

Then follow your child’s lead. Many want to keep believing. If an older child asks again and clearly wants the truth, give it gently: “The tooth fairy is a game parents play out of love. I was your tooth fairy. Now you can join the tooth fairy team and help keep the magic going for younger children.”

What to avoid

• Pulling a tooth that isn’t ready. It can hurt and bleed more, and make the next loose tooth scary.
• Making it all about money. Amounts vary a lot, and friends compare. A note or a small surprise matters more than the sum.
• Teasing about the gap. Some children feel shy about their new smile.
• Panicking if the tooth fairy forgets. It happens. “She must have had a busy night” buys you one more evening.

When to get help

See a dentist if a fall or bump loosens or chips a tooth, if your child starts losing teeth before about age 4 without an injury, if a baby tooth is still firm a couple of months after the grown-up tooth has come in behind it, if there’s swelling, pain or fever, or if bleeding doesn’t stop after about 15 minutes of steady pressure with clean gauze.

If a grown-up tooth is knocked out, call your dentist right away: hold it by the top, not the root, and bring it in a cup of milk. Don’t put a knocked-out baby tooth back in. If your child may have breathed in a tooth and keeps coughing, call your doctor now, or 911 if they struggle to breathe.

Read together

Professions begins with Whyia wondering what her parents do at the office. She turns into a kitten, hides in the car and surprises them at work. Her dad designs houses and her mom is an accountant. Later, on a walk with her gran and her cousin Ethan, Whyia meets a crane operator, a woman selling buns, a bus driver, a teacher, a police officer and a lifeguard, and hears that her aunt is a doctor.

After reading, add one more helper to the list: the dentist, who looks after the new teeth. Then draw your child’s gap smile together and keep the picture with the tooth.