The first lost tooth: what to expect and how to celebrate
4 November 2026
Most children lose their first milk tooth at around six, usually one of the bottom or top front teeth. Sheffield Children's NHS Foundation Trust says children begin losing baby teeth around the age of six and lose the last one at around 12. It's a big moment for a child, and worth marking with a photo, a date in a notebook and a visit from the Tooth Fairy.
When do children lose their first tooth?
NHS sources agree on the broad timetable:
| Stage | Typical age |
|---|---|
| All 20 milk teeth have come through | About 2 to 3 years |
| First milk tooth falls out | Around 5 or 6 years |
| First adult back teeth (first permanent molars) come through | Soon after the front teeth start to go |
| Last milk tooth falls out | Around 12 years |
The NHS teething guide says most children have all their milk teeth by the time they are 2 to 3 years old. NHS Norfolk and Suffolk says these 20 baby teeth start to fall out around age five or six, making way for 32 adult teeth. Sheffield Children's NHS Foundation Trust says the first teeth to be lost are usually the lower and upper front teeth, followed by the first big adult teeth at the back, and the last baby tooth usually goes at around 12.
These are typical ages, not deadlines. Some children lose a tooth before they start school; others are still waiting at seven. If you're worried, ask your child's dentist at their next check-up.
Which tooth falls out first?
Usually a front tooth. Sheffield Children's NHS Foundation Trust says the first teeth to be lost are usually the lower and upper front teeth. These are also the first to arrive: the NHS teething guide says front teeth usually come through at around 6 months. After the front teeth start to go, the first big adult teeth come through at the back. These are new teeth, not replacements, so there's no Tooth Fairy visit for them.
If anything about the way your child's teeth are coming out or coming through worries you, mention it to their dentist. The NHS says children should have regular check-ups as advised by the dentist.
What to do when the tooth comes out
- Stay calm and cheerful. Some children are excited, some are upset by the gap or a bit of blood. Your reaction sets the tone.
- Rinse and dab. A clean tissue or cloth pressed gently on the gap usually helps.
- Save the tooth. Pop it in a small bag, box or envelope straight away. Tiny teeth vanish easily.
- Write the date down. You'll want it later for a baby book, a letter or a certificate.
- Take a gap-toothed photo. This is the picture you'll treasure.
Ideas to celebrate the first lost tooth
- A first-tooth certificate with your child's name, the date and which tooth it was.
- A letter from the Tooth Fairy that mentions the tooth by name: "your bottom front tooth". See our Tooth Fairy letter ideas for wording.
- A special tooth box or pouch for the tooth to wait in overnight.
- A gap-tooth photo in the same spot each time a tooth comes out. Over six years, it becomes a brilliant series.
- A tooth chart on the fridge with 20 teeth to colour in.
- A "first tooth" breakfast: pancakes, or their favourite, the morning after.
- A phone call to Grandma or a relative to tell them the news. Children love being the one with news.
- A note in a memory book: how long it wobbled, how it finally came out, what your child said.
How much does the Tooth Fairy leave for the first tooth?
UK surveys suggest about £2 a tooth on average: a RIFT survey of 6,673 parents, published in November 2023, found £1.96. Many families add a little extra or a keepsake for the first one. Decide what the normal rate will be for the other 19, so the next tooth isn't a let-down. Our guide to the Tooth Fairy going rate in the UK has the full figures.
Looking after the new adult teeth
The first adult teeth arrive as the baby teeth go, and these ones have to last a lifetime. The NHS guide to taking care of children's teeth says:
- Children aged 3 to 6 should use a pea-sized amount of toothpaste with 1,000ppm to 1,500ppm fluoride.
- Children aged 7 and over should use toothpaste with between 1,350ppm and 1,500ppm fluoride.
- Spit out after brushing, and don't rinse.
- Children of 7 and over should be able to brush their own teeth, but it's still a good idea to watch them.
A first lost tooth is a good moment to talk about this. The Tooth Fairy can help: a note praising sparkly teeth does more than any lecture. For more magical touches, see our Tooth Fairy ideas.
Frequently asked questions
At what age do children lose their first tooth?
Usually around five or six. NHS sources say milk teeth start to fall out around this age, beginning with the front teeth, and the last baby tooth usually comes out at about 12. Some children start a little earlier or later, which is normal.
Which baby tooth falls out first?
Usually one of the lower or upper front teeth. Sheffield Children's NHS Foundation Trust says these are normally the first to go, followed by the first adult back teeth coming through.
How many baby teeth do children lose?
Twenty. Children have 20 milk teeth, which are replaced over the years by 32 adult teeth.
What should I do if my child's tooth is knocked out?
Do not put a baby tooth back in, as NHS advice is that this could damage the adult tooth growing underneath. See a dentist as soon as possible, or call 111 if you can't get an appointment.
Should I keep my child's first tooth?
Many parents do, in a small labelled box with the date. If the Tooth Fairy takes it, you can keep the letter or certificate instead as a keepsake.