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Primary tooth development is a process which begins before birth. There are rare cases where babies are even born with teeth. Many of us have questions as to when the teeth are developing and when they should be expected to appear in the mouth. Below, you will find a schedule approximating when your child’s teeth should erupt into the mouth. The schedule is based upon averages, so  every child will be different.  It is important for your child to receive regular dental exams and xrays to ensure that the proper number of teeth are developing.

Tooth Eruption Schedule

It is important to note that every child will develop at their own pace. It is not unusual to have certain teeth erupt earlier or later than the charts below say. As long as the child is under a dentist’s care, you will be able to know any issues that might be arising based on dental examinations and dental radiographs.

Upper Primary Teeth Development

Upper Teeth When tooth emerges When tooth falls out
Central incisor 8 to 12 months 6 to 7 years
Lateral incisor 9 to 13 months 7 to 8 years
Canine (cuspid) 16 to 22 months 10 to 12 years
First molar 13 to 19 months 9 to 11 years
Second molar 25 to 33 months 10 to 12 years

Lower Primary Teeth Development

Lower Teeth When tooth emerges When tooth falls out
Second molar 23 to 31 months 10 to 12 years
First molar 14 to 18 months 9 to 11 years
Canine (cuspid) 17 to 23 months 9 to 12 years
Lateral incisor 10 to 16 months 7 to 8 years
Central incisor 6 to 10 months 6 to 7 years

The complete set of primary teeth is in the mouth from the age of 2 ½ to 3 years of age to 6 to 7 years of age. Dental issues which occur in development of primary teeth directly affect the development of the permanent teeth. If you do not develop a baby tooth, you consequently will not develop the replacement permanent tooth. There may also be extra teeth which may need to be removed so as not to impede eruption of the permanent counterpart. Overly small or large teeth can also cause issue. Genetics play a large role, so if you know that there are tooth issues running in your family such as missing teeth or extra teeth, have them checked out early.

Primary Teeth Eruption Facts

-A general guide is that for every 6 months of life, about 4 teeth will erupt into the mouth.

-Girls usually get their teeth before boys.

-Usually teeth in both jaws erupt in pairs, one on the right and one on the left.

-Lower teeth usually erupt before upper teeth

-Primary teeth are smaller in size and whiter in color than the permanent teeth that will follow them.

Around the age of 4 years old, the jaw and the bones of the face begin to grow. This will create space between the primary teeth. This added space is needed for the much larger permanent teeth to erupt into the mouth. From 6 years old  to about 12 years old, children will have a mixture of baby teeth and adult teeth, referred to as the mixed dentition.

Purpose Of Primary Teeth

Primary teeth are a necessary part of a child’s development. While only in the mouth for a short period they are vital for the following reasons:

-They hold space for the permanent teeth.

-They give the face its normal appearance.

-Aid in speech development.

-Aid in obtaining good nutrition for growth and development.

-Teach Good Oral Hygiene. They help give a healthy start to the permanent teeth.

Upper Permanent Teeth Development

Upper Teeth When tooth emerges
Central incisor 7 to 8 years
Lateral incisor 8 to 9 years
Canine (cuspid) 11 to 12 years
First premolar (first bicuspid) 10 to 11 years
Second premolar (second bicuspid) 10 to 12 years
First molar 6 to 7 years
Second molar 12 to 13 years
Third molar (wisdom teeth) 17 to 21 years

Lower Permanent Teeth Development

Lower Teeth When tooth emerges
Third molar (wisdom tooth) 17 to 21 years
Second molar 11 to 13 years
First molar 6 to 7 years
Second premolar (second bicuspid) 11 to 12 years
First premolar (first bicuspid) 10 to 12 years
Canine (cuspid) 9 to 10 years
Lateral incisor 7 to 8 years
Central incisor 6 to 7 years

The first permanent molars  begin to erupt into the mouth at around the age of 6, they do not replace any baby teeth, they come in behind the last primary molars. By age 13 most of the 28 permanent teeth will be in their respective places in the mouth. The wisdom teeth will erupt (or not if they are impacted or missing) between the ages of 17 and 22. If we count the wisdom teeth we all should have 32 permanent teeth erupting into the mouth when the process is complete.

Tooth Eruption Conclusion

Tooth eruption schedules can be confusing due to the broad age ranges. Understanding the role of primary teeth in growth and development is what is most important. Irregular timing of tooth development, missing teeth, crowded teeth, extra teeth, misshapen teeth should always be assessed by your dentist. A full examination with xrays should help fully assess your child’s dental development. The earlier issues are found, they can be addressed and treated, allowing for the best future outcomes. If you have any questions regarding the timing, amount of teeth, etc. have your dentist do a full assessment so that all of your questions can be answered.

Most kids tend to have accidents that cause some sort of injury while growing up. The injuries usually range from a scraped knee to a broken bone. Most of us don’t make it into adulthood without a scar, or chipped tooth. When a child falls and loses a tooth, what can be done?

Dentists generally refer to a tooth that has been knocked out as an avulsed tooth. The accidental loss of a tooth through trauma is considered a very serious dental emergency for a permanent tooth (occurs in about 10% of the population). When a primary tooth is avulsed, re-implantation is generally not successful. The remaining space is usually left open for the permanent tooth to arrive. When a permanent tooth is avulsed, if you act quickly enough, there is a chance the avulsed tooth can be saved and maintained for many years. Even the best techniques and intentions do not always lead to a successful outcome for an avulsed tooth.

The usual cause of an avulsed tooth is a  force sufficient to break the bond between the tooth and the connection (periodontal ligament) to the bone. An avulsed tooth has no oxygen or blood flow and will die quickly if not re implanted. The primary goal of quick reimplementation is to maintain the periodontal ligament, so that the tooth is not rejected. The avulsed tooth will always need to be splinted to the other teeth, and usually, but not always, require a root canal. The speed in which the tooth is re implanted, the cleanliness of it, and how hydrated or wet it has been, all play key roles in whether or not re-implantation of the avulsed tooth will be successful.

My Child Lost A Tooth Too Early…What Now?

So what if the tooth is lost…..Can my child get dental implants?

Unfortunately, for children, the answer is no. Dental implants can only be placed after the bones of the jaw are finished growing. Dental implants placed during growth will impede jaw growth as well as proper movement of teeth into their natural places in the mouth.

The earliest recommended ages for dental implants  are as follows:

-Males – At least 17 years old.

-Females – At least 15 years old.

The determining factor for males and females is completion of growth. Females generally complete growth at an earlier age and thus can receive dental implants sooner to replace lost teeth.

Alternate Treatment Options To Dental Implants

Few children and most teenagers are going to want to replace their missing tooth as soon as possible. The options are quite limited and include the following:

-Flipper -This is a removable appliance that is able to fill the space of the missing tooth with an artificial tooth. This can create a cosmetic appearance that would be undetectable by others. It can appear very natural looking, but may affect speech and taste.

-Dental Bonding – While very rare, there are instances where a “fake” tooth can be bonded to a natural tooth.

-Braces (Orthodontics) – Sometimes the missing tooth space can be closed with braces, or a false tooth can be placed on an orthodontic wire while the bite is restored.

Conclusion

Accidents happen. Fortunately, most tooth loss is short-lived for a child, as permanent teeth will soon come in to replace the baby teeth. For many, the cosmetics are not much of an issue, and can be left alone to fill in naturally. For others, there are options to help with the space maintenance and cosmetics after tooth loss. No matter what, you should discuss options with your dentist. While some teeth may be replaced by permanent teeth in a few months, others may be several years. Choose what works best for you and your child. If a permanent tooth is lost, your child will most likely need replacement after growth has ended.  Once a child matures and completes growing, dental implants can replace the lost tooth and give a lifetime of smiles.

A discolored tooth can be a real worry for many parents. A tooth discoloration in children (and even adults) generally occurs from some sort of tooth trauma. It is believed that about 1/3rd of all children will suffer some sort of tooth trauma by age of 7. The discolored tooth may be a cause of embarrassment for a child, and the cosmetics of it may bother the parents. The issue that is most important is that a discolored tooth can lead to pain and infection.

Why Does A Tooth Change Color?

When an accident occurs involving a tooth, blood can leak out of blood vessels. The by products of this blood leakage (mainly iron) can make their way into the small tubules inside the tooth. These by products can cause a tooth to appear grey, brown, or even black. The color change usually does not happen right away. It can take about 2-3 weeks before the color change appears. The other color changes could be from deep tooth decay, or a pink/red looking tooth is usually caused by resorption.

Treatment For An Injured Tooth

The damage done inside the tooth is generally irreversible but sometimes it can be repaired especially if it is from decay only. The general rule of thumb is the darker the tooth the higher the likelihood, that the nerve of the tooth has died.

If your child’s tooth has darkened the prudent thing to do is to have your child’s dentist examine it.  If there are other signs that the tooth is dead, has a deep cavity, is resorbing or shows signs of inflammation or an infection. Many of these signs can be seen on the x-ray. The dentist will then diagnose the problem and recommend treatment. Treatments range from a root canal treatment, removing the tooth, or doing a filling or crown. If there is no sign of infection or other symptoms, the dentist may choose to leave the tooth alone. The tooth will eventually fall out on its own and it will maintain space in the meantime for the permanent tooth to erupt. Studies have shown that about 3/4′s of discolored primary teeth normally fall out on their own without any ill effect to the permanent teeth.

Other Color Changes

Other colors can include pink or red. Just like the other colors above, the tooth can turn right away or wait a few weeks.

When a tooth turns red after an accident, it generally means a blood vessel has broken. When this happens, blood leaks inside the nerve of the tooth (pulp). This is referred to as pulpal hyperemia. This can be very difficult to diagnose and over time the tooth may darken as well. The possible long term complication of this is that our body’s defenses may begin to resorb some of the internal layers of the tooth (called internal resorption). As the resorption occurs the pink or red color becomes more noticeable as the tooth structure becomes thinner and thinner. If this occurs, the teeth are either left alone until they fully resorb or they can be removed by your dentist. Resorption can also happen just prior to tooth eruption, the tooth is already on its way to falling out, and the permanent tooth pressure has caused it to resorb from the inside out.

Tooth Discoloration Conclusion

It is the nature of the parent to want to treat their children as quickly as possible. That is precisely what should be done. If you have any concerns about changes in your child’s teeth you should see your dentist immediately to diagnose the problem. Do not leave a potential infection unchecked, ask your dentist what your options are, and make an informed decision in your child’s dental treatment.

National Children’s Dental Health Month

Bringing Awareness to our Children’s Dental Health

 

Children's Dental Health Marielaina Perrone DDS