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Celebrating National Tooth Fairy Day

February 28, 2013

Marielaina Perrone DDS Tooth Fairy

Tooth eruption is a process in tooth development in which the teeth erupt into the mouth and becomes visible.

The arrival of a new tooth, or tooth eruption is a big event for most of us! As a baby, tooth eruption allows for introduction of new foods with more substance. Later on, many parents and kids look forward to a visit from the tooth fairy, and for their new “grown up” teeth to come in. It is an exciting time for parents and children alike and losing baby teeth is an important milestone in most kids and parents lives. It means they are growing up, getting bigger, and taking on more responsibility for themselves at home and school.

Tooth Eruption Facts

Humans have two sets of teeth, primary (or baby) teeth and then permanent teeth. These teeth develop in stages. The schedule is different but the development and tooth eruption of each of these sets of teeth is very much the same. Following are a few facts about tooth eruption:

Tooth eruption tends to happen in parallel. This means that the bottom molar tooth on your left side should erupt into your mouth at about the same time as the bottom molar tooth on the right side.

-Primary tooth development begins during the 2nd trimester of a woman’s pregnancy. Primary teeth are place holders for permanent teeth.

-Loss of primary teeth due to extraction or loss of space due to breakdown of baby teeth, makes a child susceptible to malocclusion and more likely to need orthodontic treatment.

-The crown of a tooth is the first to begin forming. The roots continue to develop and lengthen even after the teeth have come through the gums.

-There are 20 primary teeth. These are usually fully erupted by age 3, and remain until around 6 years of age when they begin to fall out to make room for your permanent teeth.

-Adult teeth usually begin to erupt into the mouth between 6 and 12 years of age. Most adults have 32 permanent teeth.

-Permanent teeth are larger and take longer to erupt than primary teeth.

Tooth Eruption – Types of Teeth

A person’s teeth will vary in size, shape, and their location. Each tooth in your mouth has a job to do and that is why it is shaped the way it is and where it is located. Tooth eruption follows a definite pattern.  There are 5 types of teeth:

1) Incisors. Incisors are the eight teeth in the front of your mouth (four on top and four on bottom). These teeth are used to take bites of your food. Incisors are usually the first teeth to erupt. Primary incisors erupt at around 6 months of age.Permanent incisors should come in at  6 and 8 years of age.

2) Canines. We have four canines in our mouths. These are the next type of teeth to erupt. Canines are your sharpest teeth and are used for ripping and tearing food apart. Teeth eruption for primary canines usually occurs between 16 and 20 months of age, with the upper canines coming in just before  the lower canines. The order is reversed for permanent teeth. Lower canines erupt around age 9, with the uppers erupting at about 11-12 years of age.

3) Premolars. Primary molars are replaced by premolars. Premolars (also called bicuspids) are used for chewing and grinding of food. You have four premolars on each side of your mouth, two on the upper and two on the lower jaw. The first premolars appear around age 10 and the second premolars arrive about a year later. Premolars are generally the teeth that may need to be removed during orthodontic treatment to create space.

4) Molars. Primary molars (replaced by the permanent premolars) are also used for chewing and grinding food. Teeth eruption for these happens between 12 and 15 months of age. The first permanent molars erupt around 6 years of age while the second molars come in around 11-13 years old.

5) Third Molars. These are also referred to as “wisdom” teeth. These are the last teeth to erupt into the mouth and do not typically erupt until age 18-21 years of age. Some

Tooth Eruption Issues - Peg Laterals - Marielaina Perrone DDS

Tooth Eruption Issues – Peg Laterals

people never develop third molars at all. These molars may cause crowding and need to be removed. Other times they develop in the jaw but never erupt into the mouth. When this happens it is referred to as impacted.

Tooth Eruption Issues

-Supernumerary teeth.  Extra teeth may form and make normal tooth eruption more difficult, delayed or impacted. This happens most often in the wisdom tooth area. Another type of extra tooth is called a mesiodens. This is an extra small tooth growing right between the two upper front teeth and needs to be removed surgically. There is also Gemination, or twinning of a tooth, wherein, a double tooth forms.

Malformed  Teeth. Tooth eruption is not always perfect. Sometimes genetics, medications etc. can cause malformed teeth. Examples are peg laterals (very small lateral incisors), mulberry molars (a molar

Fused Tooth - Marielaina Perrone DDS

Tooth Eruption Issues – Fused Tooth

that has a raspberry like appearance), Fused teeth (two different teeth which form conjoined into one tooth such as a lateral and canine),  Dens in dente (a tooth growing completely inside of another tooth).

If a tooth does not form in the primary dentition (for example a child never forms a front baby tooth), there will never be a permanent tooth to replace it. Also, tooth eruption in the lower arch in front can sometimes erupt behind the primary teeth. This is quite normal but may necessitate the need of removal of the primary teeth to aid tooth eruption.

If teeth are not erupting properly, have your dentist take an x ray. Sometimes there are developmental or genetic issues causing malformed teeth, extra teeth or lack of tooth development. It is important to monitor tooth eruption as it happens. The earlier these issues are detected, the better you can prepare for future treatment needs.


Primary Tooth Eruption Chart

Tooth Eruption Chart - Marielaina Perrone DDS

Tooth Eruption Chart


Losing teeth can be a serious health and self esteem problem for many Americans. If we do not take proper care of our teeth eventually we will lose them. As a child, tooth loss is normal as the primary teeth give way to our adult or permanent teeth. The tooth fairy comes when we lose our baby teeth but not for our adult teeth that we lose through neglect, trauma or disease.

There was a time when it was considered quite normal to lose your teeth as we got older. Losing teeth affects our lives by losing the ability to chew our food properly and stay healthy. With modern dentistry, we are able to care for and replace teeth so that we can maintain our health and hopefully live longer

Causes of Losing Teeth

A person can begin losing teeth by a variety of means. These can include trauma, disease or poor dental maintenance.

Poor dental hygiene. It is recommended that we brush our teeth at least twice a day and floss at least once a day to help prevent losing teeth. It is also recommended that we visit our dentist every six months for regular examinations and cleanings. If we do not follow these recommendations you are more likely to have cavities and periodontal disease. If untreated this will eventually lead to a person losing teeth.

losing teeth from poor nutrition

Losing teeth from poor nutrition

Maintaining a diet of poor nutrition. Continuously digesting foods that contain high amounts of sugar, carbohydrates and acids can and will damage your teeth and gums. These types of diets will again lead to tooth decay as well as periodontal disease.

Poor habits. Tooth grinding (bruxism) can be a very tough habit on our teeth. People who aggressively grind their teeth will eventually wear away the outer enamel of teeth causing teeth to be come more sensitive and to crack, as well as more prone to tooth cavities. Chewing on ice and biting down on oral piercings are also far more likely to fracture teeth over time. Another major habit that directly affects teeth and gums is smoking. Smoking is a leading cause of adult periodontal disease. Advanced periodontal disease will lead to losing teeth as well.

Contact sports. Many people play contact sports on a regular basis. This includes children, teenagers and adults. The sports vary from football, hockey, basketball, snowboarding and even bike riding. A traumatic accident to the mouth can cause a loss of teeth, or an avulsed tooth. Wearing a mouth guard is very important to prevent fracture or injury to teeth from traumas. These can be the standard over the counter types or custom made ones.

Dental phobia. Some people are so afraid of the dentist that they refuse to see one. These people will not go even if they have a tooth ache. This is a recipe for losing teeth. There are ways to overcome your dental fears, finding a dentist who can work with your phobia is the first step. Seeing your dentist regularly or even at first signs of pain or trouble can lead you to saving the teeth in question versus losing teeth.

Cost. Most people assume that dental treatment is too costly so they just do not go until they have a major problem. It is actually far cheaper to go regularly for prevention than to just go when there is an emergency. Plus going regularly puts you at ease that you are maintaining your oral health as best as possible. Losing teeth should never happen because of cost.

Everybody is at risk of losing teeth. Although tooth loss is usually associated with the seniors of our population, research has shown that about 25-30 percent of people lose their first tooth between the ages of 21 and 30 years old.

Children become far more active as they grow up and the chances of trauma to the teeth increases. Such tooth injuries can occur on baby teeth or adult teeth. If your kids play sports, make sure they wear a mouth guard for protection.

Adults must pay special attention to brushing and flossing because poor oral hygiene is the main cause of periodontal disease. The inevitable outcome of periodontal disease as it advances is tooth loss. Periodontal disease also affects your general health. This is especially true if you have diabetes or heart disease.

Losing teeth usually affects seniors the most. As people grow older, they have more chances to develop certain diseases. These diseases can lower their immune system as well as require them to take medications that can have an affect on their oral health. Maintaining good dental hygiene is very important throughout life but especially as we age.

Consequences of Losing Teeth

General health problems may not be your only concern when it comes to losing teeth. A persons self esteem is directly affected by your smile. Losing teeth changes the way you smile and look as well as feel about yourself. Some other consequences of losing teeth include:

-Problems with speech. Depending on where you are losing teeth you can have definite problems with enunciation of words. This is especially the case as you move towards the front of your mouth.

-Problems chewing and eating certain foods. If you are losing teeth towards the back of your mouth you will have major issues chewing and digesting meatier and healthy crunchy foods. The chewing process is the beginning of digestion. If you do not break your foods down properly it will throw off your entire digestion process.

-Self esteem and self-consciousness issues.

-Earlier breakdown of other teeth because there are less teeth to use when you eat.

-Other teeth will begin to shift towards the open spaces

-Bite closing, loss of teeth causes deeper closing of the mouth, and a change in your appearance.

-Losing teeth as a child will create issues for the eruption of permanent teeth. The primary teeth serve as space holders for the permanent teeth to erupt into. With premature loss of primary teeth, the remaining teeth will shift forward into the space. The loss of space will cause crowding in the arch when the permanent teeth begin to come in.

Options for Replacing Lost Teeth

There are many options in modern dentistry to replace lost teeth. If you have one or more missing teeth you have the following options for replacement:

Dental implants  Dental implants are an artificial tooth root that is placed into your jaw bone to support restorations that resemble a tooth or group of teeth. Dental implants can replace a single tooth, be a support for a bridge, or as support for a denture. It looks and feels like a real tooth and does not require any other teeth for anchoring or support. Implants are considered to be the best and most comfortable tooth replacement solution as well as the one that should last the longest with proper care. They are also have the highest cost as replacements go.

Dental bridge is a set of three or more crowns fused together as a group, where the one in the middle replaces the missing tooth. The crowns on the edge cover your own teeth which are used as anchors. A bridge is permanently cemented in, and can not be removed.It can be very cosmetic in nature, looking like your real teeth.

-Partial and complete dentures. These are removable and replace several (partial) or all (complete denture) missing teeth. Since they are not fixed, they are not as natural feeling as implants or bridges, and do not help you chew foods as effectively. Depending upon where your missing teeth are, dentures can give your smile an aesthetic look. Partials also prevent your other teeth from shifting and moving. With the advent of dental implants, dentures have been given a whole new life. Implants can be used to anchor a complete denture giving it much more stability and esthetics than the traditional complete denture.