Tuesday, January 29, 2013

Permanent tooth or Baby tooth??

I was calling a patient back at work a couple days ago and the parent entered our consult room with the child and seemed terribly concerned. The parent mentioned the child sucked her thumb and it was ruining her permanent teeth. Looking at the patient's information, I noticed the patient had just made five years old. Although it is possible, most kids her age don't completely have their upper permanent teeth in the front. I explained to the parent to not worry and that it all could be fixed. After taking the patient to the back and sitting her in the exam chair I immediately looked and saw the patient had all primary (baby) teeth. Then, I got to thinking, most parents don't know the development of their child's teeth. I didn't know the development of teeth until I started studying the world of dentistry. So today, I am going to have a quick overview of when children's teeth begin to erupt, how many teeth they get, when they begin to exfoliate and how many permanent teeth they get to replace the primary teeth.

On average your child's first tooth should erupt between 6-8 months of age. There are cases where children are born with teeth, also called neonatal teeth. Some children don't get their first tooth until after a year old. Although that may not be the average it is not abnormal. I always remind parents, boys tend to develop slower than girls. The first teeth to come in are the lower central incisors (front two teeth in the middle, see charts below) or the upper central incisors. Then, the lateral incisors (upper or lower). There are rare cases where we see teeth erupting out of sequence, meaing the canines erupt before the laterals. Once again although this is not within the average of most children it is not abnormal or mean there is a problem. After the front four (top and bottom) are in, the 1st molars will erupt, canines and the 2nd molars will follow. Your child should get 20 teeth total by the age of three.

Around age 6 children began to lose and gain teeth. The central lower incisors (see chart below) are usually the first to fall out. Most of the time children's teeth will fall out in the order they erupt. Children tend to lose all the incisors (front teeth) and then their development takes a 1-2 year hiatus and the molars/canines will exfoliate. But noticed I mentioned that children also gain teeth at this age. A child's 1st secondary molars begin to erupt around age 6, commonly known as 6 year molars. Children do not lose any teeth in replacement of the teeth erupting. They erupt in the very back of the mouth, 1 tooth in each quadrant. We get several calls a day from parents concerned because their child is in pain or they see "half" of a tooth in the back of their mouth. All of these symptoms are normal, it is as if the child is going through teething all over again. You can administer motrin/advil, etc. to help with your child's discomfort. Around age 9, your child should begin to exfoliate the remainder of the primary teeth and should be finished losing teeth around age 13. Around age 12, another set of molars erupt behind the 6 year molars called the 2nd molars. This gives your child 28 teeth total. Most commonly known as wisdom teeth, the 3rd molars can erupt around the age of 17 but are usually extracted surgically because our jaws do not accomodate the space needed. Your dentist should evaluate the wisdom teeth around age 17. If the wisdom teeth do erupt and remain on will have 32 teeth total.

There are several cases where some are congentially missing teeth whether baby or permanent. Most orthodontist can adjust to this happening and still make your remaining teeth natural and symetrical. For any other questions about development of teeth you can check out ada.org or call us at 225-769-1969.

This chart depicts the dentition of permanent teeth.

This chart depicts the dentition of the primary (baby) teeth.