Most of us do not think of newborns as having teeth, but their teeth actually start to develop before birth. The eruption of these teeth is a significant event for children and their parents. Some children have teeth that do not follow the normal timing or sequence of eruption. Others have teeth that are missing or fail to erupt at all.
The front four baby (primary) teeth usually erupt first, about six months after birth, although there is a wide range that is considered normal. Some babies become irritable and sleepless from sore gums, and they may lose their appetite and drool more than usual. This is normal, and they can be soothed with clean teething toys, gum massages using a clean finger, or a cool washcloth. If your infant has a fever or diarrhea, this is not likely a result of teething so please notify your physician. Rarely a cyst develops before a tooth erupts. The tooth will eventually rupture this as it pushes through the gums. Eruption cysts are harmless and should be left alone.
Most kids will have a full set of 20 primary teeth by the age of three, and girls often develop a little more quickly than boys. Although primary teeth are temporary, they play an important role in eating and speaking. They also are responsible for holding space and developing bone as permanent (adult) teeth develop. A prematurely lost primary tooth may require an appliance to be placed to maintain space, and an infection from decayed primary teeth can damage the permanent teeth developing under them. Therefore, it is important for primary teeth to be healthy.
As kids grow, space is created in their jaws for their developing permanent teeth, and most children have 32 of them. The first to erupt is usually a lower incisor or first (six-year) molar, which is expected to occur around age six. These six-year molars should erupt behind the last baby tooth. Most children have their “full set” of 28 adult teeth between ages 11-14. The remaining four teeth to develop are the third molars, often referred to as “wisdom teeth.” Sometimes these teeth are missing, or they may become impacted and fail to erupt.
Below is a chart from the American Dental Association summarizing the typical eruption sequence of primary teeth:
It is a good idea to have regular dental checkups from infancy through adulthood. Occasionally teeth are missing, disfigured/discolored, or impacted (fail to erupt). In addition, primary teeth sometimes need to be extracted to assist the underlying permanent teeth to erupt. Your dentist is trained to identify these problems and will help you determine the appropriate treatment for your child.
Dr. Carl Drake is an Orthodontist and owner of Drake Orthodontics here in Bloomington-Normal. He is passionate about providing quality orthodontic care and educating the community about proper dental care.
*Photos provided by Drake Orthontics. The photo above is an x-ray of an 8-year-old illustrating the relationship of her primary and permanent teeth
