4 minute read
Dentistry: Primary to Permanent Teeth
General Dentistry.
Advertisement
THE MOVE FROM PRIMARY TO PERMANENT TEETH: WHAT TO EXPECT
New teeth can be exciting, whether you are seeing your little one’s first tooth arrive or a child is getting their first visit from the tooth fairy. However, with new teeth, as with many major childhood milestones, numerous questions may arise. Parents and guardians may have concerns about their child’s oral health.
A child’s first set of teeth are known as the primary or baby teeth. On average, a child’s first tooth emerges around 6 to 10 months of age. Typically, the very first tooth is usually one of the bottom front teeth. Baby teeth arrive in a pattern of lower teeth first, followed by the corresponding top teeth arriving until all 20 baby teeth are present. Most children have all of their baby teeth by age 3.
How do I help my child with discomfort?
Normal signs of teething are inflammation of the gums, disruption in sleep, increased drooling, rubbing of gums, loose stools and loss of appetite. Recommended remedies for these symptoms include providing the infant with cold teething rings, cool wet washcloths and Motrin and Tylenol. While gels that can be used orally or on gums exist to numb the gum area, parents and guardians are advised to avoid using such products due to the risk of the infant developing methemoglobinemia, a rare blood condition that prevents the release of oxygen from the red blood cells to the rest of the body. Before using any medicine, it’s a good idea to review any products, even over-the-counter items, with a physician or dentist prior to administering it to a child.
As children continue to grow, the mouth will increase in size. The first adult or permanent tooth to arrive in the mouth is usually the first permanent molar, lovingly called the six-year molar. The majority of parents and guardians and even children are not aware of this tooth’s presence as it erupts into place behind the last primary molar with no baby teeth being lost prior to its arrival.
Why are these baby teeth still around?
Following the arrival of the permanent molars, the bottom front teeth come in. It is not uncommon for these teeth to come in behind still-present baby teeth, giving a child’s mouth a shark-like appearance. For many children, the baby teeth are loose enough for a child to easily and comfortably wiggle them out, as the roots of baby teeth are typically reabsorbed by the child’s body prior to permanent teeth erupting. However, sometimes children still have a significant amount of baby teeth root remaining. This may make the baby teeth resistant to loosening and require a dentist’s assistance to comfortably and safely remove them. Once the baby teeth are no longer in that space, the adult teeth will slowly move forward into their normal position.
An adult tooth and baby tooth present at the same time can also be seen when the premolar arrives in a child’s mouth and pushes a baby molar toward the inside of the mouth, closer to the child’s tongue. This may result in discomfort for a child/pre-teen and may also require the baby tooth to be removed by a dentist.
Why is there a bump?
After a child has lost their front top baby teeth but before their adult teeth arrive, an eruption cyst may form over the area where adult teeth are coming in. This cyst may make the area swell and be a deep red/blue color. If the child is not experiencing any discomfort and there is no infection present, the cyst can disappear on its own. However, if the child expresses they are in discomfort, a dentist can address this issue by numbing the area and allowing the cyst to drain. It is not uncommon to see eruption cysts arrive in the area where adult molars come in as well.
Are there differences between primary and permanent teeth? Most individuals will have 28 permanent or adult teeth by the time they reach 14 years of age, an increase from their 20 primary teeth. There are noticeable differences between baby teeth and adult teeth, including size, shape and color. Adult teeth generally appear more yellow than baby teeth because more of a tooth’s structure or dentin is present under the white enamel. In addition to size and color, adult front teeth may have little bumps, called mammelons, along the biting edge. These will be worn down once the teeth have fully erupted in the mouth.
Your dental care provider is your child’s oral health care partner and can address any concerns related to the journey from primary to permanent teeth.
About the Author Dr. Kelly Dingrando is an assistant professor at the University of Kentucky College of Dentistry. As a pediatric dentist, her interests are in preventing tooth decay, dental public health issues and educating the next generation of dentists. More information about UK Dentistry is available at www. ukhealthcare.uky.edu/dentistry.
