Thursday, 14 January 2016

Look ‘ma I got a new tooth: A short guide on the eruption of permanent teeth

For some teething is eons past, unlikely remembered by children, but the days of dental eruption is far from over! Those 32 permanent teeth erupt on average over the ages of 5.5 to 30 years old. With all these changes taking place, parents of Burlington Pediatric Dentistry frequently ask common questions regarding dental growth and development. I’d like to take this opportunity to highlight some of those questions and how I would speak to them as if we were sitting on the bright green benches of the clinic.

Q: When do the first permanent teeth erupt and in what order?
A: The first permanent teeth to erupt are typically the lower front incisor or the first molar (6-year molar), on average between 5.5-7 years old.  These are followed by the upper central incisors, then upper and lower lateral incisors, around 8 years old. Most children take a break in this “mixed dentition” stage until 10 years old.

Q: My child’s baby tooth is gone, when will the permanent tooth take its place?
A: Although we often expect when a baby tooth is lost it will get replaced immediately, the upper incisors are notoriously late arrivers, erupting as late as 12 months after the baby teeth are shed. While these maybe average times and patterns, some children deviate without concern, however it is best to make sure with your Pediatric Dentist.

Q: How are permanent teeth different from baby teeth?
A: Have a great look at that exciting new tooth, and recognize it is much different from the one it replaced in size, shape, and colour.

Size - It is bigger in every dimension, and so is each composing layer.  The larger shape of the permanent incisors starts to make the mouth look pretty full and may close spaces or cause crowding. Your Pediatric Dentist will be able to give you a good idea as to how it will all fit together, but the real space experts in dentistry are Orthodontists.  The current recommendation for a first Orthodontist consultation is age 7, but don’t worry, this doesn’t mean treatment will start then for most children!

Shape – You may wonder, what are those ridges on the top of my child’s teeth? These bumps or ridges known as mamelonsmay look funny, but they will wear down naturally on their own. Don’t let anyone grind them down; they sometimes have tiny pulp (nerve) horns the inside.

Colour - Permanent teeth are darker than baby teeth, this is because they are bigger in every dimension.  Even the inner layers are thicker, so less light passes, resulting in a darker tooth that is less translucent.  The colour of new teeth may be affected by a history of childhood trauma, disease, certain antibiotic or drug exposures, or other infections including infections of the baby teeth. Your Pediatric Dentist will be able to help determine any specific dental anomalies.

Q: My child’s permanent tooth has grown in but the baby tooth is still there, is that okay?
A: Ideally, as new teeth emerge they will replace the position of the corresponding baby teeth. This does not always occur, so watch for teeth that erupt inside or outside the arch form, especially if the corresponding baby tooth is not lost. The newly erupted tooth no longer forces the loss of the baby tooth and it may need a little encouragement from your Pediatric Dentist.

Remember, permanent teeth are supposed to last the rest of your child’s life, help them brush and floss daily for a lifetime of excellent oral health.