RAISING a child is one of the greatest responsibilities that parents have.
For many, it is very stressful because of lack of experience and uncertainty.
Parents and guardians implement different methods in grooming and nurturing a child, but they do not always work.
There is a lot of reading, counselling, failing and learning from one's mistakes that goes on.
Health issues are especially difficult to understand, but the core of the wellbeing of the child which calls for extreme literacy in this area.
Tooth eruption is one of the confusing developmental events to occur, the duration, the timing, the teething process as a whole.
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Delayed tooth eruption can indicate certain systemic or local problems which can be addressed early before it is too late.
Therefore, it is crucial to know or to be able to predict the period certain types of teeth are expected to erupt to help with early diagnosis.
Delayed tooth eruption is an issue of paramount importance, but to be able to know if eruption was really delayed, it comes with the knowledge of when exactly the right time for tooth eruption is.
Tooth eruption begins at six months and by three years, all 20 milk teeth should have erupted.
As for permanent teeth, by 12 to 13 years, all 28 teeth (excluding wisdom teeth) should have erupted, unless there are issues hindering eruption.
If your child proves to have more or less teeth, you should consult the dentist.
Every child is unique so is their smile.
The following ages are averages, so a few months’ variation is perfectly normal.
Not every baby begins to show signs of tooth eruption at six months.
Delayed eruption is inevitable.
The question is when are parents expected to seek the help of a professional.
Caretakers and guardians cannot know if something is wrong if they are not aware of the time of eruption.
It is important to understand the name of teeth and their groups, milk or baby teeth include incisors, canines, first molars and second molars.
However, in permanent dentition, there are five groups of teeth: four in the primary dentition plus the premolars.
Hence if you notice that your baby has no premolars, do not be alarmed for it is normal in milk teeth.
The first year (The “baby: or primary teeth): The journey usually begins between six to 10 months with the lower front middle teeth (central incisors).
The upper front teeth follow shortly after at around 10 months followed by the lateral incisors which are the shorter ones adjacent to the centrals.
By their first birthday, many children have a few teeth to show off.
The first molars, which are used for grinding food, typically arrive between 13-19 months.
The toddler years (1-3 years): The pointy canines (cuspids) erupt next, followed by the second molars.
By age three, most children have a full set of 20 baby teeth.
The Big Kid Shift (6-12 years): This is the era of the “mixed dentition”, with a charming mix of baby and adult teeth because some teeth still have to fall as permanent teeth erupt.
Around age six, the first permanent teeth to erupt are the first molars, which erupt in the very back behind all the baby teeth, so their arrival is very easy to miss or not notice.
Around the same time, the lower front baby teeth become loose and fall out, making way for the larger permanent incisors.
This process of losing and gaining continues until around age 12, when all 28 permanent teeth (not including wisdom teeth) are typically in place.
Red flags: When to consult the dentist
While variation is normal, certain signs warrant a professional opinion.
Don’t hesitate to seek advice if you notice:
Significant delay in eruption:
If your child is over 18 months old and has not had any teeth eruption, it should not be normal, do not delay.
As soon as you make this observation, call the dentist.
Similarly, if no permanent teeth have appeared by age seven or eight, a dentist’s evaluation is a good idea.
A missing tooth (or an extra one!):
Sometimes, a permanent tooth may be completely absent (a condition called congenitally missing teeth).
Conversely, an extra tooth (a supernumerary) can block the path of a permanent tooth trying to erupt.
An X-ray can reveal what is happening beneath the surface where the naked eye cannot see.
In some cases, tooth eruption can be hindered by either fibrous gum tissue or obstruction by a tumour or due to systemic causes.
For instance, children with syndromes like down syndrome or cleidocranial dysplasia or Gardner’s syndrome could exhibit signs of delayed eruption or missing teeth.
“Shark Teeth”: The double row:
This is a common and often harmless scenario.
A permanent tooth erupts behind a stubborn baby tooth that has not fallen out, creating two rows of teeth.
In many cases, the baby tooth will loosen and fall off on its own.
However, if it remains firm for more than a few weeks after the permanent tooth has broken through, visit the dentist.
A simple extraction may be needed to guide the permanent tooth into its correct position.
Extreme pain or swelling:
While some discomfort is normal, severe pain, a small, soft bump (eruption cyst) that does not resolve on its own or significant swelling and redness are not.
This could indicate an infection or another issue that needs immediate attention.
Cysts can be successfully removed by a specialist.
Asymmetry that persists:
Teeth generally erupt in pairs.
If one tooth on the left has been in for six months and there is no sign for a partner on the right, it could signal an obstruction.
It is important to consult the dentist
Early loss or trauma to a baby tooth:
If a baby tooth is knocked out prematurely due to a fall, the space it leaves behind can close up, blocking the path for the permanent tooth.
Your dentist may recommend a space maintainer to prevent future crowding.
Space maintainers are important to avoid the closing of the gap left by the tooth that fell out.
In conclusion, this is a guide to help parents navigate their way in tooth eruption.
If any of the mentioned red flags happen to you, please do not hesitate to visit the dental office.
Dental visits for children should begin as soon as the tooth starts to erupt, which is usually at six months.
It may save you a lot of complications later on for it is better to be safe than sorry.