Modern terms of formation of temporary and permanent occlusion in children

The order of eruption of baby teeth

Everyone is different, but it is still important to know how most babies develop. Children's first teeth usually erupt almost simultaneously on the right and left. The sequence is as follows: first the anterior ones (incisors, canines), then the posterior ones.

It is important to understand that this pattern of teething in children is average, and in your case it may happen in a different order or at a different time. This does not necessarily indicate any violations.

Doctors have compiled an approximate, average diagram of teething in children:

Don't worry if you don't meet these standards for several months. If the parents got teeth late, most likely the children will have the same. Heredity has a very strong influence on development. The teething pattern should not become an unnecessary source of parental anxiety. This is just a guideline, like all other norms.

Both the sequence and timing of teething in children can vary greatly. Only if you are “late” by more than 6 months (for example, nothing appears until a year), it is worth discussing this with your doctor. There are genetic disorders when the rudiments of teeth do not develop at all. However, this is extremely rare. Some diseases also affect the timing of teething, but these conditions in children always manifest themselves with some more obvious symptoms.

In any case, there is no remedy that would “cut teeth” - we won’t pull them out of the jaw. We also do not regulate the cutting order. All that remains is to observe the process in children and take care of their health in general.

Sequence of eruption of permanent teeth

Milk teeth have a weak root system, which begins to dissolve by the age of 7. Therefore, in addition to changing incisors and molars, a new bite is formed. Sequence of physiological process:

• from 6-7 years old the first molars appear;
• then, by the age of 7-8 years , the incisors located in the center are replaced;
• by the age of 8-9 years, the lateral primary incisors are renewed with permanent units;
• at 10-12 years of age the relay moves to the first premolars;
• permanent clicks replace milk predecessors closer to 9-11 years ;
• from 10-12 years of age, the second premolars erupt;
• by the age of 13, the second molars are formed;
• Third molars appear between the ages of 16 and 25 ; in some people they never appear.

Names of teeth for easy reference in tables.

What problems may arise during teething in infants?

Difficulties do not always arise. But sometimes, about 3 days before and 3 days after teething, the baby’s condition changes:

• gums swell;
• saliva flows more strongly (although a lot of it can be released without connection with teething);
• the temperature rises slightly;
• mood deteriorates (child is less active, cries more often);
• sleep becomes restless;
• stools become slightly looser and more frequent;
• your cheeks turn slightly red (no need to immediately look for allergens and change your diet).

These symptoms may not all appear, in any combination.

The difficulty is that the same symptoms, but usually stronger, can also occur in children with infections. Therefore, if your condition has changed significantly, consult your doctor.

Red flags (tell your doctor if your child has):

• temperature above 38 degrees in the absence of cold symptoms;
• a rash that is unfamiliar to you, which appeared along with a high fever;
• diarrhea, vomiting;
• lethargy;
• mouth ulcers or other sores.
• Eruption cyst (hematoma).

Assess how much the child's condition has changed. If he begins to clearly feel unwell, there is no need to attribute this to the teething of baby teeth. In this case, you need a doctor to rule out more serious problems.

Possible problems with deviations from the norm

Complete edentia is a case when teeth are completely absent.

Regardless of the fact that the molars have just appeared or are about to erupt in the mouth of their beloved child, parents should be vigilant, because there are many dental problems. The main issue is the delay in the growth of permanent teeth (a baby tooth has fallen out, but a new one has not appeared).

The reason may lie in a genetic predisposition or edentia, which arose due to a violation of the formation of rudiments during intrauterine development. If there is no way to influence the situation, the child is indicated for prosthetics.

When permanent teeth erupt, another problem may arise – pain. This is most often due to thin, not fully formed enamel, which does not have sufficient mineralization. It is at this stage that the tooth is susceptible to various diseases, in particular caries.

With deep destruction of dental tissues, even more serious diseases develop: pulpitis, periodontitis. Therefore, you cannot ignore a child’s toothache; you need to make an appointment with a pediatric dentist as soon as possible.

At the very beginning of the growth of permanent teeth, other problems can occur:

• loss of a root unit is a signal of serious problems with the child’s health;
• an increase in the level of trauma - the active lifestyle of children during the period of maturation of molars often leads to injury to the incisors and canines, and attempts to chew hard objects end in the breakage of molars and premolars.

Each case requires the intervention of a specialist to eliminate the negative consequences.

Medicines for teething in children

When your baby is in pain, you would like to have a reliable, effective medicine that you can give and sleep peacefully. As in the case of colic, when teething, the pharmacy will offer you a variety of remedies. Pediatric experts do not advise giving any medications without a doctor's permission.

Why? Homeopathic medicines are divided into true homeopathic (containing no active substance at all, and therefore ineffective) or pseudo-homeopathic. The latter contain some amount of plant components (usually chamomile and other, more exotic plants). The first ones do not work under any conditions, including teething in children, but at least they are harmless. Homeopathic remedies for pain containing belladonna (which was not even always listed in the composition) caused many deaths and were therefore strictly prohibited in developed countries.

In our country, the Commission of the Russian Academy of Sciences recognized homeopathy as a pseudoscience, but, unfortunately, there is no strict ban on potentially dangerous drugs. Since manufacturers do not always indicate belladonna in the composition, we recommend that you generally refrain from using any homeopathic remedies for teething pain in children.

Another case is gels with a local anesthetic drug (their name ends in “-caine”: usually benzocaine or lidocaine). Medicines like these are “freezes” that are injected into the gums when treating teeth. Although these drugs are obviously effective, they have also caused many child deaths. Substances of this group affect the functioning of the heart, because the gel is quickly washed off with saliva, and the child swallows it. It is especially dangerous if the parent uses a higher dose than recommended in the instructions. This happens often because these drugs only relieve pain for a few minutes. When the baby starts crying again, the parents apply more, often exceeding the dose. Now professional communities of doctors do not recommend the use of products with local anesthetics, but this does not stop their widespread advertising.

The order and timing of teething

The table shows the approximate timing of the eruption of permanent teeth. Small differences are allowed for each age group, which is due to the individual characteristics of the body and the influence of external factors.

What to do when children are teething?

The most natural and one of the most reliable ways to reduce pain is cold. Pick up an item - a “rodent” that can be put in the refrigerator. Freezing them is not recommended because it can damage the baby's delicate gums.

Often children prefer to gnaw on their parent's finger or, unfortunately, on their mother's breast. But parents may not have enough patience for a long time, so it is better to find a suitable teether.

It should be:

• whole and durable (the child should not bite off pieces that could cause choking);
• without ropes and beads (the rope can pinch the neck or break, creating a risk of choking on a bead);
• without paint with toxic components;
• just clean (no need to disinfect it).

You can refrigerate the fruit puree or put a few wet cloth toys in the refrigerator so you can replace them.

Of course, children chew not only objects that are ideal for this. But if with a teether made of one piece of silicone or a mitten with a silicone pad the child can be left alone in the playpen for some time, then with a bunch of small objects on a string around the neck or a bracelet made of beads, the same as with some fruit or vegetable, you need to look after it.

If cooling does not help, and the stress of teething is very severe, discuss taking pain relievers and fever reducers (ibuprofen is most often used) with your pediatrician. To be on the safe side, consult your doctor, but a single dose by weight (for ibuprofen is 10 mg/kg), given once at night for 3-4 days of active teething, will not cause harm.

What are baby teeth and how do they erupt?

Temporary teeth are colloquially called baby teeth because they begin to appear when the baby is still breastfed. The rudiments of dental elements are formed during intrauterine development (6–8 weeks of pregnancy). Eruption is the process of teeth emerging onto the gum surface. Mechanism: the tooth root develops, over time it begins to rest against the hard bone tissue of the bottom of the alveoli, pushing the crown part of the tooth onto the surface of the gum. In total, 20 elements appear in the primary occlusion, 10 on each jaw.

Should I brush my newly erupted teeth?

Dentists strongly recommend starting to take care of oral hygiene from infancy. For newly emerging teeth, they offer special silicone brushes or wipes. A simpler option is a finger wrapped in gauze. You can simply moisten it with water or use toothpastes for children under 3 years of age (they are marked 0+ and can always be swallowed). The main thing when brushing your teeth is no violence! A little more cleanliness isn't worth the stress.

Teething

According to the tradition of many peoples of the world, there is a custom of giving gifts to a child on the occasion of the appearance of the first tooth. This ritual symbolizes wishes to the baby for health, happiness and long life. The appearance of a baby’s first tooth is a solemn moment for relatives and parents, but at the same time, teething can also be a “restless” period for parents and the baby. I would like to reassure parents and orient them to the fact that teething is a physiological process and must be approached philosophically. As if it were inevitable. And timely and correct teething is a guarantee of a healthy future child.

What is teething?

Teething is the process of vertical movement of a tooth from its origin and development within the jaw until a crown appears in the oral cavity. The process of teething begins after the crown has finally formed and is accompanied by its further development and growth of the jaw bones. Signs of physiological teething are: timeliness, sequence of eruption of certain groups of teeth and pairing.

There are temporary teeth (more often called milk teeth) and permanent teeth. According to the number of teeth, the primary teeth are 20, the permanent bite is 32 teeth. According to modern data, the period for the eruption of the first temporary teeth is usually considered to be from 4 months. The end of eruption is 3-3.5 years. Most often, the first teeth appear at the age of 6 months, and as a rule, the teeth on the lower jaw erupt first - the central incisors, then the lateral incisors, canines and molars. The timing of teething can vary from 4 months to 2 years (early teething) or from 8-10 months to 3.5-4 years (late teething).

Average time for eruption of primary teeth according to (R. Illingworth, 1997)

It should be noted that the quality of nutrition, sanitary and hygienic conditions and pathological conditions of the child (rickets, hypovitaminosis, intoxication, states of oxygen starvation, the nature of feeding, etc.) significantly affect the process of teething. For example, disordered teething with disruption of the time intervals between groups of teeth, delayed eruption may be a manifestation of a pathology such as rickets.

Adverse effects during teething

Temporary teeth are not permanent, that’s why they are called that. As the child grows and develops, after a certain period of time, all 20 primary teeth will be replaced. As an exception, in individuals, milk teeth do not change, remaining in adulthood (most often this occurs due to the absence of the rudiments of permanent teeth).

When primary teeth erupt, the child is in a state of “stress” and can often manifest itself with general somatic disorders. The first signs of teething, often the main ones, are the appearance of swelling of the mucous membrane of the gums in the projection of the erupting teeth. Profuse salivation appears, the child may be irritated and tearful. The eruption of central teeth often occurs without any manifestations, except for swelling of the gums and profuse drooling. When the chewing group of teeth erupts and a larger area of ​​the gum mucosa is involved, a secondary infection may occur if the resistance of the child’s body decreases. Symptoms such as increased body temperature, upset bowel movements, redness of the mucous membrane of the gums in the mouth, decreased appetite may appear. To relieve the annoying itch, the child begins to “drag” fingers and various objects into the mouth (toys, sucking the edge of clothing, a blanket) to scratch gums, thereby can damage and infect the mucous membrane. Which can manifest itself as erosive rashes. And aggravate this condition.

How can you help your child when they are teething?

To relieve itching of the gums in a child, it can be recommended to give hard vegetables or fruits (peeled apples, carrots), or a crust of bread to chew. It is good to massage the gums with special “teether” rings or a toothbrush (silicone, or a regular baby brush with soft bristles). Some rings can be pre-cooled, but you should carefully inspect these devices and purchase them in special places in order to avoid counterfeit, uncertified goods and subsequently not harm the baby’s health, so that the child does not get hurt. If the temperature rises, antipyretic drugs can be given. To reduce the sensitivity of the mucous membrane and reduce pain in pharmacies, pharmaceutical manufacturers offer special anesthetic gels for topical use. But we recommend using these drugs only as prescribed by a doctor, so as not to cause allergies in the baby and not miss more severe complications. Contact a pediatric dentist who will conduct an examination and give qualified prescriptions to improve your well-being.

Changing temporary teeth

Permanent teeth most often appear between 5.5 and 7 years of age. Their eruption practically occurs in the same sequence as temporary teeth. The lower central incisors appear first, then the upper central incisors, and in parallel, and sometimes earlier, the first large molars erupt (the first molars, or by their number, they are called “sixths”). Please note: The sixth teeth do not fall out! They should serve your child for life. Parents mistake them for temporary teeth, which is a misconception, especially in the case of absence or poor oral hygiene and damage to this group of teeth. Which can lead to a disastrous result – tooth loss. But this group of teeth - the “First molars” - are fundamental in the formation of a correct bite; they are also called the key of occlusion. The shape of permanent “young” teeth differs from more mature ones. The cusps and cutting edges of the crowns are more pronounced, especially the cutting edges of the central teeth have a scalloped (wavy edge), the size of a permanent tooth differs from a temporary tooth, it is larger. Some parents are alarmed by this fact. To which we answer, there is no reason to worry, literally a year after eruption, the enamel edge will become even and even. And regarding the size of the crowns of the teeth, while the child is small (the appearance of the first permanent teeth is 5.5-6 years old) relative to the facial skeleton, there is a certain disproportion; as the bones of the facial region grow and develop, a harmonious relationship between the face and teeth occurs.

Average time for the eruption of permanent teeth in children (according to Schroder, 1991)

1. In order for the teeth to last a long time and not have to “say goodbye” before the appointed time, they need careful care when they erupt.

2. Go ahead for a consultation with a pediatric dentist, who will select age-appropriate hygiene products (toothbrush and toothpaste) for your child. He will provide training in teeth brushing techniques.

3. Brush your child’s teeth at least 2 times a day (in the morning after breakfast and in the evening before bed). Helping clean hard-to-reach areas from an early age

4. Limit your child’s consumption of carbohydrate-containing foods (we do not recommend eating sweets for children under 3 years old)

5. If a child drinks liquid drinks before bed or at night, they must be replaced with regular drinking water, without added sugars.

6. The use of toothpastes containing fluoride is very important for children of the Khanty-Mansiysk Autonomous Okrug-Ugra

7. Visit the dentist 2 times a year!!!

The article was prepared by: pediatric dentist Malakhova A.A. Head of TOD - Mokrinskaya N.G.

Photos used in the article from satyov:

1. https://ladyspecial.ru

2. https://otvetymamam.ru

How to determine that a child will soon have molars?

There are certain signs that indicate that permanent teeth will soon begin to erupt:

• The spaces between the teeth increase. The jaw grows and the free space increases;
• baby teeth become loose as the root gradually dissolves. It cannot be firmly fixed in the jaw tissues;
• in case of loss of a temporary tooth. This confirms that the molar will soon come out as it has pushed out the previous one;
• The gums are slightly swollen and red.

When permanent teeth erupt, the child’s general well-being usually remains the same, the temperature does not rise, and there is no pain.