Throughout your life, you will have two sets of teeth: primary or “baby” teeth, and secondary or “permanent” teeth. Many teeth begin forming before a child is even born with primary teeth starting formation at 6-8 weeks in utero and some permanent teeth starting at around 20 weeks in utero. A baby’s first tooth is often a lower central incisor and the average age of eruption is between 6-10 months. The remaining primary teeth typically erupt by the age of three, but the place and order vary. These ages are only averages and every child may be different.
Permanent teeth will begin to erupt into the mouth at around age six and except for wisdom teeth, are all present by age twelve to fourteen. Wisdom teeth typically begin breaking through from age seventeen and on. The total number of permanent teeth is 32, though few people have room for all 32 teeth. This is why wisdom teeth are often removed.
Teething
When an infant is teething it is common for their gums to be sore and tender which may cause irritability. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits-they contain sugar that isn’t good for baby teeth.
Importance of Primary Teeth
Primary teeth must be kept in place until they are lost naturally. These teeth serve several critical functions. Primary teeth:
- Maintain good nutrition by permitting your child to chew properly.
- Are involved in speech development, and allow for proper pronunciation and speech habits.
- Help the permanent teeth by saving space and guiding their eruption to prevent crowding and the need for future orthodontic treatment.
- Help your child feel good about their smile and the way that they look to others.
Sealants
The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult to clean, no matter how much a child brushes. Sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from residing in these areas. The sealant material is a resin that is typically applied to the back teeth, molars, and premolars, and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.
Composite resin restorations
Composite restorations (white fillings) are used for primary and permanent teeth after the removal of tooth decay.
Stainless steel crowns
Stainless steel crowns are prefabricated and are adapted to individual teeth. They are indicated when gross decay, decalcification, or developmental defects are present. They are also used following pulpotomies (see below) that weaken the teeth and make them prone to fracture. The crown will last the life of the primary tooth, and the patient will not have to undergo repeated restorations on the same tooth.
Pulpotomy
A pulpotomy is a procedure that requires the removal of part of the nerve tissue that has been infected. The remaining vital tissue is then treated to preserve the function of the tooth.
Space maintainers
The best space maintenance therapy is the preservation of the primary molars until they are lost naturally. Sometimes, when the teeth are unrestorable, the need for extraction is unavoidable. The purpose of the space maintainers or “spacers” is to preserve the space for the developing permanent teeth.