The first teeth your child develops are known as primary dentition, more commonly called “baby teeth” or “milk teeth.” They begin to form beneath the gums before birth, during the second trimester of pregnancy. A complete set of this initial dentition consists of 20 teeth, with 10 in the upper jaw and 10 in the lower jaw. These teeth serve specific purposes in a child’s early years.
The Eruption Process
The process of teeth breaking through the gums, known as eruption, typically begins around six months of age. However, this timing can vary widely among children, with some seeing their first tooth as early as four months or as late as one year. The first teeth to appear are usually the two lower central incisors—the front bottom teeth. These are followed by the four upper incisors, which generally emerge between 8 and 13 months.
Following the front teeth, the pattern of eruption continues with the lower lateral incisors and then the first molars, which are the larger teeth in the back of the mouth. The pointed canine teeth, located between the incisors and molars, erupt next, typically between 16 and 23 months. The final teeth to arrive are the second molars, which complete the full set of 20 primary teeth by about 25 to 33 months, or around age three.
This period is often associated with teething, which can cause discomfort. Common symptoms include irritability, excessive drooling, gum swelling, and a strong urge to chew on objects. To soothe tender gums, parents can offer a chilled, solid teething ring or gently rub the area with a clean, damp cloth. While a slight increase in body temperature can occur on the day of eruption, a high fever is not a typical teething symptom and may indicate an illness requiring a pediatrician’s attention.
The Role of Baby Teeth
Primary teeth have functions that extend well beyond simply being a precursor to adult teeth. They are directly involved in a child’s ability to obtain proper nutrition. The arrival of incisors, canines, and molars allows a child to transition from a liquid diet to solid foods, enabling them to bite, tear, and grind a variety of textures.
These first teeth are also instrumental in speech development. The correct positioning of the front teeth helps a child form sounds and pronounce syllables correctly. They work with the tongue and lips to create the distinct sounds required for clear language, preventing the tongue from straying during speech formation.
Primary teeth also act as natural space holders for the permanent teeth that will follow. Each baby tooth reserves the exact amount of room in the jaw required for its permanent successor. The primary teeth guide the permanent teeth into their proper positions, helping to ensure correct alignment later on. Losing a baby tooth too early due to decay can cause adjacent teeth to shift, potentially leading to crowding issues when the larger adult teeth erupt.
Oral Care and Hygiene
Proper oral care should begin even before the first tooth appears. Parents can gently wipe their baby’s gums with a clean, damp cloth after feedings to remove bacteria and establish a routine. As soon as the first tooth emerges, it is time to begin brushing with a small, soft-bristled toothbrush designed for infants.
When brushing, the amount of toothpaste is important. For children under the age of three, a smear of fluoride toothpaste, about the size of a grain of rice, is recommended. After age three, this can be increased to a pea-sized amount. Teeth should be brushed twice a day, especially before bedtime, and parents will need to brush their child’s teeth for them until they are around age eight.
The American Dental Association recommends scheduling a child’s first dental visit within six months of the first tooth erupting, or by their first birthday. This initial checkup allows a dentist to assess the child’s oral development and identify any potential issues early. It also provides an opportunity for parents to receive guidance on proper cleaning techniques and diet.
The Transition to Permanent Teeth
The natural process of losing baby teeth is called exfoliation. This transition typically starts when a child is around six years old and continues until about age 12. The sequence of tooth loss often mirrors the order in which the teeth originally erupted, with the central incisors usually being the first to be lost.
The mechanism behind exfoliation involves the developing permanent tooth. As a permanent tooth grows in the jaw beneath a primary tooth, it puts pressure on the primary tooth’s root. This pressure signals specialized cells to dissolve, or resorb, the root of the baby tooth. As the root shortens, the tooth becomes loose until it eventually falls out, clearing a path for the permanent tooth.
By the time a child is about 12 or 13, they will likely have lost all 20 of their primary teeth. These will be replaced by 28 permanent teeth, with the final four wisdom teeth appearing in the late teens or early twenties. This period of mixed dentition, with both baby and adult teeth present, is a normal part of dental development.