At what age does a child get permanent teeth?

Milk and molar teeth in children

Many people believe that there are no differences between permanent and temporary teeth, but this is not true. So, how to distinguish a baby tooth from a molar? At a minimum, their number differs (milk - 20, permanent, as a rule, 32). Temporary teeth have a light shade, while permanent teeth are naturally more yellow. Indigenous ones are also significantly larger in size than dairy ones - visually it is quite easy to distinguish them. Here are the most common questions asked by Internet users on this topic.

1. Do children have molars?
   Of course, there are, and at a certain point they begin to actively erupt.
2. How many molars do children have?
   From 28 to 32 (the maximum set appears after all eights appear).
3. Which molars appear first in a child?
   Typically, the lower central incisor erupts first.
4. At what age do children start to get their molars?
   Usually, dentition renewal begins after 6–7 years, but there are no strict limits.
5. Do children lose molars?
   By themselves - no, as a result of injuries and illnesses - yes.
6. What are the risks of removing a molar tooth in children?
   As corny as it may sound, his loss. And yes, a new one will not grow. Everything is like adults.
7. What to do if a child has yellow molars?
   Permanent teeth have a more yellowish tint than temporary teeth. Plaque on a child’s molars is normal, but hygiene should never be neglected.
8. What to do if a child has black molars?
   When teething, baby teeth may have a black color (the so-called Priestley plaque, or pigment bacteria). However, this does not happen with molars. If they are black, go to the dentist immediately.
9. What to do if a child does not have molar buds?
   This happens, but very rarely. Fortunately, with modern implantation and prosthetics technologies, the problem can be solved.
10. Is it normal for a child to have crooked molars?
    Contact an orthodontist immediately: correcting a bite in childhood is much easier and faster than in adults.
11. Which teeth do children replace with molars?
    All twenty, plus new molars appearing.

First lower molar

Average age of teething: 6 years

Average age of root formation: 9-10 years

Average length: 21.0mm

The mandibular first molar erupts earlier than other permanent teeth and most often requires endodontic treatment. It usually has two roots, but sometimes three roots are found, with two canals in the mesial root and one or two canals in the distal root.

The distal root is easily accessible for endodontic cavity preparation and mechanical treatment.

The doctor can directly see the opening(s) of the canal. The distal root canals are wider than those of the mesial root. Sometimes the mouth is wider in the buccolingual direction. This indicates the presence of two channels or a slit-like channel with a complex network-like configuration that can complicate cleaning and shaping.

The mesial roots are usually curved, with the greatest curve in the mesiobuccal canal. The orifices of the canals at the bottom of the pulp chamber are usually clearly separated from each other and located buccally and lingually relative to the upper tubercles.

The tooth often undergoes extensive filling. It almost always experiences a strong chewing load, so the coronal pulp cavity can be obliterated. It is easiest to identify the mouths of the distal canals.

Then the mouths of the mesial canals are found, which will be located in the above locations in the same horizontal plane.

Since the mouths of the mesial canals lie under the mesial tubercles, they may not be detected during normal cavity preparation. In this case, to determine their location, it is necessary to remove the hard tissue of the tubercle or filling. During access preparation, overhanging molar cusps need to be ground down [15]. Remember that this tooth, like all other lateral teeth, after endodontic treatment requires complete restoration of the entire occlusal surface area. Therefore, to identify anatomical landmarks and orifices, it is better to make a wider access cavity than to skip one or more channels for the sake of “sparing” preparation, which may cause failure.

Skidmore and Bjoradal [11] found that approximately one third of the mandibular first molars examined had four root canals. If there are two canals, “they either remain separate with separate apical foramina, or unite and form a common apical foramen, or communicate with one another by transverse anastomoses partially or completely... If the tooth, instead of the usual triangular shape, had a more rectangular shape, this would allow better vision and explore a possible fourth canal in the distal root.”

In the area of ​​bifurcation of the roots of the lower molars there are several orifices of additional canals [9]. They are usually impossible to clean and shape, and are rarely visible except incidentally on radiographs when they are filled with root cement or heated gutta-percha during treatment. It would be correct to assume that if irrigation solutions tend to clean the canal from protein decomposition products, then the area of ​​root bifurcation in the pulp chamber must be thoroughly cleaned (remove denticles, etc.) so that the solutions can reach the small mouths of the canals.

All infected dentin, leaking fillings, and pulp denticles must be removed before endodontic treatment begins. It is recommended to completely cover the cusps with a restorative structure after endodontic treatment.

Molars in children: symptoms of eruption

• Fever. When teething in children, body temperature may rise, usually not higher than 38 degrees.
• Itching and pain at the site where the molar appears. Various gels and ointments, as well as gum massage, will help relieve children from unpleasant sensations.
• Increased salivation and runny nose.

Important!

The growth of molars in children, especially at the initial stage, leads to weakened immunity. Take vitamins and do not forget about preventive visits to the dentist.

What does the dental formula look like?

The medical record, which the big one keeps in the dental clinic at his place of residence, contains notes about his dental condition. To avoid confusion, doctors number the teeth on each side of each jaw. So, the 1st and 2nd teeth are incisors, the 3rd are canines, the 4th and 5th are small molars (doctors call molars molars), the 6th and 7th are large molars. The 8th - the farthest one - is a “wisdom tooth”; a number of people do not have it, or they do, but not all. Each side of the jaw is also numbered: 1 - top right, 2 - top left, 3 - bottom left, 4 - bottom right. For example, entry 48 does not mean that you are a “Tarkatan” with a combat superset of teeth that does not exist. You simply do not have a “wisdom tooth” on the lower right. Entry 41 - a person lost one of the frontal incisors on the same side on the same jaw. You can write down the formula of the teeth more clearly: for example, “there is no 8th tooth from the bottom right.”

It often turns out that due to lack of space on the jaw, the wisdom tooth develops incorrectly - it can grow crooked, in which case its removal is indicated. For example, it may remain under the gum and, because of this, be affected by caries, which can subsequently develop into pulpitis or a dental cyst. Problematic “wisdom teeth” are quickly and decisively removed, and their absence will not greatly affect the quality of chewing food.

When does a child's molars come out?

Most parents are interested in the question: at what age do children’s molars begin to erupt? The first buds form in the fifth month of pregnancy. The exact timing of their appearance has not been determined and depends on the individual characteristics of the organism. Nevertheless, an approximate scheme for the eruption of molars in children exists. If the appearance of a permanent tooth is delayed for more than six months from the extreme threshold (especially after the loss of a baby tooth), consult a specialist. The doctor will take control of the process and be able to identify complications.

Possible problems

Despite the fact that changing teeth is a natural physiological process, some children and their parents may encounter a number of problems that require contacting a pediatric dentist.

No molars

The absence of permanent units can be caused by congenital edentia - the complete or partial absence of tooth buds.

Another reason for the absence of molars is previous inflammatory diseases - periostitis or periodontitis, resulting from progressive caries. Inflammatory diseases of the periosteum and periodontal tissues have an extremely negative effect on the condition of the tooth buds and can lead to their death.

Important! It is absolutely necessary to treat baby teeth for caries. You should not assume that the problem will go away on its own with the change of teeth. The progression of the disease can negatively affect the health of the tooth buds.

Molar tooth hurts

The enamel of newly emerging permanent teeth is still poorly formed. The low level of its mineralization makes teeth vulnerable to cariogenic microflora. This can lead to the development of caries and cause pain.

Due to poorly formed enamel, tooth sensitivity to external irritants (cold, hot, sour, sweet) may increase, which is also accompanied by painful sensations.

Important! Normally, permanent teeth do not hurt. If pain occurs, you should contact your pediatric dentist. The specialist will determine the cause of the pain, carry out the necessary treatment, fluoridation or remineralization of tooth enamel.

Molars grow crooked

The incorrect position of permanent teeth can be caused by two reasons - the growth of the permanent unit outpaces the process of loss of baby teeth or they were removed ahead of schedule, which led to incorrect formation of the rudiments of permanent teeth.

In this case, there is only one way out - orthodontic treatment of malocclusion.

Important! A malocclusion must be corrected. The sooner you contact a dentist, the more successful the treatment will be. The child will be prescribed to wear removable or fixed orthodontic appliances that will help straighten the permanent teeth and bite.

Injuries

Due to their activity and lack of experience, children can accidentally injure a newly emerging permanent tooth. Due to mechanical damage, cracks and chips may appear on it. The damage looks unattractive. Caring for such teeth is complicated, since food debris can get stuck in the cracks, which will certainly lead to the development of caries.

Important! If a child accidentally injures a permanent tooth, it is necessary to seek help from a dentist. The specialist will assess the complexity and depth of the damage and will build up the missing volume of tooth tissue with composite materials.

Tooth loss

Loss of healthy permanent teeth can only occur as a result of severe trauma to the jaw, for example, during a child’s fall or fight. A diseased molar may fall out on its own. In this case, you will also need to consult a specialist. Most likely, the child will undergo temporary prosthetics for the lost unit, which will not disrupt the formation of a correct permanent bite.

The tooth is loose

Looseness of a permanent tooth is an alarming symptom indicating a pathology of the dentofacial apparatus or the presence of inflammation. Consultation with a specialist is required!

Pattern of growth of molars in children

In most cases, the permanent tooth appears 3 to 5 months after the temporary tooth falls out. The order of eruption of molars is in many ways similar to the appearance of milk teeth. The first molars in children are the central lower incisors. The upper permanent teeth develop later than the lower ones, if we consider them in pairs.

Second lower premolar

Average age of teething: 11-12 years

Average age of root formation: 13-14 years

Average length: 22.3 mm

The second lower premolar, which is very similar in crown shape to the first premolar, has a less complex root.

Its crown has a well-developed buccal cusp and a much better formed lingual cusp than on the first premolar. The access is made slightly oval, wider in the mesial-distal direction. They begin to form access in the central sulcus with a fissure bur with a cutting apex, and then expand and form the contour of the burr hole with spherical burs No. 4 and 6.

Researchers reported that only 12% of mandibular second premolars studied had a second or third canal [17]. Vertucci [13] also showed that second premolars had one apical foramen in 97.5%, while only 2.5% of the teeth examined had two foramina.

An important circumstance that should not be forgotten is the anatomical location of the mental foramen and the vessels and nerves passing through it. Due to the proximity of these structures, an acute inflammatory process in the area of ​​the lower premolars can cause temporary paresthesia. The exacerbation of the pathological process in this area is more severe and resistant to conservative treatment than in other areas.

Complications during teething

• Delay in the appearance of permanent teeth.
  This may be due to genetic characteristics, immune system problems and a number of other diseases.
• Uneven teeth and other malocclusions.
• Hyperdentia.
  The child’s molar tooth (or teeth) grows in the second row. Hyperdentia, or supernumerary of teeth, is a fairly rare phenomenon, but requires the intervention of a dentist to eliminate the risk of malocclusion in a child.

Where do teeth come from?

Teeth are formed in the fetus’s body during the mother’s pregnancy. When a mother abused something and undermined her own health, the subsequently born child was guaranteed to have diseased teeth that were no longer permanent. At the 15th week of pregnancy, the mother has hardened dental tissues in the fetus - starting from the crown area and ending with the root zone. The embryos of molar teeth are formed by the 5th month of fetal life. The body of a developing fetus and child is designed in such a way that in the upper jaw the anlage of the permanent teeth is located above the anlage of the milk teeth, and in the lower jaw - vice versa. The formation and development of teeth begins as early as the sixth week of fetal development. The source for them is a special epithelial dental plate. Already by 14 weeks of pregnancy, the unborn baby is actively forming hard dental tissues, initially in the area of ​​the coronal part, and then in the area of ​​​​the roots of the tooth. When a child is born, primary teeth are the first to grow - by the end of the child's first year of life, they will erupt. However, the dentition contains a group of large molars - they, in turn, do not have milk predecessors and subsequently, when they fall out, grow “on a permanent basis”. Nature has arranged it in such a way that while the child’s jaws are still too small, large molars are not needed there.

Common problems with molars in children

Anatomy of permanent teeth

The molar tooth includes three zones: the root, which sits deep in the jaw socket and holds the tooth in place, the neck, located in the periodontal area, and the crown, which extends directly into the oral cavity. After the apex of the tooth appears, a protective film forms on the enamel, the strongest layer of the tooth, which is soon replaced by a salivary layer, formed from the saliva itself. The dental tissues themselves are not just a piece of bone, but a certain heterogeneity, which includes, in addition to enamel, dentin (the main substance of the tooth) and the dental cavity, in which nerves and blood vessels branch. Compared to bones, for example, the phalanges of the fingers, dentin is noticeably stronger - it contains an increased amount of minerals, for example, the same calcium-based compounds. The root zone of dentin is connected to the periodontium using a special layer - dental cement, which communicates with the tissues of the periodontium itself and supplies the dentin with nutrients.

Care instructions

Molars in children require even more careful care than in adults. Frail enamel is much more susceptible to the effects of carious bacteria and the external environment, and the love of sweets and carbonated drinks does not add strength to it. When children develop a permanent bite, parents need to take special control of oral hygiene and diet (at least until the age of 14–15, when the teenager himself begins to realize the importance of dental health). In general, there are no difficulties here: in order to keep children's teeth strong and healthy, you need to follow several basic points.

• Daily hygiene.
  Brush your teeth at least twice a day, use dental floss and special rinses.
• Proper diet.
  Limit your intake of sweets and carbohydrates.
• Preventative visits to the dentist at least once every six months.
  If necessary, fluoridation and sealing of molars in children (so-called fissure sealing).
• Do not forget to wear a protective mouth guard during active games and sports.

Injuries

An accident or incident, such as a fight, can cause a tooth injury. And it doesn’t matter whether a small part has broken off, or the tooth has cracked, as they say, “to the point of bleeding” - the help of a doctor is definitely needed. In some cases, lost dental tissue is replenished. If a tooth is broken into pieces, it will most likely need to be completely removed and a prosthesis replaced every year. And the answer is simple - the dental tissues have not yet fully matured, the body is growing. And it is necessary to take full care of your teeth at such an early age. In case of extension, the operation is performed by introducing composite materials that replace enamel and dentin.

Can milk root remain in the gums?

If you carefully examine fallen children's teeth, you will not be able to see any semblance of roots. Some mothers unknowingly begin to panic - it seems to them that a significant part of the unit remains in the deep tissues of the gums.

There is no need to worry - this is how it should be. The absence of roots is the result of their gradual resorption. This process starts long before the day of loss. That is why during a natural change (when a tooth falls out without outside help), the child does not experience pain.

Is there always a change?

Not a single child's tooth should be preserved - they all fall out. Instead of each temporary one, a permanent one is cut through. But it also occurs in dental practice that the rudiment of the root unit is missing. This can be seen in the X-ray of the jaws.

In this case, the life of the baby tooth is extended to the maximum - after all, nothing will grow in its place. When an empty space appears in the dentition, the issue of prosthetics is discussed.

To eliminate partial congenital edentia, you can implant an implant or install a dental bridge. In the first case, there is no need to file adjacent teeth. The doctor, under local anesthesia, installs an artificial titanium root into the jaw tissue. When it takes root, it fixes the dental crown.

In the case of a bridge, it is necessary to depulpate and prepare the neighbors . This is not very healthy, since their service life after such manipulations is significantly reduced. Therefore, young patients who do not have separate molars are recommended by dentists to resort to implantation.