Molars (permanent) teeth in children

How does teeth change?

The rudiments of future permanent units are located under the root of the baby tooth and are separated from it by a thin bone septum. At 6–7 years of age, osteoclasts of the connective tissue surrounding the baby tooth dissolve the mineral component of the septum and destroy it. At the same time, the pulp of the temporary unit is gradually transformed into granulation connective tissue rich in osteoclasts, which gradually destroy the dentin of the primary tooth. At the same time, the roots of the temporary units dissolve and, in fact, only the crown of the baby tooth remains. It can be easily removed on its own, with the help of the dentist’s manipulations, or it can be pushed out by an actively growing molar (permanent) tooth.

Anatomy of permanent teeth The permanent units of a child (and an adult) have a complex anatomy.

Visually, the tooth consists of three parts - crown, neck, roots.

The crown is the visible part of the tooth that rises above the gum.
The neck is the part of the tooth at the gum level, in the place where the crown meets the root, and the enamel of the unit turns into cement.
The root is the part of the unit invisible to the eye, located in the alveolar socket. The base of each unit is made of dentin, a hard tissue. In the coronal part, dentin is covered with enamel, and in the root part there is cement. Inside the dentin is the dental pulp - loose fibrous soft connective tissue, penetrated by a large number of blood and lymphatic vessels and nerve endings. Passing along the root canal, through the apical foramen located on the upper part of the root, they communicate with the main neurovascular bundle, providing nutrition to the tooth, drainage of excess fluid and its innervation.

Normally, by the age of 13, when a permanent bite is formed, a child has 28 permanent teeth. At the age of 17 - 25 years, third molars (wisdom teeth) erupt and the number of units may increase - 32 teeth.

How many teeth should a child have per year?

During this period, baby teeth begin to cut.
They begin to break out in the following sequence on the upper and lower jaws. On the top:

8-12 months. Central incisors.
9-13 months. Lateral incisors.
16-22 months. Fangs.
13-19 months. First molars.
25-33 months. Second molars.

In the lower jaw, this process is distributed in time somewhat differently:

6-10 months. Central incisors.
10-16 months. Lateral incisors.
17-23 months. Fangs.
14-18 months. First molars.
23-31 months. Second molars.

It is worth noting that these time limits are averaged and deviations up or down by 1-3 months are considered normal.

If you want to know how many teeth a child has per year is considered normal, you should refer to the chart described above. You get that at the age of 12 months there should be 6-8 of them.

Timing and order of eruption of permanent teeth

Normally, the eruption of permanent units occurs 3 to 4 months after the loss of baby teeth. In girls, this process occurs a little earlier and faster than in boys. In both sexes, the first lower molars appear first. Then the sequence of eruption of permanent teeth is approximately the same as for milk teeth and looks as follows.

6 - 7 years - central incisors.
7 - 8 years - lateral incisors.
9 - 12 years - fangs.
10 - 12 years - premolars.
10 - 12 years - molars.

The eruption of the second molars completes the formation of the permanent dentition.

How many baby teeth do children have?

Milk teeth and even some molars begin to form at the stage of intrauterine development. Of course, a child has no visible teeth at birth - they begin to erupt only after 6 months. During this six-month period, they are hidden under the gums, but slowly develop and form, beginning to move outward.

In total, a child grows 20 baby teeth:

Central and lateral incisors – 8.
Fangs – 4.
First and second molars – 8.

Their main function is to form a space where molars will then grow.

The main differences between baby teeth and permanent teeth

Unlike 28 permanent teeth, the primary dentition requires the presence of 20 units. At the same time, they have a number of characteristic features.

Smaller in size compared to permanent teeth.
White with a slightly blue tint (permanent units have a slightly yellowish tint).
Less developed and slightly short roots compared to permanent teeth.
The enamel of primary teeth is poorly formed - thinner.
Milk units can be erased (permanent ones can too, but this is considered a pathology).

As the child grows, baby teeth fall out on their own - this is the norm. The permanent dentition units should not fall out on their own.

What not to do when baby teeth fall out

Incorrect actions of children and parents can lead to the formation of malocclusion, increased pain, or the formation of crooked teeth. To avoid this, it is recommended to adhere to the following rules:

Don't help baby teeth fall out if they are straight and not loose. Even if, according to the child’s age, it is high time for him to have a toothless smile.
Don't loosen your teeth with your hands. And do not pull them at home, for example, with a thread.
Baby teeth are quite fragile in preschool age. Therefore, your child should not indulge in solid foods. The crown may break, but the root will remain in the gum.
If a tooth falls out, do not allow your child to touch the socket with his tongue or hands. Gentle rinsing with antiseptic solutions or herbal decoctions is recommended.

If you have a fever, cough or lethargy, do not rush to resort to antiviral drugs. Poor health can be a harbinger of the imminent change of baby teeth.

How to determine that a child will soon have molars?

An increase in jaw size is the main sign of a future change of teeth. Visually this may not be noticeable. But the appearance of three and diastema (gaps) between the baby teeth indicates that the child’s jaw is growing and preparing for the formation of a permanent bite.

The following signs are purely individual - they may or may not be present in the child.

Increased salivation.
Redness, swelling of the gums and oral mucosa.
Sore gums.
Unpleasant itching of the gums.
Increased body temperature.
Unreasonable cough, runny nose.
Stool disorder.
General malaise, lethargy.
Loss of appetite.
Sleep disturbance or, on the contrary, drowsiness.
Anxiety, irritation, whims.

Important! During the period of permanent teeth erupting, parents should monitor the condition of the child, the oral cavity and gums. If symptoms that cause concern appear, you should immediately consult a doctor - a pediatrician or pediatric dentist.

What should you do to keep your baby teeth healthy?

Let’s summarize all those simple and, in general, obvious rules that will help us preserve the baby’s healthy baby teeth given by nature throughout the entire period of their functioning and not lead to the moment when the child’s baby tooth hurts or its premature loss occurs.

Avoid unnecessary use of medications during pregnancy and breastfeeding to avoid damaging developing teeth.
Eat right during pregnancy.
Feed your baby breast milk.
Introduce solid foods into your child's diet in a timely manner.
Do not share food with your child (especially before the age of two), and do not lick his pacifier for the purpose of “disinfection.”
Don't let your child fall asleep with a bottle of sugary drink.
Carefully monitor your child’s oral hygiene from the first days of life.
Have your child undergo regular preventive examinations with a pediatric dentist.

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!

Features of the period.

During this period, the formation and further development of the roots of baby teeth occurs: they are strengthened in the bone tissue of the jaws. The processes of root formation smoothly flow into the processes of their resorption and replacement with permanent teeth, the rudiments of which are located under the milk teeth.

The presence of interdental spaces between the incisors and canines of the upper and lower jaws is a sign of a “normal” correctly developing occlusion of primary teeth. The absence of interdental spaces in the primary dentition indirectly indicates a lack of space for the eruption of permanent incisors and canines, the crowns of which are significantly wider.

PHOTO: Teeth of a 3-year-old child. By the age of 3, a child already has a full set of teeth in his mouth. There should be spaces between baby teeth.

Starting from 5-6 years of age, the bite of temporary (baby) teeth is replaced with permanent ones. This is preceded by the growth of the rudiments of permanent teeth and the physiological resorption of the roots of milk teeth. As the roots of baby teeth are reabsorbed, mobility of these teeth appears. At this age, parents often note mobility of the lower and upper front teeth (deciduous incisors). When the root is completely absorbed, the tooth may fall out on its own: sometimes children “help” the tooth fall out with their tongue, constantly rocking it. Sometimes the “loss” of a resorbed tooth occurs while eating or playing.

Closer to 6 years, the first permanent chewing tooth (first molar) erupts behind the last milk tooth. The eruption of the first permanent molar is not accompanied by the loss of any tooth and does not cause any discomfort to the child, so it often goes unnoticed.

Parents often take the first permanent chewing tooth for additional milk, as it bursts behind all the milk teeth and this does not precede the loss of the milk tooth: it seems that the child has 24 malate tooth.

PHOTO: Milk teeth in children aged 6 years. The lower lateral incisors fell out. Soon permanent lateral incisors will appear in their place.

Dental treatment for children under anesthesia

In most cases, treatment is carried out after the introduction of anesthesia, which is divided into two types - application with local application of medication and injection, which involves the administration of an injection. The second option is safer and more effective.

If a child has panic fear or is simply restless, anesthesia is used, but before using it, a number of diagnostic measures are prescribed:

biochemical blood test;
general blood and urine tests;
blood to determine sugar levels;
electrocardiography to assess the state of the heart.

You should not eat food 5–6 hours before anesthesia, and drink water and other liquids 4 hours before.

Sleep is induced very gradually using sevoflurane-based gas. If the child needs to be woken up, the doctor increases the amount of oxygen supplied, and this can be done at any time. After waking up, all reflex functions are fully restored within the first 15 minutes. As a rule, there are no complications.