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If your child does not have their first teeth by the age of one and a half teeth, it may be a good idea to tell the staff at the children’s health centre. They can help you get in touch with a dentist if necessary.
The Dental Centre
The dental appendix is what will become teeth. They are found in the jaw. From the beginning, the dental appendix is just a small, soft collection of cells. They mature into enamel and dentin, a kind of bone that teeth are made of. The teeth grow, take their proper shape and become hard as minerals are stored in the teeth.
When baby teeth arrive
A child has 20 baby teeth.
Humans have two sets of teeth: milk teeth and permanent teeth.
Milk teeth are the first teeth. They are adapted to the mouth of the small child and are often whiter than the permanent teeth. In total, a child will have 20 baby teeth: ten in the upper jaw and ten in the lower jaw.
A child’s first teeth
Usually two front teeth in the lower jaw come first, followed by two front teeth in the upper jaw. The first baby teeth usually come in at one to one and a half years of age. By the time a child is three years old, he or she usually has all the baby teeth.
Gums may become irritated
The mouth can itch and the child usually drools a little more when the teeth come out. That is why a light massage of the gums, for example with a soft teething ring, can be pleasant for the child. You can also gently rub your child’s gums with a finger or a soft toothbrush.
Sometimes the gums become irritated. The new tooth may have difficulty penetrating the gums. Sometimes your child may have a slight fever when the teeth come out. You can talk to the clinic staff if your child seems to be in pain. There may be other reasons if your child has a fever when the teeth come in.
When baby teeth come out
When your child is between five and seven years old, the first baby teeth start to come loose. The front teeth in the lower jaw usually come out first, followed by the front teeth in the upper jaw. As the new permanent tooth grows in, the roots of the baby tooth gradually wear away and eventually the baby tooth has no attachment and the child may wiggle the loose tooth.
The new tooth appears underneath and often slightly inside the baby tooth. This is why the child may have both the baby tooth and the permanent tooth visible in his or her mouth. In this case, he or she may have to shake the baby tooth a little more to get it to come loose.
Behind the last milk teeth on the front teeth come the first four permanent molars, the so-called sixth teeth.
New teeth are important to recognise because their surface is not fully formed and decay can occur quickly. That is why it is important to start brushing your molars early. They are often bumpy and difficult to reach in order to brush them.
The dentist will check for missing teeth
Your child will be seen regularly by the dentist. The dentist will count the teeth to see if any of the following are true:
– The teeth may be missing.
– There may be too many teeth.
– Teeth can encounter obstacles when they are about to erupt.
– They may have a different shape.
– There may be a problem with the mineralisation of the tooth.
It can be easier to treat teeth if abnormalities are detected early. For example, the dentist may need to remove a baby tooth to help the new tooth grow in the right place.
You can have 32 permanent teeth. The four teeth in the middle of the two jaws are called the front teeth. There are canine teeth on either side of the front teeth in both jaws. The rest of the teeth at the back of the mouth are called molars. The third molar at the back of the mouth is usually called the wisdom tooth.
The first permanent teeth are usually the front teeth, which the child gets between the ages of five and seven. The appearance changes and the new teeth look big on the child’s face. They need to be bigger to fit the growing face.
The transition from baby teeth to permanent teeth is usually complete when the child is between 9 and 13 years old. By then they will have a total of 28 permanent teeth. Wisdom teeth tend to appear in the later part of adolescence and until about 25 years of age. Some wisdom teeth never erupt and remain in the dental bone.
The teeth gradually straighten in rows with the help of pressure from the tongue and the cheeks and lips.
Complications of tooth development
The tooth that most often causes problems is usually one of the canines in the upper jaw. This is because it is positioned so high in the jaw and is the last of the 28 teeth to emerge.
The canine tooth can grow even if there is not enough room for it. The canine tooth can get into the wrong place, either on the palate or on the outside of the tooth, and sometimes gets stuck in the tooth bone without coming out properly.
When the child is nine to ten years old, the dentist checks the position of the canine tooth by feeling it where it is. An X-ray may be needed to determine if the canine tooth is pressing on the teeth next to the canine, if they are not clearly felt on the outside of the tooth bone.
There is a risk that the pressure from the canine tooth will cause damage to the permanent teeth next to it when they erupt. In this case, the child will need to be treated at a specialist orthodontic clinic. They will assess what needs to be done, if and when any orthodontic treatment should be carried out.
A wisdom tooth that is well inserted into the jawbone is usually left there. If the wisdom tooth is only half way out, the dentist will assess whether it should be left in place or removed. Perhaps the tooth should be removed if it is causing inflammation and discomfort to the gums. However, if the tooth can be kept clean and is not causing discomfort, it can probably be left in place.
Teeth may be missing
About one in ten children will not have all their permanent teeth. An assessment is then made to determine the best solution for chewing, even if the child is missing some teeth.
Sometimes orthodontic treatment is needed to make the gaps between teeth smaller. Orthodontics can make the gaps smaller. Sometimes gaps in teeth may also need to be enlarged to make room for artificial teeth attached to titanium screws, called dental implants.
The most common anomaly is a front tooth that is narrow and slightly pointed. It is hereditary and sometimes the front tooth can also be missing.
Double teeth also occur between the permanent front teeth. In these cases, it is usually a matter of appearance whether treatment is necessary. Sometimes the tooth is damaged on the inside and has to be removed. Deviations in the number and shape of the teeth are hereditary.
One extra tooth
Children can sometimes have one too many teeth. This is because too many permanent teeth have been formed from the start.
An extra tooth is most common among the front teeth of the upper jaw. The tooth may prevent the front teeth from growing in or the front teeth from coming in crooked. It can stay in place if the tooth does not interfere with the development of normal teeth. If it grows into the mouth, it can be removed in the same way as a normal tooth.
Sometimes a minor operation may be needed to remove the tooth if it is in the way of the front teeth.
Sometimes there are also extra teeth located in the molar area. In this case, the permanent molar can have difficulty passing through. The attachment may have to be removed, after an evaluation by the dentist with orthodontic and paediatric specialists.
Stains on teeth
In some children, one or more of the permanent teeth have poor quality enamel and dentin. The hardness of the tooth is then affected in parts or the whole crown when the teeth erupt.
This can appear as a small white or yellow spot in the enamel on the surface of the tooth. When larger parts of the tooth are affected, it can start to ulcerate and hurt, often when the child eats or drinks something hot or cold.
It is most common to get an impacted tooth crown in the back of the mouth by the age of six. Sometimes the child also gets it on the front teeth at the same time. Usually the damage is so mild that daily brushing with fluoride toothpaste is enough to strengthen the tooth.
What can affect the development of teeth?
Certain diseases and treatments can affect the development of a child’s teeth:
– There can be damage to tooth enamel from radiation and cancer medication.
– Vitamin D deficiency and other deficient diseases can cause damage to teeth.
– Medicines given for severe infections can cause discolouration of the teeth.
– Genetic diseases can affect the development and shape of teeth.
Help and treatment is available. Paediatric dental specialists will assess what treatment your child may need.
Fluoride in the right dose
By the age of six, enamel, the outermost layer of permanent teeth, is formed. Too much fluoride can cause stained teeth. Follow your dentist’s recommendations on the amount of fluoride in your toothpaste. The fluoride content depends on the age of the child. Children should not drink water or mineral water with too much fluoride.