A frequent topic in a family dental practice is child development, especially questions about when teeth first form and when they eventually fall out. Our bodies are amazing machines, and while you can make generalizations, there is also a fair amount of variation that should be considered “normal.” Your deciduous (“baby” or “milk”) teeth begin forming in utero, usually in the third to fourth month. That’s one of the reasons we try to avoid certain medications like tetracycline during pregnancy.
Typically, we see teeth erupt when the root is about 70% formed. The deciduous incisors will come in first, usually at about 5-6 months of age. Interestingly, it is not unheard of for babies to be born with some of their teeth already showing. In this case, because breast milk has a high sugar content, those teeth will usually decay before they are shed naturally. Typically, the front four teeth will come in during the latter half of the first year of life. The four canines and the first molars will come in during the first half of the second year. Lastly, the second molars will come in during the latter part of the second year. That’s a total of 20 baby teeth before kids turn three years old!
The adult dentition (tooth development, number, and type) is more variable for several reasons. In fact, about 25% of the population will get less than 32 adult teeth, and about 4% will have more. The ages at which these teeth begin to erupt are even more varied! According to my textbooks, losing that first baby tooth can happen naturally between 4.5 and 8 years of age. So, now you can laugh along with me when the “Doctor” in a movie emphatically claims that a skeleton was exactly 7 and 1/2 years old based on dental records. It’s just not that precise. I should also mention that those first adult teeth to show, which are usually the front two, and the first permanent molars, are already starting to calcify, or form, in the first few months after birth. Our bodies really are amazing machines!
Are you curious about those white spots that are often seen on teeth? White or opaque spots on front teeth are fairly common and are caused by something disturbing the cells that lay down enamel. This type of cellular change is purely cosmetic, though it can be hard on a self-conscious tween. It could have been a fever, medication, trauma or just normal cellular variation that caused the visual change. We have seen darker-colored enamel defects that can also form in several ways. Often, this is caused by minerals present in well water or by too much fluoride. These darker colored teeth tend to be cosmetic as well. Occasionally, there is an indication that the enamel was poorly formed, and what you’re actually seeing is the dentin underneath. In this case, the patient will need to be seen by a dentist because the teeth are prone to sensitivity and decay.
Did you know that the adult molars will not push out any of the baby teeth? These adult first molars will come in around age 6. The second molars come in around 12 years of age, and the wisdom teeth come in around 18 years of age. The adult canines replace the baby canines around 12 years of age, and the premolars replace the baby molars around 10-12 years of age.
I hope that you enjoyed my quick overview of the developing mouth and that you find awe and wonder in our developing bodies. Please feel free to reach out with any questions. I would be honored to get to know your family.
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