The structure of milk teeth - important features

Children's teeth appear in a certain sequence and in pairs (for example, two central incisors or two canines). But often the timing of teething in children shifts upward: many parents begin to worry and get nervous, but this is not worth doing, since the deviation from the norm is explained by the individual characteristics of the body, the uncharacteristic course of pregnancy, or various injuries received during childbirth.

Teething in children and features of this process

Quite often, a few weeks before the appearance of a baby or molar tooth, a lump filled with a clear or bluish liquid forms on the gum. Naturally, it worries parents, but there is no pathology in this formation, and the lump, which does not look very aesthetically pleasing, does not indicate the beginning of the inflammatory process. In most cases, no intervention by a doctor is required. You can contact the dentist if the lump increases in size: the doctor will make a small incision and release the liquid.

Signs of the imminent appearance of molars

You can determine when you should soon wait for the baby teeth to begin replacing with permanent teeth based on several signs:

• The gradual growth of the baby's jaws leads to increasing gaps between the teeth.
• The tooth begins to wobble. This is due to the fact that the already small root begins to gradually dissolve, causing the fixation of baby teeth to be significantly weakened.
• A fallen tooth indicates that the formed permanent one, which is about to appear, pushed it out.
• Swelling and redness may appear on the gums at the site of the eruption of a permanent tooth.
• Pain in the gums, where the permanent tooth erupts, increased temperature, and poor health of the child indicate problems have arisen, and it is necessary to see a doctor. The process of erupting molars should be painless.

Baby teeth in children: order of eruption

Any newborn baby has follicles of milk teeth (20 pieces) and molars (16 pieces) inside the jaws. The remaining 16 rudiments will form later.

Teething in infants begins with the lower jaw: first the central incisors appear (6-10 months of the child’s life), then the canines (10-13 months), then comes the turn of the first (14-18 months) and second (17-23 months) molars .

Emerging teeth differ from adult teeth in having low-mineralized enamel. If you do not maintain oral hygiene, caries may begin to develop. In addition to careful adherence to hygiene rules, special gels and ointments that significantly accelerate the mineralization process will help make teeth stronger and more resistant to pathogenic microorganisms.

How is milk teeth removed for orthodontic reasons?

If a young patient has crowded teeth, the offending primary teeth should be removed to avoid bite problems during primary replacement.

This dental procedure takes place in four stages:

• Removal of primary posterior incisors at the time of eruption of permanent incisors.
• Extraction of primary canines (this is necessary for the proper growth of permanent incisors).
• Extraction of primary first molars, provided that the first premolars are 1/2 to 2/3 the length of the root.
• Stage four: removal of permanent first premolars before the eruption of permanent canines to make room for them.

Approximate timing of eruption of permanent teeth

The first of the molar permanent teeth to appear are molars (at the 6th year of life), located at the end of the dentition. But it is they who are most susceptible to caries, since there are deep depressions on their surface where bacteria accumulate due to poor cleaning and neglect of flossing.

The second molar appears 4-6 years later, when the child reaches 11-13 years of age. Incisors erupt at 6-8 years of a person’s life, canines - after 9 years of age.

Like newly emerged milk teeth, permanent teeth contain few minerals (a tenth of their amount in a mature adult). It is for this reason that it is important to teach a child proper hygiene. It wouldn’t hurt to treat your teeth with gels containing a large amount of fluoride once a quarter.

When do baby teeth fall out?

“Childhood is over,” some parents say to their children whose baby teeth have been replaced by molars. Of course, this statement is mostly in a humorous form, since the average age when a child’s dentition ends is 12 years. At this time, the time of adolescence begins - one of the most interesting and eventful periods of our lives. As is the case with the eruption of baby teeth, their loss does not have a clear age limit. For example, today dentists are increasingly noting the early appearance of a full set of molars (as early as 10–11 years), whereas 20–30 years ago this could occur in adolescence (at 14–15 years). The service life of each baby tooth is on average 3-4 years: before the process of changing the dentition begins, the roots of the baby teeth are absorbed, so their loss does not bring severe pain and discomfort to children. Below is a table with the approximate timing of the loss of different groups of baby teeth.

Milk teeth on the lower jaw

Name of teeth	Drop time
Central incisors	5 - 6 years
Lateral incisors	7 - 8 years
Fangs	9 - 10 years
Premolars	10 - 11 years
Molars	11 - 12 years

Milk teeth on the upper jaw

Name of teeth	Drop time
Central incisors	7 - 8 years
Lateral incisors	8 - 9 years
Fangs	10 - 11 years
Premolars	11 - 12 years
Molars	12 - 13 years old

**Note: The first molar becomes the sixth molar, which does not have a primary tooth and erupts on its own at the back of the jaw.

Teething in children: symptoms

The first signs of the imminent appearance of teeth appear about a week before their appearance. The symptoms will not stop until the tooth breaks through the gum lining.

Signs of teething in a baby are as follows:

• the child becomes irritable for no reason;
• sleep deteriorates (if the child cries at night and tosses and turns, there is no need to immediately start rocking him to sleep - it is better to give the baby the opportunity to calm down on his own);
• the gums become very swollen and swell at the site where the tooth appears;
• the appetite deteriorates, the baby may even refuse to eat altogether, feeling hungry;
• the child begins to chew on various objects to relieve severe itching in the gums;
• salivation increases;
• Due to drooling, a rash may appear around the mouth, chin and chest.

There are also additional ones, i.e. optional symptoms of teething in infants:

• heat. If the temperature has increased, this most likely indicates an inflammatory process that develops in parallel with teething and is in no way connected with it (it could be stomatitis or any cold).

When the temperature rises, you need to carefully examine the oral mucosa. If there are small bubbles filled with a cloudy liquid, erosion, and the gums themselves are bright red, then the child has herpetic stomatitis. Any baby receives antibodies to the herpes virus from its mother, but usually by the time the first teeth appear, their effect ends. Often the catalyzing factor in the development of stomatitis is trauma to the mucous membrane, which is inevitable when teeth appear. If the above signs cannot be detected, then it is recommended to give the baby Panadol (suppositories are the preferred form of medication). As practice shows, it is useless to call a pediatrician, since this is not their specialization. Only a dentist can determine the specific type of stomatitis (aphthous, herpetic, etc.).

• hematomas on the gums. Sometimes the gums become swollen, turning an eerie shade of blue. Despite their frightening appearance, hematomas do not require treatment. Doctor intervention is allowed only for large hematomas that do not decrease over a long time.

• vomit. The only acceptable cause of vomiting is excess saliva entering the stomach and esophagus. If vomiting begins against the background of elevated temperature and, especially, diarrhea, then these symptoms have nothing to do with teething - you need to call a doctor.
• coughing is not a natural cause when teeth appear, unless the child has swallowed saliva that has entered the respiratory tract.
• A runny nose is a sign of a cold, not teething.

Caring for children's teeth

The pattern of teething in children determines the approximate time of their appearance, but it is necessary to start observing oral hygiene as early as possible, without waiting for the teeth to erupt.

Breasts cannot take care of themselves, so they need help cleaning their gums. This is done either with the help of a fingertip, or, if there is none, with the help of an ordinary bandage dipped in warm boiled water and wound around the finger.

If teeth begin to erupt, you cannot do without the use of special products (baby pastes, brushes, etc.).

Diagram of teething of primary occlusion

A newborn child has 20 primary tooth buds inside the upper and lower jaws (10 follicles for each jaw). The timing of teething in children, according to different authors, can vary greatly, and in diagram No. 1 below you can see generally accepted figures from the “National Guide to Pediatric Dentistry”. In this diagram you can see the timing of the eruption of baby teeth in completely healthy children who do not have any pathology.

Scheme of teething in children without pathology (scheme No. 1) –

According to statistics, the normal schedule for teething in children is observed only in 42% of cases. A delay in the timing of eruption is observed in approximately 48% of children, which is associated with illnesses suffered - both by the mother during pregnancy and by the newborn child (you can read about the main reasons for the delay in eruption below). Approximately 10% of all children experience early eruption of primary teeth, and in a small percentage of cases this can occur even during fetal development.

What may cause delayed teething?

Many factors can influence the delay in the eruption of primary teeth. For example, in premature children with general somatic pathology, the eruption of the first teeth in 61% of cases occurs only at the age of 8 months and older. Moreover, if a premature baby has suffered an intracranial birth injury or a severe infectious-inflammatory disease, then eruption may begin even later - at 11-12 months and older.

The timing of the onset of teething also depends on the duration of natural feeding. In bottle-fed children, in 60% of cases, the first temporary teeth erupt only at 8 months or later. In mixed-fed children, delayed eruption was observed in only 30% of cases. A lot depends on the state of health of the mother during pregnancy, as well as on the course of pregnancy. For example, when examining children under 3 years of age whose mothers suffered severe toxicosis, it was found that the start of the eruption of primary teeth in them shifted to 8-10 months.

It is also worth noting that delayed eruption in a small percentage of cases can occur even in completely healthy children, which is associated with a genetic factor (for example, when late eruption was observed in one of the child’s parents). The “National Guide to Pediatric Dentistry” published a table that clearly shows what the delay in eruption may be if a child has various diseases.

Table No. 1 - timing of the onset of eruption in the presence of pathology

List of reasons for delayed eruption of baby teeth:

1) The first group of reasons includes diseases of a woman during pregnancy, as well as features of the course of pregnancy. Moreover, it is worth noting that all these reasons have only a moderate effect (unlike diseases in the 1st year of a child’s life). These reasons include:

• toxicosis of the 2nd half of pregnancy,
• kidney disease,
• previous pneumonia or acute respiratory infection with high fever,
• herpes infection, rubella, toxoplasmosis,
• constant chronic or short-term severe stress.

2) The greatest influence on the delay in the eruption of primary teeth is caused by diseases suffered during the 1st year of the child’s life:

• neonatal sepsis,
• pneumonia, frequent acute respiratory infections,
• atopic dermatitis, rickets,
• general somatic pathology,
• convulsive states,
• intestinal toxicosis,
• prematurity and postmaturity,
• hypothyroidism (lack of iodine intake),
• poor unbalanced diet,
• for epilepsy.

Causes of early teething: studies have found that early teething is most often characteristic of children born with a large body weight. Moreover, there is a clear correlation - the greater the child’s body weight, the earlier the eruption of temporary teeth begins. Also, premature eruption is observed with adrenal tumors accompanied by hyperfunction (24stoma.ru).

Violation of the sequence of teething in children -

Physiological teething is characterized not only by timing, but also by such characteristics as pairing and sequence. Those. all teeth should erupt in pairs, for example, first 2 central incisors of the lower jaw erupt at once, then 2 central incisors of the upper jaw, etc. See diagram No. 1 above for the timing and sequence of baby teeth eruption. In healthy children, there are usually no violations of pairing and sequence during teething.

But in children who have suffered from rickets, sequence violations occur in approximately 52% of all cases, pairing disorders occur in approximately 35% of cases. In children with rickets, the eruption of primary teeth very often begins with the central and lateral incisors of the upper jaw, and when the crowns of the teeth erupt approximately halfway, the eruption process may stop for many months. The latter is associated with a violation of the formation of the roots of milk teeth, because when milk teeth just begin to erupt, their roots are still only 25-50% formed.

Types of teething disorders

Teething in children, the sequence of which is clearly defined, can occur with a delay caused by various reasons (illness of the mother during pregnancy, diseases suffered by the child, etc.). Due to the delay, deformation of the jaws may begin, because There is not enough free space for teeth that have not yet erupted. In this case, only the dentist can decide on treatment after a thorough visual examination of the child and analysis of the photograph taken.

The next very common disorder is enamel hypoplasia, which manifests itself in spots of different colors on newly emerging teeth, pits or grooves. Hypoplasia causes complications during pregnancy.

Why do teeth erupt with irregularities?

The condition of a child’s teeth in the first years of life depends on the health of the mother during pregnancy. The formation of hard dental tissues may be disrupted if a woman:

• suffered from toxicosis at the initial stage of pregnancy;
• experienced severe prolonged stress;
• was treated for kidney disease;
• suffered from rubella.

In addition to maternal diseases, the maturation of teeth and the development of the jaw system can be affected by:

• fetal prematurity or, conversely, delayed birth;
• conflict of Rh factors;
• sepsis suffered by a child in the first month of life;
• frequent colds, pneumonia;
• convulsions;
• toxicosis;
• refusal to breastfeed.

Often, parents, driven by the best intentions, want to alleviate the baby’s suffering by giving him medications. You must understand that any medicine, even if it seems completely safe, cannot be taken without consulting a pediatrician!