Terms of eruption of permanent teeth: a detailed scheme according to WHO and Vinogradova. Terms of eruption of milk teeth

The process of teething is understood as a complex process of their vertical movement from the place of laying and development inside the jaw bones to the eruption of the crown in the dentition.

The process of teething begins at the time of the final formation of the crown of the tooth and is accompanied by its further development, growth and development of the jaw bones.
The main changes occurring in the tissues surrounding the tooth in the course of its eruption include (V.L. Bykov, 1998): development of the tooth root; periodontal development; restructuring of the alveolar bone; changes in the tissues covering the tooth (Fig. 76).

The development of the tooth root is associated with ingrowth into the mesenchyme of the dental papilla of the epithelial root sheath of Hertwig. Its cells determine the production and development of odontoblasts that produce root dentin. With the reduction of the Hertwig sheath, the cells of the dental sac undergo differentiation and produce cementum over the root dentin.
The development of periodontium is expressed in the growth of its fibers, both from the side of the root cementum and from the side of the alveoli. These processes become more intense just before the eruption of the tooth.

The restructuring of the alveolar bone is accompanied by complex processes of osteoapposition and osteoresorption. The intensity of the restructuring of the alveolar bone is varied and depends on many factors, including: localization, group belonging of the teeth. During the formation of the tooth root, it reaches the bottom of the bone alveoli and causes its resorption in the compression zone. At the same time, intensive processes of bone formation continue in the root at the point of contact with the alveolus.

In multi-rooted teeth, bone deposition occurs most intensively in the region of the emerging interradicular septa. In single-rooted teeth, the area of ​​increased bone tissue deposition is the bottom of the hole from the lingual surface.

Resorption of bone tissue along the eruption of the tooth provides a local decrease in the strength properties of the bone and weakens its resistance.

Changes in the tissues covering the erupting tooth. When the tooth approaches the oral mucosa, regressive changes occur in the connective tissue that separates the tooth from the epithelium of the mucous membrane, this is facilitated by the reduced enamel epithelium covering the tooth crown (Fig. 76, 1).

Approaching the epithelium lining the oral cavity, the reduced enamel epithelium merges with it (Fig. 76, 3). The latter in the central sections stretches and breaks through (Fig. 76, 4). Through the resulting hole, the crown of the tooth erupts into the oral cavity (Fig. 76, 5). In this case, there is no bleeding, since the crown moves through the canal lined with epithelium.

Having cut into the dentition, the crown continues to erupt at the same speed until the tooth is established in the correct occlusal relationship with the antagonists and adjacent teeth (Fig. 76, 6).

The reduced enamel epithelium remains attached to the enamel in the part where the crown has not erupted, it is called the primary attachment epithelium. Later it is replaced by secondary attachment epithelium, which is part of the gum.

In modern literature, there are four main theories that explain the mechanism of teething (V.L. Bykov, 1998):

1. Theory of tooth root growth.
2. Increased hydrostatic pressure in the periapical zone or pulp of the tooth.
3. Restructuring of bone tissue.
4. Periodontal traction.

The eruption and replacement of temporary teeth with permanent ones is a complex physiological process. Signs of correct teething are: consistency, pairing and symmetry.

First teeth erupt on the lower, then on the upper jaw. Teething is an indicator of the correct development of the child, it is closely related to the general state of his health. It should be noted that the process of normal teething is individual, therefore only sharp deviations from the natural ones are considered to be anomalies.

The beginning of teething of the temporary bite refers to the second half of the 1st year of the child's life (Table 4).

Table 4
Average terms of eruption of temporary teeth

Teething begins with the formation of dense bulges on the gums, corresponding to the future crowns of temporary teeth.

At 6-8 months of life, the cutting edges of two central incisors appear on the gum surface: first on the lower, then on the upper jaw.

By one year, 4 incisors should erupt in the upper and lower dentition of the child, i.e. 8 teeth in the mouth.

By 30 months, the child has a temporary bite.

The development of permanent teeth generally resembles the development of temporary teeth. The dental lamina serves as a source of formation of the anlages of the enamel organs of the permanent teeth.
Bookmarks that will give rise to permanent replacement teeth (incisors, canines, premolars) arise due to increased proliferation of dental plate cells near the enamel organs of temporary teeth and its growth in the form of a replacement dental plate. They are located on the lingual surface of temporary teeth.

Permanent molars do not have temporary predecessors, so they are called additional. Their initial development differs from that of permanent replacement teeth.
During the eruption of permanent replacement teeth, destruction and loss of temporary teeth occurs, which includes progressive resorption of the roots of temporary teeth and their alveoli (Fig. 77).

Due to the pressure of a permanent tooth on the alveolus of a temporary tooth, differentiation of osteoclasts begins, which are actively involved in the processes of bone tissue resorption.
The localization of zones of physiological resorption of the roots of temporary teeth is different depending on the group of the tooth: in single-rooted teeth it is located in the region of the apex of the tooth on the lingual side, and in multi-rooted teeth it is located in the zone of bifructation of the roots.

The timing of eruption of permanent teeth with the correct development of the child coincides with the time of loss of temporary teeth (Table 5).

The process of falling out of a temporary tooth proceeds synchronously with the process of eruption of a permanent tooth.

Clinically, after the loss of a temporary tooth, tubercles or part of the cutting edge of the erupting permanent teeth are found.

The eruption of permanent teeth begins with the first permanent molar at 6 years of age. Then, sequentially at the age of 6-8 years, the central and lateral incisors erupt.

At 9 - 10 years old, the first premolars erupt, followed, most often, by the canines (10 - 11 years old) and the second premolars (11 - 12 years old).

At 12-13 years old, the second permanent molars erupt. Thus, by the age of 12-13, all temporary teeth are replaced by permanent ones. The final formation of the roots is completed by the age of 15.

The replacement teeth have a special anatomical structure that contributes to their eruption - a conductive canal, which contains a conductive cord.

The laying of such a permanent tooth is initially placed in a common bone alveolus with its temporary predecessor.

In the future, it is completely surrounded by alveolar bone, with the exception of a small canal containing the remnants of the dental plate and connective tissue. Together, these structures contribute to the directional movement of the permanent tooth during its eruption.

Table 5
Formation and eruption of permanent teeth.

Orthodontics
Under the editorship of prof. IN AND. Kutsevlyak

Any mother is looking forward to the first tooth of her little one, so it is interesting for almost all parents to know in what order the milk teeth will erupt. In addition, knowledge about how teeth climb is also important for assessing the correct development of a baby, because, having noticed some violations, dental problems can be prevented in time.

Timely erupted teeth are one of the indicators of the correct development of the child.

Teething rules

1. Babies' teeth usually come in pairs. When a mother notices one new tooth in a baby, she needs to wait for his eponymous "brother" to appear in the near future. It happens that the crumbs cut 2 or 4 teeth at the same time.
2. In most children, teeth first erupt in the lower jaw. For example, the lower central incisors appear first, and then the same teeth at the top. The same situation occurs with molars and canines, and only the lateral incisors climb differently (they first cut through at the top).
3. The approximate number of teeth at a certain age is calculated on the basis of the following formula: "the age of the baby in months minus four." She suggests that on average, at 6 months, children have two teeth, and by 24 months of life - all twenty teeth.

The opinion of Dr. Komarovsky about the first teeth and all the problems that arise due to their appearance, see the video:

Symptoms

Although teething is a physiological and natural process, it still burdens the child's body, causing discomfort and such manifestations:

• Increased secretion of saliva.
• Decreased appetite up to the complete refusal of food.
• Tendency to take things into the mouth and gnaw on them, because of itching in the gums.
• The appearance of swelling, redness and swelling at the site of eruption.
• Capriciousness and irritability due to pain and itching.
• A disturbed dream.

Restless sleep is a sure sign that soon the first tooth will come out of the crumbs.

In some babies, other symptoms are added to such symptoms:

• Increased body temperature (in most cases within + 37 + 37.5 ° C).
• Runny nose and cough due to excess saliva.
• Slight liquefaction of feces.
• Skin irritations on the chin and chest.

When teething, a subfebrile temperature may last for several days.

Which teeth appear first?

The very first tooth that "pecks" in a baby is called an incisor. In most of the little ones, it appears on the lower jaw, after which another incisor is shown quite quickly nearby. Such teeth are distinguished by narrow crowns and are designed for biting off food. Most often, they erupt at the age of 6-8 months, although in some little ones the first incisor begins to knock on a spoon at 3-4 months, and some mothers have to wait for the first tooth to appear only by the age of one year.

In most cases, the first teeth look like this

Eruption sequence

Although the order of appearance of milk teeth is only approximate and may differ for each individual child, parents should focus on the following sequence:

• The first teeth in most children, as we noted above, are central incisors, called "ones" for their position in the dentition.
• They are then supplemented side cutters, which are called "doubles".
• After the incisors comes the time of appearance first molars, which in the dentition go "fours".
• The next step is eruption of canines between lateral incisors and first molars so they are called triplets.
• The last among the milk teeth are the “five”, which dentists call second molars.

The average time for the appearance of milk teeth in the table

The process of eruption of each new milk tooth in different children takes place individually, however, if you look at the order and time of the appearance of the first teeth in most children, you can notice the average terms that parents and pediatricians are guided by. Here is a table that shows the average time for the appearance of teeth, taking into account the sequence of their eruption:

In most children, the last milk teeth "hatch" by the age of 2-2.5 years.

When do milk teeth fall out?

The average terms of loss of milk teeth will be as follows:

• The central incisors begin to wobble and fall out at 6-8 years of age.
• Loss of lateral incisors is observed in children 7-8 years old.
• The period of loss of the first molars is 9-11 years.
• Canine teeth most often fall out between the ages of 9 and 12.
• The second molars stagger and fall out at 10-12 years of age.

An orthodontist, Ph.D. Svetlana Nikolaevna Vakhney:

Eruption of permanent teeth

The first among the permanent teeth of a child to appear are “sixes”, that is, teeth that are located in the dentition immediately after the second milk molars. They are called first molars, and milk molars are replaced by teeth called premolars. The first permanent molars erupt in children aged 6-7 years, and this happens, as a rule, before the first milk teeth fall out.

• At the age of 6 or 7 years, central incisors appear on the lower jaw.
• At the age of 7-8 years, the central incisors erupt in the child and on the upper jaw.
• The lower "twos" also erupt at the age of 7-8 years.
• Lateral incisors at the top are cut at 8-9 years.
• On the lower jaw, fangs grow at 9-10 years.
• The upper fangs appear in children of 11-12 years of age.
• The appearance of the first premolars in the upper jaw is observed on average at 10-11 years.
• The period of eruption of the first lower premolars is 10-12 years.
• The second premolars at the top are cut in children aged 10 to 12 years, and in the lower jaw - at 11-12 years of age.
• The second molars come out at the bottom at 11-13 years.
• The eruption of the second molars in the upper jaw is noted at the age of 12-13.
• The third molars both at the top and on the lower jaw are cut at the age of over 17 years.

Possible problems with eruption

The main problems that occur during teething are violation of the timing of their appearance, as well as in the wrong sequence. In addition, since the appearance of new teeth lowers the immunity of the child, the crumbs may develop:

• Pneumonia
• Caries
• Stomatitis
• Abscess (pharyngeal)

Why can eruption be delayed?

If the baby has not yet had a single milk tooth by the age of one, it is worth showing the child to the doctor and find out the reasons for this situation. They may include:

• Influence of a hereditary factor. If mom, dad or other close relatives teeth erupted later than average, then the situation will be the same for the crumbs.
• calcium deficiency, which also provokes rickets.
• Lack of hormones produced by the thyroid gland.
• Problems with digestion and absorption of nutrients.
• Absence of tooth buds.
• Prematurity of the child.
• Development of an infectious disease.

Advice to parents on what to do and how to behave during teething is given by the Union of Pediatricians of Russia:

Gaps between teeth

Milk teeth appearing in a child under 3 years old can be asymmetrically located or with gaps between them. This is a variant of the norm, if the entire dentition has not yet erupted. As soon as it is fully formed, due to active chewing, all teeth will fall into place. Further, by the age of 6-7, when the change of milk teeth begins, gaps will again appear between the teeth, since the size of the permanent teeth is much larger. The appearance of such gaps should not bother parents.

The first symptoms of teething are profuse salivation, swollen gums, frequent loose stools and, in some cases, fever. The child constantly gnaws toys or constantly climbs into the genus with his fingers, as the gums itch. The baby can behave restlessly, sleep poorly at night and be moody. Saliva is important for oral disinfection.

teething symptoms

During the period and timing of eruption, the child's immunity weakens and the temperature must be taken seriously, since it can be caused not only by eruption, but also indicate the development of an infectious disease. Pay attention to the symptoms, if there is a cough or runny nose, then you need to call a doctor, and if there are no other symptoms, then usually it lasts no more than three days. Also during this period, there is also loose stools more often than once a day, there have been cases that 4-5 times a day. But if loose stools are accompanied by vomiting, fever, then this is already a rotovirus infection and you should consult a specialist. And if only one vomiting, without additional symptoms, then this may be a consequence of swallowing a copious amount of saliva.

Terms of eruption of milk teeth in children

There are times when the timing of the appearance of milk teeth in children varies. This can be explained by genetics or the time the child was born. For example, in children who were born in winter, the order of teething of milk teeth begins earlier, but if by the first year of life they have not yet erupted, then urgently consult a specialist. Since this may be a sign of rickets, indicate problems in metabolism or talk about a lack of calcium in the body.

There are times when the timing of teething in children is doubles, that is, two snow-white friends immediately erupt or follow each other. If the first left bottom grows, then soon expect the second right. Often the upper teeth follow without interruption. So get ready.

How to make teething easier

To make it easier for the child to endure this period, you can buy toys "assistant - to rodents", these toys distract from pain, massage the child's gums. You can also use medication. For this, there is Kalgel gel, it anesthetizes, cools the gums. You can drink Nurofen, it both anesthetizes and reduces the temperature, if any. Panadol can also be used to lower the temperature, it also lowers the temperature. When taking, follow the reaction, there is an allergy to these drugs.

How to take care of your teeth

Immediately after the first teeth, you need to start caring for them, as they are exposed to negative effects from the external environment, microbes settle on them, forming a plaque. In this plaque, microbes are actively produced, under their influence, the enamel easily collapses and a carious cavity is formed.

Causes of caries in the first year of life, in the first place, becomes acid production. The production of this acid occurs more reactively in the presence of sugar. It is present in breast milk and formulas for artificial feeding. And the longer the mother does not transfer the child to regular food, the greater the likelihood of caries.

It is recommended to wean a child from breastfeeding and artificial feeding in a year, since in a year the child has already tried many foods and his first teeth have formed, he will be able to chew on his own. Sugar is also found in juices, so do not abuse this drink.

Start taking care of your oral cavity to the first milk teeth. With the help of a moistened napkin on the finger, the oral cavity is wiped, the first incisors are also wiped with a napkin. And from the first year of life, you can buy a toothbrush for your finger and children's toothpaste. The paste indicates at what age it can be used, so we get the one that indicates 0+ and start cleaning the oral cavity every day.

When choosing a paste, you should carefully study the composition and check the expiration date. It is best to have fluoride in your toothpaste. It should be remembered that the child is prone to swallowing toothpaste while brushing the mouth, so we recommend up to 6 years of children's toothpastes with reduced fluoride content. To clean the oral cavity, it is enough to use a small amount of fluoride-containing toothpaste - about the size of a pea. In the second year of life, a toothbrush is already purchased. Specially children's toothbrushes appeared on the sales market - they are not and have special bristles and a handle in the form of a toy. They form an interest and a positive attitude towards cleaning the oral cavity and accustom to regular brushing.

The early development of caries is increased with a low content of fluorine in drinking water. Therefore, children aged 2 to 14 years need a daily intake of fluoride in the body. We recommend that you take fluoride in the form of tablets or drops, but before you start taking these tablets, you should consult your doctor.

How to avoid early caries

• In no case should you lick the baby's nipple, there are a lot of bacteria in the saliva of an adult
• Reduce the amount of sugar in your daily life, let's drink water more often instead of juice and in no case give sweets at night
• Teach your child to drink a few sips of water after meals, and for an older child to rinse the mouth after eating so that food particles do not destroy it.
• Get regular checkups with your dentist. From 9 months to 2 years, you need to visit a doctor every 3 months, when you turn 2 years old - every six months
• Try to prevent the child from injuring himself and the oral cavity. If the enamel is damaged, they begin to break down faster.
• Encourage your child to brush their teeth at least 2 times a day, and ideally after every meal.

Molar teeth in children, the order of eruption

At the age of 7 years, children begin to change milk to molars. The milk teeth fall out and the permanent teeth grow in their place. The child begins to form an overbite. In terms of teething from 7 to 15 years, a replacement takes place. It used to be thought that late replacement was a sign of rickets, but this is not the case. Research has shown that replacement delays are common to many normally developing babies.

1. 6-8 years - central incisors
2. 7-8 years - lateral incisors
3. 9-12 years - fangs
4. 9-11 - first molars
5. 10-12 - second molars

Teething periods in children may be delayed, this may be due to rickets disease, infectious disease, prolonged intestinal disturbance and changes in metabolism. BUT early eruption can be a wake-up call about endocrine disorders.

Such violations may be the result of pathological processes in the child's body and require consultation with a doctor.

myths

The most common myth is that all children fit the tooth growth chart, but this is not true. Each child is different and each has its own growth period. Deviations from 2 to 3 months from the standard are allowed.

Thumb sucking leads to deformation of the dentition. A similar problem leads to a violation if this habit is present constantly, and not from time to time. Cough, fever and runny nose are not only teething, but also symptoms of viral diseases. So do not attribute everything to the growth of teeth, in order to avoid complications, it is better to contact specialists. Milk teeth need to be taken care of as they affect the formation of permanent teeth.

So be attentive to all signs and do not confuse the symptoms of teething with the symptoms of the disease. It is always better to consult a specialist than to deal with complications later. We also advise you to be patient, because during these periods of life, children are more capricious and restless. Therefore, try not to break down and not start the symptoms, it is better to immediately buy toys and medicines to make this period easier for the child and not to be nervous. With proper care, the child will not have problems with his teeth.

The appearance of milk teeth in a child is a long-awaited event, which is often associated not only with joy, but also with unpleasant manifestations that cause discomfort to the baby and worries to parents. Among the questions that concern mom and dad regarding the eruption of dental units, in addition to the problems associated with this, include the sequence, age limits, when this happens, and what is considered normal in this regard, and what goes beyond the generally accepted framework.

Signs of teething in a baby

Teething in a child is an individual process that can proceed in completely different ways. In some, it passes almost imperceptibly and painlessly, while in others it is accompanied by a lot of unpleasant sensations and discomfort. Factors such as:

Parents should be prepared for the moment when the teeth begin to climb, in order to reduce the severity of symptoms if necessary and alleviate this difficult period in the life of the baby. To do this, you should carefully monitor the condition of the crumbs. The following signs will indicate the approach of the appearance of the first teeth:

In queue! The order of eruption of milk teeth

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

An interesting fact is that the rudiments of milk teeth are laid during pregnancy, and appear only six months after the birth of the baby. There is a specific schedule for how, when and in what order the milk molars erupt, and then they are replaced by the molars. Despite the fact that in such a calendar the terms for the eruption of each dental unit in infants are set according to age, they are not accurate. Deviation from the tooth growth calendar within a few months is not considered a pathological disorder.

In children under 3 years old, you should wait for the appearance of teeth in the amount of 20 pieces, which will subsequently be replaced by indigenous ones, starting at the age of six. It is curious that the formation of molars begins within a few months from the moment of birth.

According to the standard generally accepted tables, which give the order of teething, the first dental units should climb out in the following sequence:

• lower central incisors;
• upper central incisors;
• lateral upper incisors;
• lower lateral incisors;
• anterior molars from below and above;
• lower and upper fangs;
• back molars in the lower and upper rows.

Central and lateral incisors

The table of teething puts the incisors in the first place by the time of appearance. It is with them that the formation of the dentition in children begins. Typically, in infants up to a year old, the central incisors pierce the gums first. Usually this occurs in pairs, first on the lower jaw, then on the upper. The lower incisors can show off in the mouth as early as 5-6 months. Then the top pair appears after them. The interval between them can be from one to two months.

There are two more pairs of lower and upper teeth, which are called incisors. They are located on the sides of the central incisors. It is due to their localization that they received the name "lateral". The timing of teething of this four varies in the range of 9-11 months for the top pair and 11-13 for the bottom.

In this sequence, the incisors erupt and grow in most babies. However, there are many cases where the order of their eruption does not coincide with the generally accepted pattern. For example, the upper central incisors may appear first rather than the lower central incisors. Sometimes the process begins with the lateral incisors, and behind them the central ones are already erupting. Any deviations from the usual sequence are not considered a violation and are quite acceptable, because the body of each baby is individual.

Summing up, we can say that by the year a child usually has 8 incisors in his mouth. True, it is absolutely not scary if there are less or more of them. As Dr. Komarovsky says, no one has yet been left without teeth (although this is not entirely true!).

Chewing teeth or molars

According to the tooth growth table, the next to grow are not the canines, which are next to the lateral incisors, but the molars, or the first chewing dental units. They are also called premolars or small molars. Their first four according to the schedule appear in the interval from a year to a year and a half. The second two pairs of molars erupt only after the child reaches the age of two.

This seemingly inconsistent growth of pre-canine molars can be worrisome for parents, but it's a natural process. Almost everyone has a photo of the baby, where he smiles, and the gaps between the teeth are visible in the mouth, which are waiting for the teeth to erupt.

As for the timing of the eruption of these teeth, the first pair in the upper jaw is usually shown in the period from 13 to 19 months. The second pair of lower jaw appears a little later, at 14–18 months. However, as with incisors, there may be irregularities in sequence and shifts in timing in one direction or another for several months. For this reason, you should not attribute any pathologies to the crumbs if his teeth are not cut according to the standard scheme.

Plus, the process itself can be slower than with incisors. This is due to the shape and size of the teeth. They are more massive and wide, so they pierce the gum longer.

teething

Fangs erupt one of the last. The time to appear and close the holes between the already existing premolars and lateral incisors for them comes at 16–23 months. The upper canines are usually shown first between 16 and 22 months. Behind them, the fangs of the lower row take their place - at 17–23 months.

By the age of two, a child has an almost complete set of dental units in his mouth, namely 16 pieces, without four second molars, which will erupt closer to three years.

There is an opinion that it is the eruption of fangs that gives the child and his parents the greatest amount of discomfort, discomfort and stress. This may cause confusion for some, because the fangs are the sharpest in shape and, on the contrary, should erupt quickly, easily and without complications. However, in reality this is not the case, and indeed they often create much more temporary health difficulties than their predecessors.

The reason for such a heavy eruption of fangs lies in their location. Often they are also called "eye" teeth. The place of their localization coincides with the close passage to the gum of the nerve connecting the central nervous system with part of the face. As a result, the crumbs may additionally experience tearing, sores and thrush in the oral cavity.

Are we on time? Table of appearance of teeth by age

All parents look forward to the appearance of the first milk teeth in their crumbs and begin to worry if this does not happen at the right time, especially when a neighboring baby of the same age can already boast more than one tooth. However, in most cases, being late or ahead of schedule is not a reason to sound the alarm. The table below shows the generally accepted time indicators of at what age which tooth usually erupts:

The data in the table are indicative. Usually there is nothing to worry about if the teeth erupt in the wrong order. Sometimes several teeth can come out at once.

Due to the fact that teething can last more than one week, it is important to monitor the condition of the child during this period very carefully, since his immunity is weakened, and the baby can easily catch a cold or catch an infection. This will complicate an already difficult stage in his life.

In what cases are deviations from the generally accepted schedule a reason for a visit to the doctor?

In some cases, unfortunately, untimely eruption of dental units or a violation of their sequence cannot be attributed to the individual characteristics of the development of the baby and considered the norm. It happens that such deviations in the process are due to pathological processes in the child's body. Only a specialist can detect them. Among such health deviations that violate the sequence of eruption of milk units, the following stand out:

Other possible reasons for the deviation from the schedule include:

• tumor formations;
• metabolic disease;
• disorders of the gastrointestinal tract.

However, such problems are quite rare. Usually, fluctuations in standard norms within six months are not considered a deviation. That is, teeth can begin to be cut even at 10–11 months. Experts are of the opinion that no measures should be taken to speed up or slow down the eruption process, especially since this is basically impossible to do. If the child behaves normally and his condition does not cause concern, parents should just be patient. Everything has its time.

The epithelial lamina serves as the source for the formation of permanent teeth. The timing of their laying is somewhat behind those for milk teeth. Indigenous rudiments begin to appear only by the fifth month of intrauterine development.

Permanent teeth are divided into 2 groups:

• Substitute, which have analogues in the dairy kit. These include incisors, canines and premolars.
• Additional, which have no temporal predecessors. These teeth are represented by molars.

The rudiments of permanent replacement teeth begin to grow in the same alveolus with milk ones, located behind their lingual surface. And only after some time they are completely isolated by bone tissue.

The formation of additional teeth begins even later, only after a year, which is associated with the need to increase the size of the jaw.

Molar teeth in most cases complete their growth by 15-18 years.

At what age do they appear?

The start and end time of the change of milk teeth to a permanent set is approximately the same for all children. Slight fluctuations from the average age indicators can be observed in representatives of different regions. It is believed that the hotter the climatic conditions, the earlier the child's molars grow.

The table shows age indicators that reflect the time when teeth from a permanent set begin to erupt, according to various authors.

Disagreements in terms of when molars climb according to various authors are explained by the fact that the studies were carried out in different regions and with a difference of several decades.

Eruption order

Most parents believe that the first permanent teeth that appear in a child's mouth are the incisors, which grow to replace the milk ones. But it's not. Before the temporary teeth begin to fall out, in children at the age of about 5-6 years, the first molars come out, which are not in the milk bite.

• lower and then upper central incisors appear;
• then the lateral incisors on the lower and upper jaws emerge;
• after the incisors, the upper and lower first premolars erupt;
• fangs change next;
• then the second premolars appear above and below;
• the last to erupt are the second and third molars, while the "wisdom teeth" may never appear on the gum surface at all.

This sequence of appearance of molars in a child is not accidental. In it, nature took into account all the necessary growth rates of the maxillofacial system. Therefore, if this order is not violated, the correct bite is formed.

How much grow

In most cases, in a child of 12-13 years old, the last milk teeth already fall out, although the resorption of their roots occurs somewhat earlier. At this point in the oral cavity there are teeth from the permanent bite, which continue to grow and have a different degree of root formation.

Knowing the normal timing of growth and root formation is important in the event of any pathologies, since these parameters are decisive when choosing a treatment strategy.

In the process of development of dental roots, it is customary to distinguish 2 stages:

1. The stage of the unformed apex.
2. The stage of the open apex.

At the first stage the root reaches its maximum length, but at the same time its walls are parallel to each other. The root canal is wide enough and ends in the region of the future apex with a bell. In this case, the periodontal gap is noticeable only on the sides of the root.

At the second stage there is a gradual formation of the apex of the tooth root. The root walls are gradually approaching, the periodontal fissure is finally distinguished, which is somewhat expanded in the apical region.

The end of the formation of dental roots has its own terms for different teeth:

Since the eruption of the third molars does not have a clear timeframe, it is not possible to determine the specific age of the formation of their roots.

The fact that the dental roots are finally formed can only be judged by the results of radiography. The main criteria are the absence of an apical foramen and the presence of a clear periodontal contour.

Thus, the final growth of dental elements and their full maturation ends only by the age of 15-18, when the maxillofacial apparatus of the child reaches adult size.