The initial growth phase of primary (baby) teeth commences during the second trimester of pregnancy, typically around 16-20 weeks. During this critical period, it becomes paramount for expectant mothers to maintain a healthy and nutritious diet, as essential nutrients are crucial for the development of bones and soft tissues.

While there may be slight individual variations in the timing of tooth eruption, primary teeth typically begin to emerge when the infant reaches six to eight months of age. By the age of three, a complete set of twenty primary teeth will have emerged.

To ensure optimal oral health, the American Academy of Pediatric Dentistry (AAPD) recommends scheduling the child's first "well-baby" dental visit at around twelve months of age or within six months after the first tooth erupts. This initial visit not only introduces the infant to the dental office but also allows the pediatric dentist to monitor dental development. Moreover, it provides an excellent opportunity for parents to ask any questions they may have.

Which teeth emerge first?

Typically, teeth emerge in pairs, starting at the front of the infant's mouth. Between the ages of six and ten months, the two lower central incisors begin to break through. It's important to note that cavities can develop between adjacent teeth, so flossing should be introduced at this stage.

Following that, usually between the ages of eight and twelve months, the two upper central incisors make their appearance. Teething can be an uncomfortable process for infants, but using clean teething rings and cold damp cloths can help alleviate irritation and discomfort.

Between the ages of nine and sixteen months, the upper lateral incisors emerge on either side of the central incisors. Around the same time, the lower lateral incisors also emerge, resulting in four adjacent teeth on both the upper and lower arches. Pediatric dentists recommend discontinuing the use of sippy cups by the age of fourteen months to minimize the risk of "baby bottle tooth decay."

Between thirteen and twenty-three months, an additional eight teeth emerge. On each arch, a cuspid or canine tooth appears immediately next to each lateral incisor. Positioned towards the back of the child's mouth, first molars emerge on both sides of the canines in both jaws.

Lastly, a second set of molars emerges on each arch, typically starting with the lower arch. By the age of thirty-three months, most children have a complete set of twenty primary teeth. Pediatric dentists often apply dental sealant to the molars, which acts as a barrier against food particles, bacteria, and acids that can harm tooth enamel.

How can I reduce the risk of early caries (cavities)?

Primary teeth serve important functions in preserving space for permanent teeth and guiding their alignment. They also contribute to speech production, prevent abnormal tongue posture, and play a crucial role in proper food chewing. Therefore, it is vital to learn how to care for emerging primary teeth effectively.

Here are some valuable tips:

1. Brush twice a day: The American Academy of Pediatric Dentistry (AAPD) recommends using a pea-sized amount of ADA-approved non-fluoridated toothpaste for children under two years old, and the same amount of ADA-approved fluoridated toothpaste for older children. Use a soft-bristled toothbrush appropriate for infants.

2. Start flossing: Flossing an infant's teeth can be challenging, but it is important to begin when two adjacent teeth emerge. The pediatric dentist can provide a demonstration of proper flossing techniques.

3. Provide a balanced diet: Sugars and starches feed oral bacteria, leading to the production of harmful acids that attack tooth enamel. Ensure that the child consumes a balanced diet and work towards reducing sugary and starchy snacks.

4. Set a good example: Children who observe their parents brushing and flossing are more likely to follow suit. Explain the significance of good oral care to the child, and consider using age-appropriate books to aid in the explanation.

5. Visit the dentist: Regular visits to the pediatric dentist allow for monitoring of oral development, professional cleanings, application of topical fluoride to the teeth, and the application of sealants to molars. Biannual dental appointments can help prevent a wide range of painful conditions in the future.

If you have questions or concerns about the emergence of your child’s teeth, please contact your pediatric dentist.