Your Child's Oral Health  

The switch from baby teeth to permanent teeth is a process that has a few stages.  (Photo: Contributed)
The switch from baby teeth to permanent teeth is a process that has a few stages. (Photo: Contributed)

Teething: the sequel

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In keeping with our last dental article, this is a question related to teething that arises often in the dental office and causes many parents a great deal of concern.  What happens when there are permanent teeth coming in while the baby teeth are still present?  
The switch from baby teeth to permanent teeth is a process that has a few stages.  The first stage happens between 6 and 8-years-old when the front teeth change over and the 6 year permanent molars erupt.  The second stage is between 8 and 10-years-old when very little changes from a teething standpoint, but there is much growth.  The final stage is between 10 and 12-years-old when the primary molars and canines fall out and the permanent canine and premolars come in.
Very often, the first teeth to come in are the first to fall out.  The lower front incisors start to loosen anywhere between 5 and 7-years-old, on average.  As the permanent teeth that follow begin to erupt, often they will break the surface behind the baby teeth that are still present.  As the permanent teeth erupt, you will notice some obvious differences between the baby teeth and the permanent teeth.  
The new teeth coming in are much larger, generally much more yellow in colour, and have “bumps” on the top/edge of the teeth.  Permanent teeth, like primary or baby teeth, are full size when they erupt, which is to say they don’t grow over time.  This means that when your child’s new front teeth come in, they are the same size, or very close, to yours!  This is why kids have the “awkward” appearance as the front teeth come in.  It also means that since their mouth is smaller than an adult, at this stage of development, children will often display a degree of crowding of the front teeth, especially in the bottom.  Often this crowding will resolve over time as the baby teeth further back start to fall out later, between 10 and 12-years-old.  
Permanent teeth are also different from primary teeth with regards to composition.  These new teeth have thicker enamel, and dentin that is more yellow than baby teeth.  The result is that permanent teeth are more yellow in appearance than baby teeth, rest assured, this is normal.  The bumps, or “mamelons” are normal and are generally worn off within the first few years of the tooth being present in the mouth.
In some cases, the permanent teeth will erupt quite a bit before the baby teeth fall out, giving the “shark teeth” appearance where there are two rows of teeth present at the same time.  The great majority of the time this situation will resolve itself without the need for professional assistance.  Occasionally, however, the baby teeth will need help coming out, a scenario familiar to your dentist, and one he or she would be happy to discuss with you.
These are only a few of the more common teething issues seen in our office.  If you have any questions or concerns related to these or any other dental issues, feel free to contact your family dentist, or our office for advice.
Just as an aside, halfway through writing this article my 6-year-old son lost his second baby tooth.  A proud, yet strangely ironic, moment...and yes, he had shark teeth.

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About the Author

Dr. Alan Milnes is a pediatric dentist with 35 years of practice experience and 20 years of experience as a full time University Professor at the Universities of Manitoba and Toronto. He has operated a full time pediatric dental practice in Kelowna since 1997, the only pediatric dental office in either the Interior or Northern Health Authorities.

Dr. Terry Farquhar  completed his pediatric dental residency training in Halifax, Nova Scotia and Rochester, New York. Prior to entering Dentistry, Dr. Farquhar  worked as a pediatric nurse at Alberta Children's Hospital in Calgary.

Their pediatric dental specialty practice provides a complete range of dental services for ALL children and teens including treatment in-office using various forms of behaviour guidance, oral, inhalational and intravenous sedation and treatment in hospital under general anesthesia.

"We are dealing with an epidemic of tooth decay in children, a condition called early childhood tooth decay. Many children with dental disease have a poor quality of life because of chronic pain and infection which makes sleeping and eating difficult. Providing information through our column to parents of children in the Interior of BC will be helpful in giving them important tools to prevent dental disease in their children."

Please visit our website for a look at what we do each and every day and our qualifications - www.okanagandentalcareforkids.com; email: [email protected]

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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