All about children's teeth: Growth and development

Dr. Suess, one of the most beloved children's authors of all time, once wrote, "Teeth! You find them everywhere! On mountaintops! And in the air! And, if you care to poke around, you'll even find them underground!" That was his poetic way of saying we all have teeth.  (Side note: this is an absolutely fantastic children's book, particularly for the pre-K crowd who might need some preparation for the whole Tooth Fairy ordeal coming their way).

The tooth chart above shows baby teeth, also commonly known as primary teeth or milk teeth on the interior.  These teeth begin coming in during infancy, typically around 6-12vmonths old through about age 6.

The baby teeth begin falling out when the permanent teeth, also commonly known as adult teeth, start pushing their way through.  The chart shows the permanent teeth on the outside.  It takes years for all of the baby teeth to fall out and for the permanent teeth to come in.  How long?  Well, that depends on the person, but usually, the wisdom teeth are the last set of teeth to come in during late adolescence or early adulthood.

There are 20 milk teeth total and they usually begin coming in when a baby is between 6 and 12 months of age. Of course, every baby is unique so some babies get their milk teeth early while others may get them late.  Although these teeth are not permanent, it is still important to care for them properly with brushing and flossing,  It is recommended that you start brushing teeth as soon as they emerge.  While toothpaste with fluoride is now considered perfectly safe for all ages, some parents prefer to start with fluoride free toothpaste until the child is old enough to spit the toothpaste into the sink after brushing. 

The milk teeth often emerge in sets, though not always.  The most common two teeth to emerge first are the bottom middle teeth.  Next, are usually to two front teeth (top).  Often eye teeth are next, then two more on the bottom, until finally the molars (ouch!)

The milk teeth, or baby teeth, begin to fall out around age 6.  This is caused by the permanent teeth coming down and pushing the baby teeth out to make way.  The order that milk teeth are lost is similar to the order in which the baby teeth came in.  It isn't terribly painful to lose milk teeth but rather uncomfortable.  It can be bloody, which tends to freak children out.  Its best to prepare them by telling them they will lose their teeth, reading books about it, and of course discussing the Tooth Fairy!

Permanent teeth are exactly as their name describes: permanent.  They are the last set of teeth any person will have.  They begin emerging around age 6 and come in one by one until the final teeth, the wisdom teeth, come in at the end of adolescence. It is a common dental practice, however, to remove wisdom teeth before they emerge (more on that later).

Including the wisdom teeth, there are 32 permanent teeth.  It makes sense because they emerge in larger mouths. Caring for these teeth is of utmost importance because they cannot be replaced.  Current recommendations for care of permanent teeth is brushing with an ADA recommended fluoride toothpaste and a medium to soft brush twice per day, flossing twice per day, fluoride rinse at night, and regular dental check-ups and cleanings.

Neglecting to care properly for teeth can result in problems such as cavities, decalcification, tooth decay, gingivitis, and periodontal disease.  Some of these issues can occur due to genetics or other environmental factors, however.  All of these can be treated by a dentist but the idea is to prevent them with daily care of the teeth, milk teeth and permanent teeth alike.

Braces are dental devices used by a specialist called an Orthodontist to straighten permanent teeth and correct potential bite issues. Not all children need braces, however, because permanent teeth have their own agenda as far as when they will emerge, many kids do benefit from having braces, if only for aesthetics. Braces can remedy a wide range of dental issues from imperfect alignment to major crowding and bite problems.

Braces used to be synonymous with a mouth full of metal, but modern Orthodontics have more options available than ever before. There are 4 main types of braces current used:

1. Traditional metal
2. Ceramic
3. Lingual
4. Invisalign

The first solution for teeth alignment, metal braces are still around with some improvements.  The brackets are now much smaller, so they take up less room in the mouth.  That being said, they are still noticeable, and the most noticeable of all of the options. With the option of changing the band colors at each appointment, these braces can still be fun and offer an opportunity for self-expression. They are the least expensive option on the market current day. More on traditional metal braces here.

These braces are less noticeable and typically have smaller tooth-colored brackets.  An unfortunate result of not keeping these braces very, very clean is that they can stain. Ceramic braces do not have to be worn as long as some of the even less noticeable types of braces we will later get into.  They are more expensive than traditional metal braces. More on ceramic braces here.

Lingual braces are placed on the back side of each tooth to prevent being seen at all. If a person with lingual braces smiles, you would never even know they have braces at all.  While that may sound like a perfect solution in the name of vanity, some of the cons of this method of alignment are the expense, cleaning difficulties, and added time and difficulty of adjustments.  This type is also not recommended for severe cases. Learn more about lingual braces here.

Invisalign is true to its namesake in that it is a mostly invisible teeth alignment choice.  With Invisalign, a person can eat or drink anything they want, which is a luxury that braces with brackets cannot afford them.  Foods like popcorn and gum are not recommended with braces with brackets as it can cause them to come away from the tooth.

Invisalign is not an option for severe alignment problems or bite problems.  It is also only available to adolescents and adults, NOT children. It is certainly the most expensive option and also takes the longest of the four options to correct alignment. Learn more about Invisalign here.

While a person can get braces anytime during his or her life, typically it is recommended that kids get braces between the age of 10 and 14 years old.  Usually, Orthodontists like to make sure that a child has lost all of their baby teeth and have all or most of their permanent teeth. 

The length of time a person will wear braces depends on the problems that are being corrected and the type of braces that are chosen.  The average amount of time that braces are worn is around 1-3 years.

In order to keep the teeth aligned, there is usually some type of device called a retainer that is worn after braces come off.  Some retainers are lingual and stay permanently affixed to the back of the teeth, and some can be removed to eat, brush teeth, etc. 

If you've ever heard a child grinding away at their teeth while they are sleeping, it is quite an unforgettable sound.  This condition is common, and the medical term for teeth grinding is Bruxism. According to kidshealth.org, nearly 70% of kids either clench their jaws or grind their teeth while they are deep in dreamland. Bruxism can be caused by the pain associated with teething, stress, and hyperactivity, or less commonly it can be a sign of an underlying medical condition in a child.

Despite producing a truly terrible sound, Bruxism is not as serious as it (literally) sounds.  It can cause headaches and earaches which can be an irritation, but they are not life-threatening problems.  Some remedies for Bruxism are a special piece of equipment the child puts in his or her mouth at night to protect the teeth, called a bite guard.  Alternatively, both parents and the child's dentist can watch for any tooth damage caused by Bruxism and go from there.

We've learned from both Dr. Suess and several credible online sources that teeth are an important part of growth and development.  The first set of teeth start coming in within the first year of life and continue to emerge through about age 6.  After that, the final, permanent teeth emerge over the rest of childhood into adolescence.  It is important to care diligently for both sets.  Braces can be used to improve alignment and bite and come in many types of braces in the modern day. Bruxism is a condition that is common in children where clenching the jaws or grinding the teeth happens at night during sleep.