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Maternal and Child Health Bureau logoA Health Professionals Guide to Pediatric Oral Health Management
HomeModuleModule 1: An Introduction to Infants' and Young Children's Oral HealthModule 2: Managing Infants' and Young Children's Oral HealthModule 3: Oral Conditions and AbnormalitiesModule 4: Prevention of Oral DiseaseModule 5: Non-Nutritive Sucking HabitsModule 6: Oral InjuryModule 7: Infants and Young Children with Special Health Care NeedsContentsGlossaryEvaluationHelp
Module 2: Managing Infants' and Young Children's Oral Health
Module Contents
Overview
2.1 Oral Development

Tooth Eruption and Loss
Teething
Malocclusion
2.2 Interview and
Risk Assessment

During & After Pregnancy
During Infancy
During Early Childhood
2.3 Oral Screening
2.4 Behavior Management
2.5 Oral Examination
2.6 Anticipatory Guidance

For Pregnant Women,
New Mothers, or Other Intimate Caregivers
For Parents of Infants

For Parents of
Young Children

2.7 The Dental Home
Key Points
Post-Test
References
Additional Resources



2.1 Oral Development

Note
notepad graphicChildren whose teeth have not erupted within 6 months of the schedule should be referred to a dentist for further assessment and possible intervention.

 

Tooth Eruption and Loss

For most infants, primary teeth erupt at around age 6 months, usually in right and left pairs. These pairs alternate between the upper and lower jaw, and eruption proceeds from the front of the mouth to the back. By age 2 or 3, children usually have all 20 primary teeth. At around age 5 or 6, children’s teeth start to become loose. A tooth can remain loose for some time before loss occurs. This can cause discomfort. Usually the lower front teeth are the first to become loose and then to be lost. This process is repeated for the other teeth over the next 6 to 8 years.

Around the time that primary tooth loss begins, a child’s first permanent molars (6-year molars) may be erupting. The second permanent molars (12-year molars) usually erupt at around age 12 or 13. The last permanent teeth to erupt are the third molars, or “wisdom teeth,” which erupt at around age 18.

Tooth Eruption Chart

Fig 1. Tooth Eruption Chart
(view larger version)

Reproduced with permission from the Arizona Department of Health Services, Office of Oral Health, courtesy of Don Altman, D.D.S., M.P.H. The assistance of the American Dental Hygienists’ Association is gratefully acknowledged.

 

Although variations in tooth eruption (teething) and loss can be normal, such variations can also be indicative of oral health problems. Delayed eruption can result from syndromes, developmental defects of the teeth, cysts, or tumors. This is discussed in more detail in Module 3.

Children whose teeth have not erupted within 6 months of the schedule presented in Figure 1 (left) should be referred to a dentist for further assessment and possible intervention.

 

 

 

 

 

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logo: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau