Riverpark Dental London, ON

Tooth Eruption

Proper dental care for children is crucial for their overall health and well-being. Understanding the process of tooth eruption and how to maintain good oral hygiene from an early age is essential. Here's a comprehensive guide to help you navigate this important aspect of your child's health.

The Primary Teeth

Primary teeth, also known as baby teeth or deciduous teeth, play a vital role in a child's development. They help with speech, chewing, and guiding permanent teeth into their proper positions. Here's what you need to know about the eruption and shedding of primary teeth:

The first teeth typically start to emerge at around 6 months of age. The initial teeth to appear are usually the two bottom central incisors, followed by the top four front teeth.

As time goes on, other teeth gradually come in, often in pairs – one on each side of the upper or lower jaw. By the age of 2½ to 3 years, most children will have all 20 primary teeth (10 in the upper jaw and 10 in the lower jaw).

These primary teeth remain in the mouth from ages 2½ to 3 years until around 6 to 7 years of age, when they start to shed and make way for permanent teeth.

Primary Teeth Development Chart

Upper Teeth When tooth emerges When tooth falls out
Central incisor 8 to 12 months 6 to 7 years
Lateral incisor 9 to 13 months 7 to 8 years
Canine (cuspid) 16 to 22 months 10 to 12 years
First molar 13 to 19 months 9 to 11 years
Second molar 25 to 33 months 10 to 12 years
Lower Teeth When tooth emerges When tooth falls out
Second molar 23 to 31 months 10 to 12 years
First molar 14 to 18 months 9 to 11 years
Canine (cuspid) 17 to 23 months 9 to 12 years
Lateral incisor 10 to 16 months 7 to 8 years
Central incisor 6 to 10 months 6 to 7 years

Additional facts about primary tooth eruption:

  • On average, approximately 4 teeth will erupt for every 6 months of a child's life.
  • Girls typically precede boys in tooth eruption.
  • Lower teeth usually emerge before upper teeth.
  • Teeth in both jaws tend to come in pairs, with one on the right and one on the left.
  • Primary teeth are smaller and whiter than permanent teeth.
  • By the age of 2 to 3, children usually have all their primary teeth.

Between the ages of 6 and 12, a mixture of both primary and permanent teeth coexist in a child's mouth as part of their natural growth process.

The Permanent Teeth

Permanent teeth replace primary teeth as a child grows. These teeth are designed to last a lifetime. Here's what you need to know about the eruption of permanent teeth:

Permanent teeth usually start to emerge around the age of 6. The first to appear may vary from one child to another, with some getting their first permanent molars and others their incisors.

By the age of 13, most children will have most of their 28 permanent teeth in place. This includes central and lateral incisors, canines, premolars (bicuspids), and molars.

Wisdom teeth, also known as third molars, typically emerge between the ages of 17 and 21, bringing the total number of permanent teeth to 32.

Permanent Teeth Development Chart

< td>10 to 11 years
Upper Teeth When tooth emerges
Central incisor 7 to 8 years
Lateral incisor 8 to 9 years
Canine (cuspid) 11 to 12 years
First premolar (first bicuspid)
Second premolar (second bicuspid) 10 to 12 years
First molar 6 to 7 years
Second molar 12 to 13 years
Third molar (wisdom tooth) 17 to 21 years
Lower Teeth When tooth emerges
Third molar (wisdom tooth) 17 to 21 years
Second molar 11 to 13 years
First molar 6 to 7 years
Second premolar (second bicuspid) 11 to 12 years
First premolar (first bicuspid) 10 to 12 years
Canine (cuspid) 9 to 10 years
Lateral incisor 7 to 8 years
Central incisor 6 to 7 years

Brushing & Flossing

Proper dental care for children should start as soon as their first teeth appear. Here are some essential tips for brushing and flossing:

Initially, use a soft washcloth wrapped around your finger to gently clean your baby's teeth. Transition to a toothbrush as recommended by your dentist, usually when four teeth in a row have emerged or when the child is 2 or 3 years old.

When brushing your child's teeth:

  • Hold the toothbrush at a 45-degree angle to the teeth.
  • Use circular strokes to clean the front and back of the teeth.
  • Use short back and forth strokes for the chewing surfaces.
  • Brush your child's teeth twice a day, in the morning and before bedtime, for about 2 minutes.
  • Focus on the back molars, as this is where cavities often develop.

Children may not have the coordination to brush and floss effectively on their own until around the age of 6 or 7. Until then, lead by example by allowing them to watch you brush your teeth.

Toothbrush & Toothpaste

Choosing the right toothbrush and toothpaste is essential for proper dental care:

  • Opt for a small, child-sized, soft-bristled toothbrush.
  • Soften the bristles even further by soaking the toothbrush in warm water for a few minutes.
  • Many dentists recommend using plain water for brushing up to the age of 2 to prevent excessive fluoride intake.
  • If using toothpaste, select a fluoride toothpaste that carries the American Dental Association's Seal of Acceptance.
  • Use only a pea-sized amount of fluoride toothpaste for children aged 2 and older.
  • Replace the toothbrush every 3 to 4 months, or sooner if it shows signs of wear.
  • Never share toothbrushes between children.
  • Start flossing your child's teeth daily once two teeth emerge that touch.

Mouthwash is generally not recommended for children who cannot spit and rinse effectively, typically under the age of 6. It's important to note that mouthwash is not a substitute for brushing.


Fluoride is a natural mineral that helps protect teeth from cavities. Here's how fluoride works and its role in dental care:

Fluoride works by coming into direct contact with tooth enamel, the outer layer of the tooth. It helps prevent cavities by strengthening the enamel and making it more resistant to acid attacks from bacteria and sugar.

However, excessive fluoride intake, especially in young children, can lead to a condition called fluorosis, which can cause white spots or blotches on the teeth. To prevent fluorosis while still reaping the benefits of fluoride, it's essential to use fluoride products in moderation.

How Much Fluoride a Child Needs

Children need the right amount of fluoride to prevent cavities without causing fluorosis. The optimal fluoride level in drinking water is about 0.7 parts per million (ppm), which effectively prevents cavities without risking fluorosis. Here are some guidelines:

  • Most communities add fluoride to the local water supply, but you can check with your local municipality to confirm the fluoride levels in your tap water.
  • If your water comes from wells or springs, you can have it tested for fluoride content. Water with 0.7 ppm of fluoride or less is safe.
  • If your water supply contains 0.3 ppm or less of fluoride, consult your dentist or doctor about fluoride supplements if necessary.
  • Your dentist can prescribe the right amount of supplemental fluoride based on your child's age and fluoride levels in your water supply.

First Dental Visit

Scheduling your child's first dental visit is essential for their oral health. Here's why and what to expect during the first dental appointment:

It's ideal to schedule your child's first dental visit at around one year of age. Early dental visits are crucial to monitor your child's oral development and identify any potential issues early on.

During the first dental visit, the dentist will:

  • Examine your child's teeth, jaw, bite, gums, and oral tissues to assess growth and development and identify any problem areas.
  • Clean the teeth gently, including polishing and removing plaque, tartar, and stains.
  • Discuss proper home cleaning techniques and the need for fluoride.
  • Answer any questions you have and ensure your child feels comfortable throughout the visit.

The dental team and the office should provide a relaxed, non-threatening environment for your child to help build trust.


Nutrition plays a crucial role in dental health, particularly in preventing tooth decay. Here's how nutrition relates to dental caries (tooth decay):

Foods that contain fermentable carbohydrates, such as sugary and starchy foods, increase the risk of tooth decay. These foods feed bacteria in the mouth, leading to the production of acids that erode tooth enamel.

To prevent tooth decay, limit foods high in sugars and starches and encourage a balanced diet from the five major food groups.

Baby-Bottle Tooth Decay

Baby-Bottle Tooth Decay is a dental condition that can affect infants and young children when their teeth are exposed to sugary liquids for extended periods. Here's what causes it and how to prevent it:

Baby-Bottle Tooth Decay is caused by frequent and prolonged exposure of a child's teeth to liquids containing sugars. This can happen when a child falls asleep with a bottle containing formula, milk, or juice or when using a pacifier dipped in honey.

To prevent Baby-Bottle Tooth Decay:

  • Clean your child's teeth daily.
  • Avoid letting your child fall asleep with a bottle filled with sugary liquids.
  • Start weaning your child from the bottle by at least one year of age.
  • Offer plain water for thirst between meals.
  • Ensure your child gets the necessary fluoride for cavity prevention.
  • Schedule regular dental visits for your child, starting when their first tooth emerges.

By following these guidelines and maintaining good oral hygiene practices, you can help ensure your child's dental health and promote a lifetime of healthy smiles.

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