Baby teeth start developing in the fetus. The first stage of tooth development begins about 6 weeks of gestation. This is when the first substance of the tooth forms. Next comes the formation of the hard tissue that surround the tooth at about 3-4 months of gestation. The next stage occurs when the tooth finally protrudes through the gum. It is important for the mother to have good nutrition during pregnancy to give the baby enough calcium, phosphorous, vitamin C and D.
Each tooth has 4 main parts: Enamel (the outer layer of the tooth and the hardest material in the body); Dentin (the inner layer and the main part of the tooth and the largest dental tissue); Pulp (soft tissue on the inside of the tooth that contains the nerve, blood supply, and the ability to produce dentin); and the Root (the part of the tooth that secures it into the jaw).
Johns Hopkins medicine has a brief discussion about baby teeth which has some interesting observations. There is no absolute rule about when baby teeth push through the gum. It is usually between 6 and 12 months and is usually complete at 33 months. Girls tend to have their teeth come in before boys. The first tooth is usually a middle front tooth on the lower jaw. This is followed by the second incisor on the lower jaw. Next come the upper four incisors. Then the first 4 molars followed by the bottom 2 lateral incisors. Finally the cuspids (pointed) teeth appear.
The teeth on the upper jaw usually erupt 1-2 months after the same tooth on the lower jaw. Usually about one tooth erupts per month after the teeth start to come in. There are a total of 20 primary teeth which normal have a space between them to have room for the larger permanent teeth.
This sequence can vary and they say not to worry until there has been no teeth in a year after the expected time. If no teeth after that time contact your dentist.
It is recommended that once the first tooth has erupted it should be brush twice a day with a baby tooth brush and a grain of rice size fluoride toothpaste. After age three, a pea size amount of toothpaste can be used. Adults should help until about age 7-8 years or when the child can write their name well.
Teething is not associated with true fever (over 100.4 degrees) Teething tablets, gels with benzocaine, homeopathic teething gels or tablets and amber necklaces are NOT recommended. Speak with your healthcare provider to see if your tap water contains fluoride and if your child needs supplements. You don’t want to give too much.
Between the age of 6 to 12 years the primary teeth are lost with the last tooth being the cuspid. There are usually 32 permanent adult teeth.
Sally Robinson, MD
Professor, UTMB Dept. of Pediatrics
Keeping Kids Healthy 6/2024
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