The Timeline of Permanent Teeth Eruption in Children

When do permanent teeth start to erupt? This is a common question among parents, yet there can be a lot of variability in the process. As a veteran pediatric dental hygienist with decades of experience, I will share insights that go beyond standard eruption schedules to provide valuable information for parents.

Understanding the Eruption Process

Permanent teeth typically start to erupt around the age of 6, with a range observed from an early 5-year-old to a delayed 7-year-old or even later. There can be significant variance, and both little girls and little boys are affected differently. For instance, girls tend to be slightly earlier, while boys are generally later.

Observations from Decades of Pediatric Dental Experience

During my career, I have observed interesting patterns with young patients starting from age 3 and continuing through high school. Here are some key observations not typically found in standard eruption schedules or tooth charts:

Age 6-7

The lower central incisors are typically the first to be lost. As these baby teeth become loose and are displaced, the permanent teeth start to erupt. While this process can be harmonious, it's not always the case. Sometimes, the new permanent teeth appear at the tongue side of the exiting baby teeth, and parents might notice this.

Parents may be alarmed to see the new teeth tipped inward. However, this is a common and usually temporary occurrence. Within a short while, tongue pressure will help the teeth to return to their normal position. Around this time, the first permanent molars begin to erupt, which do not replace any specific baby teeth but rather erupt distal to the rear baby molars.

Age 7-8

The eruption of the upper central incisors follows after the lower central incisors. This pattern is generally consistent throughout the eruption process. By ages 7-8, parents should expect to see the upper central incisors being lost, along with the arrival of the upper first permanent molars.

Age 8-9

The upper lateral incisors begin to erupt around this age. Pediatric dentists often note signs of crowding during this period, which can be managed through organized extractions of select baby teeth, particularly the canines. Alternatively, trimming the baby canines can be another approach, though orthodontic intervention may still be needed later.

Age 9-10

The lower primary canines are replaced by their permanent counterparts at this stage.

Age 10-12

During this time, the first primary molars are replaced by the first bicuspids, and the second primary molars by the second bicuspids.

Age 11-13

The second permanent molars appear around this age, not replacing any specific baby teeth but filling new spaces created by jaw growth.

Pro Tips:

Sealants should be applied to the chewing surfaces of new permanent molars as soon as they fully erupt. Consider fluoride tablets or drops for children up until age 12, post which they should stop as the dental benefits diminish. Wisdom teeth may emerge between ages 17-21, though extraction may not be necessary if space is available.

It is important to consult with your pediatric dentist for personalized advice and guidance on your child's specific dental health needs.

Note: The information provided is for informational purposes only and is not intended as medical advice.

Cathye L. Smithwick RDH MA, Silicon Valley Dental Hygienist