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The time when the child starts to get their permanent teeth can be a stressful one for the parents. Here are all the common questions and queries that you have answered. Read on!

Primary teeth are temporary, not disposable!

Teeth are important not just for chewing solid food, but also to enunciate and pronounce words properly. They give our facial structure vertical height. Primary teeth maintain space in the jaws for the permanent teeth, the tooth buds of which are present below the primary teeth. Primary teeth give the parents a chance to teach the child good dental hygiene that he or she will continue to follow with the permanent teeth.

Primary teeth are not exactly the same as permanent teeth. They are smaller in size and fewer in number as well. The fact that they are going to fall out anyway makes the parents think they are of no use. That is certainly not the case — their care affects the permanent tooth eruption quite a lot.

When do the permanent teeth start coming in for children?

The first set of teeth for most babies are their primary or deciduous teeth, which usually start coming in at around six months of age. The child has 20 primary teeth by the time the child turns three years old. Ten teeth in each jaw. At around six years of age, the first permanent tooth appears in the mouth and this starts the transitional phase for the child, when he has both primary and permanent teeth present in his mouth. This usually lasts till the child is about 13 years old, by when all the primary teeth shed and only permanent teeth are present in the mouth. By the time the child is 18 to 21 years, he has thirty-two permanent teeth. Sixteen teeth in each jaw, including the wisdom teeth although they are frequently extracted.

Does permanent tooth eruption cause pain to the child?

Some children may complain of pain in the gums just before a permanent tooth is about to erupt. You will be able to see a thickening on the gum in the area where the permanent tooth is expected. For any confusion regarding the cause of the pain, please consult your dentist. A dentist may take a dental radiograph (x-ray) to confirm the presence of the unerupted permanent tooth. Usually, the pain lasts just until the tooth breaks through the gums and then subsides. A lot of children don’t have any pain whatsoever.

Which are the first permanent teeth to come into the mouth?

The first permanent teeth to erupt in the child’s mouth are the first permanent molars, between the ages of six and seven years. These do not replace any primary tooth, and they erupt just behind the last primary tooth that is the second deciduous molar. There are four first permanent molars in total; two in the upper jaw (one on the right, one on the left), and two in the lower jaw. The position of these teeth decides the position of the remaining permanent teeth and also gives vertical height and structure to the child’s face.

Around what age do the primary teeth or milk teeth start falling out?

The time around which the teeth fall out varies from child to child. The process usually starts at around six to seven years of age and continues until about 10 to 12 years of age. Girls usually lose their primary teeth a bit earlier and get their permanent teeth a bit earlier too as compared to boys of similar age.

The four third molars may or may appear between 17 to 21 years of age and are the last teeth to appear in the mouth. These are popularly called wisdom teeth though they have no relation to the intelligence of the individual.

My child’s teeth are not coming out on time? Should I be worried?

This is the most common question dentists get from parents whose children are going through the tooth eruption process. These shedding and eruption dates are ranges, and some children may overshoot the range. This is not a cause for worry and you can visit your dentist for confirmation about the presence of unerupted tooth. 

Sometimes, the deciduous tooth may not shed for a long time, well beyond its expected shedding date. This may be because of a missing permanent tooth bud and a dentist can confirm this with an x-ray and inform you of further treatment options. In some cases, the permanent tooth has begun to erupt and is visible in the mouth while the primary tooth hasn’t shed, forcing the permanent tooth to erupt in an odd location. In this case also, please visit your dentist as the over-retained primary tooth may need removal.


The process of permanent tooth eruption is a long one and can cause anxiety to the parents regarding the time it is taking, the position of the teeth, and the shape of the teeth. In most cases, there is nothing to worry about and no intervention is needed. For other, much rarer cases, consult your dentist for possible treatment options.

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