A common source of parental concern is regarding the teething of their child. They are worried as to when the child will cut his first tooth. As is true with all types of development, there is no fixed time when the first tooth should erupt. In some children, it may erupt as early as 5 months, while in others; it may not erupt up to the age of 1 year and even beyond. There is nothing wrong with your child if his tooth doesn’t come out by 1 year. Most of the parents think that their child is deficient in calcium and/or vitamin-D, which is true only in a few cases. In majority of cases, it is just a normal variant and hence no intervention is required.
Some babies may be born with natal teeth i.e. teeth present at birth. These teeth are not taken out, unless they are loose or are sharp or causing some trauma to the tongue. Otherwise they are left alone and in due course of time, the milk teeth will take their place.
Parents attribute every complaint at the time of teething to it. Thus if the child has fever, irritability, diarrhoea etc., the parents feel it is due to teething. While the child may be a bit irritable due to the teeth causing discomfort while erupting out of the gums; things like fever, vomiting etc. are not due to teething. During the teething phase, there is irritation of the gums of the child, and to reduce it, he puts foreign objects in his mouth and chews on them. These foreign objects may be a source of infection in the child and cause diarrhoea.
But per se, teething doesn’t cause any problem, except a little irritability.
There are two types of teeth, deciduous or the milk teeth and the permanent teeth. There are 20 milk teeth and 32 permanent teeth. The milk teeth start erupting from the age of 5 months onwards and the first tooth to come is usually the lower central incisor.
A simple way to remember the eruption of milk teeth is that by 6 months there are 0 teeth; by 12 months, 6 teeth; by 18 months, 12 teeth; and by 24 months, 16 teeth. The last 4 teeth make their appearance by 2.5- 3 years.
The permanent teeth start erupting from the age of 6-7 years onwards. A little before that, the milk teeth are shed. This process continues on and by the age of 12-13 years, the child has 28 teeth. The last 4 teeth, popularly called as the wisdom teeth, erupt at a variable age, in the late teens or early twenties.
TABLE: Chronology of eruption of milk teeth and the permanent teeth
MILK TEETH
TEETH AGE (Months)
2 lower central incisors : 5-10 months
2 upper central incisors : 8-12 months
2 upper lateral incisor : 9-12 months
2 lower lateral incisors : 10-14 months
2 lower anterior molars : 13-16 months
2 upper anterior molars : 13-17 months
4 canines : 12-22 months
4 posterior molars : 24-30 months
PERMANENT TEETH
TEETH AGE (Years)
First molars :6-7 years
Incisors :7-9 years
Premolars :9-11 years
Canines :10-12 years
Second molars :12-16 years
Third molars :17-25 years