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Permanent Teeth Eruption Monitoring


The milk teeth represent the deciduous dentition made up of 20 elements (4 incisors, 2 canines and 4 molars in each arch).

The first teeth often start growing from 5 to 8 months in a different order and many with differences from baby to baby:

  • The lower central incisors are the first, followed by the upper central incisors (at 6-8 months)
  • The lower lateral incisors (around 7-10 months) and upper (around 8-11 months) follow
  • It is then the turn of the first milk molars around 10-16 months
  • Finally the canines (16-20 months) and second molars (20-30 months) erupt

From the age of 6 to about 12, the first milk teeth begin to fall out and are gradually replaced by permanent ones. In this period we talk about mixed dentition; milk teeth have a lighter color compared to the ivory color of the permanent ones. In some cases, between the loss of a baby tooth and the appearance of the next permanent tooth, there is an interval that can last up to 4 months.


Milk teeth, in addition to having an obvious aesthetic function, are essential for chewing. They also serve as a guide for the eruption of permanent teeth and serve the fundamental function of "maintaining space" for the corresponding permanent tooth; that is, if for reasons related to poor hygiene or incorrect nutrition the milk teeth undergo destructive carious processes, (i.e. the deciduous tooth becomes carious and reduces in size) or if they must be extracted because they are no longer curable, the space for the permanent tooth is drastically reduced, because the neighboring teeth will tend to move and occupy it, and there will be serious crowding problems in permanent dentition.

It is therefore advisable to keep all deciduous teeth in good condition until the correct period of their natural exfoliation, thanks to proper oral hygiene and healthy eating habits. Too often it is thought that a decayed milk tooth is not a real problem because “it will just fall out!”

Permanent teeth: when do they appear and how many are there?

There are 32 permanent teeth:

4 incisors, 2 canines, 4 premolars and 6 molars for each arch and appear in this order:

  • around the age of 6-7 the lower and then upper central incisors, followed by the first permanent molars
  • at 7-8 years the lateral incisors
  • the first premolars at 9
  • at 9-11 years the lower canines
  • at 10-11 years the second premolars and upper canines
  • at 12 the second molars
  • third molars (wisdom teeth) can erupt from 17 to 30 years 

The first permanent molar arises exactly behind the last milk tooth and can be difficult to locate and clean. The chewing surface is also very uneven and difficult to clean, so it is important to brush correctly to avoid the risk of tooth decay.

Already at a very early age (5-6 years) dental agenesis (congenital absence of permanent teeth - more common affecting the upper lateral incisors or lower second premolars) can be identified with a panoramic radiograph. At 7- 8 years of age problems with eruption of permanent teeth can be identified with relative risk of inclusion (impossibility of eruption of the tooth in the arch) for example of the upper canines, which being the last teeth to erupt in the upper arch, pay the costs for a possible lack of space in the arch.

A clinical and/ or radiographic screening done at this age also allows us to identify other anomalies affecting the dentition, fusions, agenesis of deciduous teeth, budding or the presence of other pathologies, such as the presence of cysts.

Last but not least, the presence of a thick frenulum, upper or lower, can cause difficulties with speech or swallowing, as well as problems with the eruption of permanent teeth or repercussions on the gums. If intercepted early, and if necessary, treatment prevents the onset of other late complications.

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