The replacement of baby teeth with permanent ones usually takes place without any problems. However, many parents worry that some processes may go wrong. Therefore, they regularly monitor the condition of the baby’s teeth. Some people wonder how to distinguish a baby tooth from a permanent one, especially when it comes to molars. Indeed, when a child is 9-10 years old, this can become a problem - the incisors have already come out and there are no problems with them, but there is confusion with the distant teeth. How to learn to distinguish between them - let's figure it out together.
Anatomy of permanent teeth
The molar tooth includes three zones: the root, which sits deep in the jaw socket and holds the tooth in place, the neck, located in the periodontal area, and the crown, which extends directly into the oral cavity. After the apex of the tooth appears, a protective film forms on the enamel, the strongest layer of the tooth, which is soon replaced by a salivary layer, formed from the saliva itself. The dental tissues themselves are not just a piece of bone, but a certain heterogeneity, which includes, in addition to enamel, dentin (the main substance of the tooth) and the dental cavity, in which nerves and blood vessels branch. Compared to bones, for example, the phalanges of the fingers, dentin is noticeably stronger - it contains an increased amount of minerals, for example, the same calcium-based compounds. The root zone of dentin is connected to the periodontium using a special layer - dental cement, which communicates with the tissues of the periodontium itself and supplies the dentin with nutrients.
What are the differences?
Even outwardly identifying molars and baby teeth will not be difficult, because the difference between them is significant. But they also differ in their internal structure.
| Dairy | Permanent | |
| Features of teething | Often their appearance in the oral cavity is accompanied by not the most pleasant symptoms: inflammation of the mucous membrane, increased body temperature, excessive salivation and others. The baby becomes capricious, his appetite and sleep are disturbed, and his immunity decreases. | The permanent units of the series follow a pre-trodden path, and therefore their appearance is usually (in 90% of cases) not accompanied by difficulties. But when the third molars erupt, pain and discomfort are possible, and the process can drag on for a long time. |
| Crown size and shape | Small and short. During the period of change of bite, the child’s jaw gradually begins to expand, wide gaps form between the teeth. This is how nature intended it, taking into account the fact that the permanent units are larger and more space is needed for their full eruption. | Normally, a fairly large and long crown, if there are no bite pathologies, increased enamel abrasion, or bruxism. If you carefully examine the chewing units, you will notice that they are more convex than milk units and have voluminous tubercles on the coronal part. |
| Color | Whitish-blue tint. | Yellow, beige, brownish and even pinkish. |
| Fortress | Enamel (about 1 mm thick) and dentin are thin and fragile, there is no pronounced barrier between them [1], as in permanent units. They have weak mineralization in the chewing and cervical areas. | Solid fabrics are very durable. The enamel is 2.5 times stronger than that of children. |
| Features of the course of infectious and inflammatory processes | They are easily susceptible to chipping, acids, and bacteria, so caries and its complications develop rapidly and are multiple in nature (on several units in a row at once). In 2-3 months, caries can “eat” a tooth into a stub and lead to severe chipping of hard tissues. But the painful sensations are minimal due to the imperfection of the child’s nervous system. | If a tooth is exposed to pathogenic bacteria, then its demineralization, the development of caries and the destruction of hard tissues occur slowly and can last for years. But with inflammation, all the striking accompanying symptoms are present: a reaction to sweets, cold and hot, severe involuntary pain due to complications of caries, for example, pulpitis. |
| Structural features | They have a large pulp chamber, as well as straight and short dentinal tubules. This again explains why all dental pathologies develop faster in children. | The pulp is narrow, the dentinal tubules are long and curved, and therefore, in the event of destruction of enamel and dentin, bacteria move slowly through the insides of the tooth. |
| Root system | The roots are short. Therefore, if it is necessary to remove them, a shallow, quickly healing wound is formed in their place, and the risk of complications after surgery tends to zero. When a baby bite changes to a permanent one, the roots naturally dissolve, the tooth itself falls out without difficulty, and a new “tenant” erupts in its place - this is the norm. But if resorption occurs ahead of time, then this may indicate a pathology, for example, the development of periodontitis at the root. Damage to the root of the milk unit is dangerous for the rudiment of the constant, leading to disruption of formation, growth and normal eruption. | Long roots. To remove a permanent element, it is necessary to make significant efforts; sometimes you have to cut out the roots with a boron. Therefore, after surgery, tissues may hurt, swell, and bleed. With insufficient care and non-compliance with medical recommendations in the postoperative period, alveolitis develops. Nature does not intend for permanent roots to dissolve, but their resorption can occur under the influence of inflammatory processes in periodontal and periodontal tissues, due to traumatic factors. In this case, the roots become mobile, and the teeth themselves can easily fall out, which, of course, is not the norm. |
“In general, to be honest, I didn’t worry about the difference between baby teeth and molars. Just go to the pediatric dentist several times a year, who will tell you everything in detail and pay attention to problems, if any!”
Sveta_T_32, review from 32top.ru
“I was so scared when my son developed large gaps between his teeth at the age of 7. And the incisors that came out were simply huge, like a rabbit’s, especially compared to the neighboring fangs! But it turned out that this is normal. This means the jaw is growing. And vice versa, it’s bad if a change in bite has begun, and the incisors and canines are close to each other. Now, given this development of events, I would turn to an orthodontist. But, thank God, everything is fine with us.”
Alisa, review from gidpozubam.ru
Differences between baby teeth and permanent teeth
The structure of primary and permanent teeth is generally the same, but there are several noticeable differences. Which are better not to neglect:
Baby teeth have whiter enamel, while permanent teeth have a slight yellowish tint. Milk teeth are not as strong as permanent teeth due to the lower percentage of mineral substances. The pulp of baby teeth is wider and thicker, while dentin and enamel are, on the contrary, thinner. This explains the facilitated, spontaneous removal of a shelf tooth - there are often situations when schoolchildren in class independently loosen and remove milk teeth that have served their purpose. In permanent teeth, the length is significantly greater, dominating over their width and cross-sectional area. The root of a baby tooth is thinner and shorter - a person is able to pull out a baby tooth without the help of specialists. Meanwhile, the permanent “embryo” of a real tooth under the shelf one is already ready to grow quickly and be born. The latter is achieved due to the dental gap, which has expanded by the time the non-permanent tooth falls out.
Adults also have milk “long-livers”
Yes, this is indeed possible. Milk teeth, which have a different structure and difference from permanent ones, may well be preserved in the bite of an adult. Whether to remove them, save them or replace them with prosthetics - this must be decided by the doctor depending on the clinical situation. For example, if they do not have the rudiments of permanent units under them, then you can simply improve the shape and aesthetics of the crown part so that they do not stand out in size against the background of their full-fledged “neighbors.” Read more about this phenomenon in the feature article on the website.
Where do teeth come from?
Teeth are formed in the fetus’s body during the mother’s pregnancy. When a mother abused something and undermined her own health, the subsequently born child was guaranteed to have diseased teeth that were no longer permanent. At the 15th week of pregnancy, the mother has hardened dental tissues in the fetus - starting from the crown area and ending with the root zone. The embryos of molar teeth are formed by the 5th month of fetal life. The body of a developing fetus and child is designed in such a way that in the upper jaw the anlage of the permanent teeth is located above the anlage of the milk teeth, and in the lower jaw - vice versa. The formation and development of teeth begins as early as the sixth week of fetal development. The source for them is a special epithelial dental plate. Already by 14 weeks of pregnancy, the unborn baby is actively forming hard dental tissues, initially in the area of the coronal part, and then in the area of the roots of the tooth. When a child is born, primary teeth are the first to grow - by the end of the child's first year of life, they will erupt. However, the dentition contains a group of large molars - they, in turn, do not have milk predecessors and subsequently, when they fall out, grow “on a permanent basis”. Nature has arranged it in such a way that while the child’s jaws are still too small, large molars are not needed there.
How many primary and molar teeth does a person have?
In children, the size of the jaw is almost half (in terms of the number of teeth that fit on it) smaller than in adults. Initially, the child has up to 20 teeth - 10 on each jaw. That is, one jaw - 4 incisors, 2 canines and 4 molars. Primary molars have not yet been clearly divided into small and large.
After 16 years, a teenager’s jaws reach approximate sizes that are accessible to an adult. A teenager already has approximately 28-30 teeth, and not 20-24, as before. The number of molars is often represented by 2 small molars and 2 large molars - on each side on each jaw. The last 2 or 4 teeth - “wisdom teeth” usually appear by the age of 20-22 - and a person acquires a full set of teeth, numbering 8 incisors, 4 canines, 8 small molars and 12 large molars - on both jaws in total.
Is there a difference?
It happens that, trying to determine which children have milk teeth, mothers make a significant wave of their hand and say that there are no differences between the new and old units. In fact, they are.
Dairy
They take their places for closer to two to three years. The very first ones erupt when the baby is 6-12 months old. There are only twenty primary teeth (while there are 32 primary teeth). Therefore, they are arranged in a row quite freely. As the jaw grows, the spaces between them increase significantly. This can be seen with the naked eye.
At the age of 5-6 years, temporary teeth begin to loosen and fall out. This process is completed by the age of 10-12 years.
Indigenous
They appear at five or six years old or a little later. First, molars grow , which become “sixes”. After this, the incisors begin to wobble. They are pushed out by a constant shift.
Children with permanent dentition usually have 28 teeth. The four terminal units (which are popularly called “wise”) usually appear after 20 years. For many, it grows at 30-40 years old. And this is the norm.
What does the dental formula look like?
The medical record, which the big one keeps in the dental clinic at his place of residence, contains notes about his dental condition. To avoid confusion, doctors number the teeth on each side of each jaw. So, the 1st and 2nd teeth are incisors, the 3rd are canines, the 4th and 5th are small molars (doctors call molars molars), the 6th and 7th are large molars. The 8th - the farthest one - is a “wisdom tooth”; a number of people do not have it, or they do, but not all. Each side of the jaw is also numbered: 1 - top right, 2 - top left, 3 - bottom left, 4 - bottom right. For example, entry 48 does not mean that you are a “Tarkatan” with a combat superset of teeth that does not exist. You simply do not have a “wisdom tooth” on the lower right. Entry 41 - a person lost one of the frontal incisors on the same side on the same jaw. You can write down the formula of the teeth more clearly: for example, “there is no 8th tooth from the bottom right.”
It often turns out that due to lack of space on the jaw, the wisdom tooth develops incorrectly - it can grow crooked, in which case its removal is indicated. For example, it may remain under the gum and, because of this, be affected by caries, which can subsequently develop into pulpitis or a dental cyst. Problematic “wisdom teeth” are quickly and decisively removed, and their absence will not greatly affect the quality of chewing food.
When does radiography come to the rescue?
Very rarely, but still situations occur in dental practice when even the doctor doubts which tooth he has to work with - a child’s or a molar. In this case, the capabilities of radiography are used. In the photographs you can see:
- length and structural features of the roots;
- presence/absence of radical primordia;
- the location of the unerupted unit and the direction of growth of its incisal edge.
If you need to find out exactly what the situation is with a change in bite in a child, contact your dentist. He will tell you the number of units that should fall out in the near future, and tell you whether it is worth interfering with this process.
Teething order
The timing of the appearance of permanent teeth to replace lost milk teeth is generally the same for all children and adolescents. After the child turns 5 years old, the first large molars make themselves felt. Then the central incisors are replaced from below, then the same teeth from above, and the lateral incisors from below. At 8-9 years of age, the lateral incisors on top are replaced. From 9 to 12 years of age, all small molars are replaced. At 13, all fangs are replaced. After 14 years, second large molars appear on all sides, which were not there before. By the age of 20-22, “wisdom teeth” finally appear. There are cases when during the rest of their lives they never erupted.
Classifications of teeth
To begin with, it is worth clarifying the terminology, since many people understand the word molars to be permanent teeth. Although these are concepts from different classifications.
The following types of teeth are distinguished:
- incisors
ー these are the front teeth (“ones” and “twos”), they have a sharp edge and are used for biting off pieces of food; - fangs
ー conical teeth used for tearing dense food; - small molars
(premolars) - these are “fours” and “fives” in the dentition; - large molars
- sixes, sevens and eights. Large teeth with a wide chewing surface serve, like premolars, for grinding food.
That is, these teeth can also be milk teeth, but with their own characteristics - in children, in the milk bite, only the first and second molars are distinguished from the chewing ones. And it is with molars that problems arise - how to determine whether a child has milk or permanent teeth?
How to determine that a child will soon have molars?
According to some of the signs, interdental intervals initially increase. This happens due to the growth of the jaw bones - the teeth begin to not fit tightly together, as happens in adults. Then the temporary teeth gradually become loose - due to the gradual disappearance of the temporary root, which can no longer reliably hold such a tooth, and itself is gradually pushed out of the soft and semi-soft tissues on the jaw. The loss of a temporary tooth is a clear sign that the permanent tooth is already growing in full force, and the top of its crown will soon push apart the gum tissue. The appearance of a new tooth is also accompanied by slight redness and swelling. If a child or teenager has a fever, their health has worsened, and their gums hurt, go to the doctor immediately.
Can milk root remain in the gums?
If you carefully examine fallen children's teeth, you will not be able to see any semblance of roots. Some mothers unknowingly begin to panic - it seems to them that a significant part of the unit remains in the deep tissues of the gums.
There is no need to worry - this is how it should be. The absence of roots is the result of their gradual resorption. This process starts long before the day of loss. That is why during a natural change (when a tooth falls out without outside help), the child does not experience pain.
No molars
The molars, despite the specific timing specified above, may ultimately not hatch. For example, temporary teeth do not fall out for a long time, and permanent teeth do not grow for a long time after they fall out. At the first stage, the dentist will take an X-ray of the condition of the child or teenager’s jaws. The X-ray machine will clearly project what should grow in place of the supposed teeth, which teeth are ready to hatch, and whether they exist at all. But the problem will immediately become obvious, and the reason for it most likely lies in the physiology of the child, which has undergone some delay. If this is true, be patient: in the end, the teeth will not take long to arrive. But if the picture shows emptiness, you are faced with a complete absence of teeth, the reason for which is a violation of the intrauterine development of the fetus during the mother’s pregnancy. Only prosthetics will help here - artificial insertion of false teeth.
Molar tooth hurts
After the molar has emerged from the gums, the “young” tooth enamel is not fully saturated with all the necessary microelements. During this period, the tooth is especially vulnerable: it is strictly forbidden to subject it to overload. It is not for nothing that children are advised not to chew, for example, candy, large quantities of peanuts, or any solid foods. If you neglect this rule, children may immediately develop caries, and this is the path to problems with specific teeth. Caries gradually turns into pulpitis (damage to the internal cavity of the tooth) and periodontitis (damage to the ligaments surrounding the tooth). The child often experiences toothache and poor general health. Without turning to a professional doctor for help in time, parents can lead their child to various consequences - up to the complete loss of a diseased tooth. If a predisposition to the appearance of carious lesions has been identified, their prevention may involve closing the natural deep pockets surrounding the molars. This is done using high-quality composite materials. In this case, food debris will not accumulate in these places, destructive microflora will not develop, and the period of susceptibility to caries will pass when the teenager grows up.
International Viola system: a convenient diagram of the arrangement of a person’s teeth by numbers
The described method is very convenient and most common in dentistry. It has received international recognition and has been generally accepted among dentists since 1971, called the two-digit Viola system. The convenience of such a system lies primarily in the fact that there is no need to create a special map of a person’s teeth, the numbering is easily calculated in the mind and information about the condition of certain dental units of the patient can be easily conveyed in an oral conversation, by telephone or by e-mail.
However, many people, having read this far, may say: but our teeth were counted completely differently, and the map contains completely different designations! That’s right, because in addition to the Viola system, there are several other systems that can be used by dentists.
Molars grow crooked
Molars are also subject to crooked growth. They can begin to actively grow before the temporary ones become loose and fall out. Encountering this natural obstacle in the process of their growth, they can grow crookedly than would be intended by nature - they are “led” to the side. If the growth of a molar is detected immediately after a temporary one, this defect leads to a curvature of the bite, which is why the child or teenager will need the help of an orthodontist. In this case, it is necessary to urgently remove the temporary tooth that is interfering with the growth of the permanent one. If time has not yet been lost, it may be possible in this way to remove the predisposition of the same tooth to acquired curvature. Despite the fact that a teenager, having realized the uselessness of a temporary tooth, can independently loosen it and remove it, doctors strongly advise refraining from such a step so that the child avoids, for example, sepsis.
Molars fall out
If molars suddenly begin to fall out suddenly, this is a sign that the child’s health is not in the best condition. Tooth loss is preceded by both systemic diseases (immune problems, impaired development of connective tissue) and local ones (caries, pulpitis, periodontal disease, etc.). Tooth from permanent dentition. When lost, it leaves behind a permanent problem. A radical solution could be a complete insertion of an artificial tooth - but... Before it is carried out, the child will have to use a removable and replaceable prosthesis before he grows up.
Deviations in timing and problems when changing teeth
One or another problem with the loss of baby teeth and the germination of molars occurs in at least every tenth child. Fortunately, dentists are ready to correct the bite during the growth stage, remove extra teeth, and even insert an implant if there is no point in waiting for a root one.
Let's look at the main deviations that may cause concern:
"Shark's Mouth"
Sometimes baby teeth do not have time to fall out, but the molars have already grown “second row”. The “shark’s mouth” is not worth admiring. You need to go to the dentist as soon as possible and remove unnecessary temporary teeth, otherwise your bite may be significantly damaged.
Untimely change of teeth
If the first baby teeth begin to leave the baby’s mouth before 5 years of age or after 8 years of age, then this is a deviation from the norm, which means you need to understand the reason. Trauma, caries, ecology, nutrition, congenital problems with bite or other heredity, various infectious diseases, hormonal problems (for example, thyroid disease), as well as diseases due to which the child is at risk for underdevelopment and delay may be to blame. formation of permanent dentition (diabetes, leukemia, immunodeficiency and others).
The molar does not grow in place of the lost milk tooth
There is no need to panic, but it is worth consulting with a specialist. For example, if a molar tooth does not erupt, although the baby tooth has fallen out a long time ago, the reason cannot be determined with ordinary eyes, but an x-ray will help. If there is no tooth germ in the picture, this is called adentia. This problem is extremely rare - the tooth simply has nothing to grow from. The decision will require the help of a prosthetist.
With retention, the germ of a new tooth is present, but it is directed incorrectly or is deep in the gum. All that remains is to wait for the tooth to grow. This problem occurs more often in the lower third molars, as well as in the upper incisors and canines.
With impaction, the tooth cannot come out due to the close fit of neighboring teeth. Here, too, you cannot do without the help of professionals.
We also advise you to consult a doctor if:
- molars appear darkened or grow crooked;
- the order of tooth loss and growth differs significantly from the above graphs;
- the child’s gums hurt and his cheek is swollen;
- baby tooth is corroded by caries;
- a tooth fell out, but blood from the socket does not stop oozing for more than an hour (not to be confused with ichor).
Injuries
An accident or incident, such as a fight, can cause a tooth injury. And it doesn’t matter whether a small part has broken off, or the tooth has cracked, as they say, “to the point of bleeding” - the help of a doctor is definitely needed. In some cases, lost dental tissue is replenished. If a tooth is broken into pieces, it will most likely need to be completely removed and a prosthesis replaced every year. And the answer is simple - the dental tissues have not yet fully matured, the body is growing. And it is necessary to take full care of your teeth at such an early age. In case of extension, the operation is performed by introducing composite materials that replace enamel and dentin.
What is important to pay close attention to
We looked at the main difference between baby teeth and permanent teeth. We found out that the latter are stronger and more durable due to their structural features. However, it is important to understand that the permanent units that have just erupted (the change of incisors occurs at approximately the age of 5-9 years, canines - 9-13 years, premolars - by 12-14 years) are not yet sufficiently mineralized. That is, they do not have the necessary strength. Their final mineralization occurs within the next two years after eruption.
Expert opinion
Tatyana Vitalievna Varlamova
Specializations: Dentist-therapist
Experience: 6+
“Many parents still think that baby teeth do not need treatment and prosthetics if they have been subjected to dental pathologies. All hope is that soon the child will have a permanent bite, in which the enamel and dentin are very strong. But it is important to know that the well-being and safety of the dairy crop also depends on the health of the dairy crop. Early removal of temporary elements and damage to their roots affects the rudiments of permanent elements and leads to developmental anomalies.”
Therefore, the teeth of children aged 7 to 15 years need especially careful care, strengthening, and control by parents and dentists. That is, they seem to be already permanent, but at first they are still very weak, which is why they are easily susceptible to caries and other dental pathologies.
