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Tooth Eruption, continued
Permanent Teeth
Eruption is similar for the permanent teeth, beginning between 5 and 7 years and usually finishing by 13 to 14 years. The typical pattern is: central incisors, lateral incisors, first molars, premolars, canines, second molars, and third molars (wisdom teeth), although not everyone develops or erupts third molars.

Natal and Neonatal Teeth
Some infants erupt teeth, usually lower incisors, before birth (natal teeth) or shortly thereafter (neonatal teeth). This is relatively rare, with an incidence of 1 in 2000 children. Extraction of these incisors may be considered if they are mobile, interfere with breastfeeding, or lead to
Riga-Fede: Ulceration of the lingual frenum or ventral surface of the tongue in infants caused by abrasion of the tissue against natal or neonatal teeth.


Delayed tooth eruption of more than 12 months can be caused by the following medical problems:
Endocrine disorders (eg, hypothyroidism, disorders of calcium/phosphorus metabolism,
Hypopituitarism: Deficient production of growth hormones by the pituitary gland.
Genetic disorders (eg, ectodermal dysplasias, Down syndrome,
Cleidocranial dysostosis: A rare condition inherited in an autosomal dominant fashion and characterized especially by partial or complete absence of the clavicles, defective ossification of the skull, and faulty occlusion due to missing, misplaced, or supernumerary teeth.
cleidocranial dysostosis)
Oral space issues (eg, another tooth blocking eruption, impacted teeth)
Dense gingival tissue (eg, anti-convulsant medications)
Dental Infection
Radiation therapy

Therefore, it is reasonable to refer a child who has not erupted a tooth by 18 months of age to a dentist if they are not seeing one already.
Permanent teeth erupt in a pattern similar to that
of the primary teeth.
The permanent teeth typically begin erupting between 5 and 7 years and finish by 13 to 14 years.
Although some infants develop natal or neonatal teeth, this type of eruption is uncommon.
Delayed tooth eruption of more than 12 months may be the result of a medical condition and should be evaluated. Referral is warranted if a child has no teeth by 18 months of age.
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