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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Tooth Eruption, continued

Permanent Teeth
Permanent teeth emergence pattern is similar to that of the primary teeth.

Eruption of the permanent teeth begins 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).

Natal and Neonatal Teeth
Some infants erupt teeth before birth (natal teeth) or shortly thereafter (neonatal teeth).

Generally, no treatment is indicated. Extraction of these incisors may be considered if they are mobile, interfere with breastfeeding, or lead to Riga-Fede ulceration.

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 Eruption
Delayed emergence of more than 12 months can be caused by:
Oral space issues (most common reason for a single tooth)
Endocrine disorders
Genetic disorders
Dense gingival tissue
Dental Infection
Radiation therapy

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.
Fast Facts
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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