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Presentation and Teeth Affected
Pattern of Primary Tooth Eruption
The typical pattern of primary tooth eruption is: (Refer to Chapter 2: Dental Development > Tooth Eruption for more information.)

 
1.
Lower (mandibular) central incisors
 
2.
Upper central incisors
 
3.
Lateral incisors
 
4.
First molars
 
5.
Canines (cuspids)
 
6.
Second molars

Affected Teeth
ECC tends to affect the upper (maxillary) incisors first because they erupt earliest and are less protected by saliva.(Chapter 2 Photo Gallery)

The primary molars are affected next because of their grooved surfaces.

Plaque stagnates in the molar’s pits and fissures, which are difficult areas to clean with a toothbrush.

The canines tend to be spared because they are smooth teeth that erupt later.

The lower teeth are better protected by saliva and the tongue.

 
 
Early Childhood Caries (ECC) affects the teeth that erupt first, those less protected by saliva, and those with grooved surfaces.
 
The upper maxillary incisors tend to be affected by ECC first, followed by the first and second primary molars.
 
The molars are at high risk of caries development because of their grooved surfaces, as food becomes lodged in the pits and fissures.
 
The canines and lower teeth are less likely to be affected by ECC.
View the Chapter 4 Photo Gallery.