Change of teeth in children

How our teeth develop

We humans are born without any teeth at all. We don't even need them at the start of life - babies only receive liquid food; they are either breastfed or fed with a bottle of milk. But this time is over at some point, of course. And then it has to come: the chewing tool in the form of the milk teeth. 

Over 200 genes are involved in tooth development. In most babies, the first milk teeth appear at the age of six to eight months - the two lower incisors are usually the forerunners. However, the development of the primary dentition begins much earlier: the germinal structures for all our teeth are already formed in early pregnancy. The crowns - the parts of the teeth that will be visible later - are already fully formed at birth. The roots, on the other hand, take another one and a half to three years to form. When the baby is around two and a half to three years old, the primary dentition is usually complete with a total of 20 teeth. 

Until around the time they start school, the usually beautifully white milk teeth flash out of children's mouths. But at around the age of six, it slowly begins: the change of teeth to permanent teeth. In the next section, we describe how this change of teeth takes place. 

Tooth change from milk teeth to permanent teeth

The permanent teeth have been waiting quietly and secretly in our jaws for a long time for their grand entrance: they have been developing since the baby started crawling. 

Why change teeth at all? 

But why do we humans experience this change of teeth at all? It would be so much more practical to start with permanent teeth straight away - or simply keep our milk teeth. Unfortunately, neither works. Because: We humans grow, and so do our jaws. While the small milk teeth fit the jaw size of babies and children perfectly, they would later be far too small for our adult jaw and our mouth would be full of gaps.To prevent this from happening, we grow a new set of teeth - our permanent dentition then consists of
32 teeth (including wisdom teeth) and fills our jaw well.

There is another very good reason why it makes sense for us to lose our milk teeth: This is because our permanent teeth are more robust and resilient overall than our milk teeth. In comparison, the first teeth have less protective enamel and a lower mineral content. This makes them more susceptible to tooth decay. It makes perfect sense that our permanent teeth have better protection here. After all, we keep them much longer than our milk teeth. 

The phases of tooth replacement

As you have already briefly learnt above, the first permanent tooth usually appears around the time the child starts school, i.e. when the child is between 5 and 7 years old. In the meantime, parents don't need to worry.

The permanent teeth erupt according to a certain plan. This fixed development is divided into three phases, which we present to you here. 

First phase: molars and incisors

The first large molars (the so-called six-year molars) appear first. This often goes unnoticed as no milk teeth fall out. The molars simply "appear" without any symptoms. The milk incisors in the lower and upper jaw fall out at around the same time, often allowing the permanent teeth to show through. By the time the child is around 8 or 9 years old, all the milk incisors gradually fall out and the permanent teeth grow in. This phase of tooth change is known for the fact that the first permanent teeth in the mouth still look too big next to many milk teeth.

Second phase: molars and canines

When the child is around 9 or 10 years old, the second phase of tooth replacement begins. Now the lateral milk teeth also fall out - these are the small molars and canines. When the second large molars have also erupted, the second phase is complete. The child now has a total of 28 permanent teeth instead of 20 milk teeth. This stage is usually reached when the child is at least 11 or even 12 years old. However, there is also no need to worry if the change is not complete until the age of 13 or even 14. 

Third phase: The wisdom teeth

This phase of tooth replacement can be quite protracted. It describes the period of time during which the four wisdom teeth erupt - this can happen as early as the age of 17 or as late as 30, both of which are completely normal. It is also not uncommon for one or more wisdom teeth to become completely or partially stuck in the jawbone or not be present at all. 

As the eruption of wisdom teeth can cause discomfort and, for example, have a negative effect on the position of the other teeth, a dentist should check whether the wisdom teeth are in place - ideally this should be done during adolescence. Sometimes it can happen that the removal of wisdom teeth is recommended. Ideally, this should be completed by the age of 25, as the root is not yet fully formed by then. The absence of wisdom teeth is not a problem at all. They are a relic from the Middle Stone Age - back then, our ancestors needed them to chew hard and tough food. Thanks to the way we prepare food today, we no longer need them. 

Complaints when changing teeth 

When milk teeth grow, it can hurt - almost everyone knows that. Babies and children can sometimes become downright ill, develop cold symptoms such as coughs and runny nose and develop a fever or high temperature because their immune system is under attack. 

However, it is less well known that the change of teeth to permanent teeth can also cause pain and the like. It can also lead to complications that require treatment. Here we have summarised some of the most important challenges and problems that young people can face when changing teeth.

Pain due to inflammation

It can happen that the gums become inflamed at the point where the permanent tooth is breaking through. Sometimes the gums become swollen. Dentists then refer to this as an "aggravated tooth change". However, those affected do not have to simply endure the pain associated with this. Talk to your dentist about your child's symptoms: He or she will then probably prescribe a painkiller. It is important not to neglect oral hygiene despite the inflammation. Even if it takes effort, the teeth should continue to be brushed very carefully. 

By the way: If you suffer from gingivitis, you may develop bad breath and blue gums. The colours can vary from dark red to blue. If this is the case for you, you should visit a dental practice as soon as possible. Gingivitis should be treated as soon as possible. 

Would you like to find out more about how gum inflammation manifests itself and how you can recognise it early on? Then read on in our article: 

What to do against gingivitis? 

Abdominal pain or headache

Does your child suffer from diffuse abdominal pain or headaches? Perhaps this is related to the change of teeth, because in some children both complaints can occur with the eruption of the molars. However, it is difficult to say whether they can really be attributed to this. Many children, especially young children, often complain of stomach aches or headaches - sometimes they are simply expressing a general feeling of discomfort. If diarrhoea, vomiting or nausea are also symptoms, you should take your child to a paediatrician and have the cause investigated. 

Important: Especially when a child suffers from pain during teething, parents understandably want to do everything they can to relieve it. There is a large market to fulfil this wish - homeopathic or anthroposophic remedies in particular can be found everywhere for teething pain. However, no scientific evidence has yet been found for the effectiveness of globules and the like - so it's better to stick to the advice of your dentist. Of course, alternative healing methods can have a kind of placebo effect and therefore have a positive impact on the psyche. If this is the case with your child, there is nothing to be said against using a homeopathic remedy. 

Blockage due to milk teeth not falling out

Sometimes parents and children wait in vain for a baby tooth to loosen. If this is the case, you should take your child to a dental practice. It is possible that the permanent tooth that is supposed to replace the milk tooth has not even come in. In medical terminology, this is called hypodontia. If several teeth are not attached, this is called oligodontia. Whether this is the case can be recognised by means of an X-ray. Another reason for a stubborn milk tooth may be that its root has not dissolved. The dentist will explain what to do in both cases. 

Often nothing needs to be done at first. The existing milk tooth remains in the dentition as long as it is caries-free and stable. An implant, for example, can then be considered later. Incidentally, there is also the case where the primary tooth falls out but the new tooth does not come in. However, this is less common with hypodontia. It is usually noticeable because the milk tooth does not loosen. 

Stress on the psyche

Have you ever heard of "wobbly teeth puberty"? It may sound funny, but it often causes affected children to have a difficult or defiant time. The emotional chaos that overtakes your child often occurs from the age of six - i.e. exactly when the change of teeth takes place. It's not just a visual change (the "big" teeth come in), but also an internal one. The change of teeth can cause anxiety for the child - some report a kind of fear of loss, for example. They are also about to start school, which means the start of a whole new phase of life. 

Many children then react with behaviour similar to that of adolescents: Joy, good humour, low moods, anger, outright outbursts - everything alternates. Many parents are overwhelmed by the emotional outbursts and ask themselves: What can help the child? There is no general recipe. The important thing is to recognise your child's worries and fears and to realise that they don't want to annoy their parents. They are suffering themselves. Many children are helped by loving attention and rituals that give them a sense of security. 

If children are suffering from the loss of milk teeth, it can be an idea to have the "tooth fairy" visit. If a tooth falls out, the fairy floats in at night and brings a small gift. The tooth that has fallen out is placed in a pretty tooth box. Many children love this little tradition. 

Premature loss of milk teeth

If the transition to the permanent tooth takes place too early (for example due to tooth decay or an accident), parents should definitely take their children to the dentist. In these cases, "too early" means that the affected milk tooth was lost at least one to one and a half years before the times described above. Treatment is then often necessary. This is because the resulting gap can cause changes in the growing jaw and disrupt tooth development. There is also a risk that the upper and lower side teeth will no longer interlock properly and malocclusion will develop, and chewing function may also be impaired. The dentist will recommend a suitable treatment method for your child - this could be a palatal plate as a space maintainer, for example, on which the missing tooth or teeth are replaced. 

Teeth grow out crooked

Not a rare phenomenon: permanent teeth grow out crookedly because, for example, their predecessor, a milk tooth that has not yet fallen out, is blocking their path. Are your child's permanent teeth already growing in the second row? Then you should go to the dentist as soon as possible. Because: Milk teeth that remain in place can actually be problematic during the tooth change process. The permanent tooth grows in the wrong position and the bone develops crookedly. This can be corrected later with braces, but it is better to take preventative measures. To do this, the dentist will probably recommend that you have the "excess" milk tooth extracted. With milk teeth, the pain is limited because milk teeth only have a very small root. With an anaesthetic, your child should not feel anything at all. Afterwards, braces may be necessary to move the already crooked tooth into the correct position. 

Which toothpaste for changing teeth?

It can be a colourful time in your child's mouth during the teething phase. Milk teeth stand next to permanent teeth - both have different needs when it comes to dental care and the type of toothpaste. However, it is not possible to clean each tooth with different products. That's why the question of toothpaste is based on the age of the children. Because, as you have already read, all children's teeth develop in roughly the same periods of time - with some fluctuations, of course. 

Important for all ages: The toothpaste you choose for children should be mild, free of harmful substances and effective. It should also contain fluoride to strengthen the enamel and protect against tooth decay. The European Academy of Paediatric Dentistry (EAPD) recommends the following values:

• Infants, from the first tooth up to the age of two: twice a day, a quantity of children's toothpaste the size of a grain of rice with a fluoride content of 1,000 parts per million (ppm)
• Children from 2 to 6 years: a pea-sized amount of fluoride children's toothpaste (1,000 ppm) twice a day
• Children aged 6 and over: a pea-sized amount of fluoride children's toothpaste (1,500 ppm) twice a day. Curaprox Kids watermelon toothpaste is suitable here, for example. 

Also important for choosing the right toothpaste: you should make sure that it does not contain the additives BPA, triclosan, SLS or microplastics. Curaprox toothpastes for children do not contain any of these artificial additives. They care for children's teeth in a natural way - with enzymes that protect tooth enamel, which are also found in saliva, as well as fluoride and xylitol.