The timing of tooth eruption is a key indicator of a child’s growth and oral development. Early (premature) or delayed tooth eruption may signal local or systemic conditions. Understanding these variations helps in accurate diagnosis and appropriate treatment.
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Tooth eruption is a physiological process involving the movement of teeth from their developmental position in the jaw to their functional position in the oral cavity. Normally, primary teeth erupt between 6 months and 3 years, while permanent teeth appear between 6 and 13 years.
However, when eruption occurs significantly earlier or later than these expected ranges, it can indicate nutritional deficiencies, hormonal imbalances, genetic syndromes, or local obstructions such as cysts or supernumerary teeth (Kumar et al., 2022).
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Early eruption can occur in natal or neonatal teeth, or in cases where permanent teeth appear before expected age.
➤ Common causes include:
▪️ Genetic predisposition.
▪️ Endocrine disorders such as hyperthyroidism.
▪️ Local factors like premature loss of primary teeth.
Clinically, early eruption may cause feeding difficulties, gingival irritation, and an increased risk of dental caries due to immature enamel structure.
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Delayed eruption is defined as tooth emergence occurring six months or more beyond the expected time for a given tooth.
➤ Possible causes include:
▪️ Nutritional deficiencies (vitamin D, calcium).
▪️ Endocrine disorders (hypothyroidism, hypopituitarism).
▪️ Genetic syndromes (Down syndrome, cleidocranial dysplasia).
▪️ Local factors, including cysts, trauma, or crowding.
Radiographic evaluation helps rule out obstruction or impaction. Treatment depends on addressing the underlying cause—ranging from nutritional supplementation to orthodontic intervention.
📊 Average Eruption Ages of Primary and Permanent Teeth
| Tooth Type | Average Eruption Age (Primary Dentition) | Average Eruption Age (Permanent Dentition) |
|---|---|---|
| Central Incisor | 6–10 months (lower), 8–12 months (upper) | 6–8 years |
| Lateral Incisor | 9–13 months | 7–9 years |
| Canine | 16–22 months | 9–12 years |
| First Molar | 12–18 months | 6–7 years |
| Second Molar | 20–30 months | 11–13 years |
Both early and delayed eruption affect occlusion, aesthetics, and oral function. Early eruption can increase caries susceptibility, while delayed eruption may interfere with normal alignment and jaw growth. Pediatric dentists should evaluate eruption chronology charts, medical history, and radiographs before determining treatment. Early identification allows for preventive and interceptive approaches, such as fluoride application, habit correction, or surgical exposure when indicated.
✍️ Conclusion
The timing of tooth eruption varies among children but remains a critical diagnostic marker of general health. Clinicians must monitor deviations from eruption norms to prevent complications in occlusion and function. Regular dental check-ups from early childhood are essential to detect eruption anomalies promptly.
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▪️ Maintain periodic dental evaluations from the first year of life.
▪️ Use eruption charts as reference tools for growth assessment.
▪️ Investigate any eruption delay exceeding six months.
▪️ Coordinate with pediatricians to address systemic causes.
▪️ Encourage balanced nutrition and oral hygiene to promote healthy eruption.
📚 References
✔ Kumar, A., Gupta, R., & Sharma, S. (2022). Assessment of eruption timing and sequence in Indian children: A cross-sectional study. Journal of Indian Society of Pedodontics and Preventive Dentistry, 40(3), 245–250. https://doi.org/10.4103/JISPPD.JISPPD_199_21
✔ Seow, W. K. (2018). Eruption disturbances of the primary and permanent dentitions in children. Australian Dental Journal, 63(S1), S55–S65. https://doi.org/10.1111/adj.12591
✔ Moslemi, M. (2021). An epidemiologic survey of the time and sequence of eruption of permanent teeth in 4–15-year-olds. Journal of Dentistry (Tehran), 18(4), 251–259.
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