The Permanent Teeth
Sometime around your child’s sixth or seventh birthday, he or she will begin losing baby teeth and adult or permanent teeth will begin to move in. It may be fine if this process starts in your child earlier or later. Each child has his or her own timetable set by heredity. Symmetry, or the order that your child’s teeth come in, is more important than when they
come in.

Most often, the first permanent teeth to emerge into the mouth are the lower central incisors. However, in some children, the first permanent molars (sometimes called the 6-year molars) are the first to emerge.

Since 32 permanent teeth replace 20 primary (baby) teeth, the permanent molars farthest back in the mouth emerge in back of the primary teeth and do not replace primary teeth. The primary molars are replaced by permanent premolars, also called bicuspids. The primary incisors and canines are replaced by permanent incisors and canines.

By the time your child is 13 years old, most of his or her permanent teeth will be in place. Wisdom teeth, or third molars, come in between ages 17 and 21. However, not everyone develops every wisdom tooth. Some people don’t get any. More often, wisdom teeth develop, but they may not be in the proper position to emerge through the gums, or there is no room in the mouth for them to erupt.
Caring for Permanent Teeth

Until your child is between 6 and 8 years old, you should continue to help him or her brush at least twice a day — once in the morning and once before bed. It’s very important to keep your child’s teeth free of food particles, especially the molars. These teeth have lots of little grooves and crevices where food particles can hide.

The easiest way to help your child brush is to cradle his or her head in your one arm, while keeping your other hand free for brushing. Once children have the coordination and dexterity, they can brush on their own. However, be sure to inspect after each brushing and go over spots he or she may have missed.

A few other tips:

* Use a soft nylon toothbrush with just a small, pea-size dab of fluoride toothpaste.
* Teach your child how to spit out the foamy saliva so he or she doesn’t swallow it.
* As soon as any two of your child’s teeth touch each other, floss the teeth. After age 9, children have enough dexterity to begin to floss their own teeth. Flossing removes food from between the teeth where a toothbrush can’t reach and helps prevent cavities.
* Talk to your child’s dentist or pediatrician to be sure he or she is getting the right amount of fluoride.