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We have 20 milk teeth and 32 permanent teeth. Milk teeth usually erupt between 6 months and 2 years; and all permanent teeth erupt between 6 and 12 years (except wisdom teeth). Permanent front teeth (incisors) replace milk incisors between 6 and 9 years. The permanent canines and premolars erupt between 10 and 12 years. The first permanent and second permanent molars erupt at age 6 and 12 years respectively, behind present teeth (without replacing milk teeth. Wisdom teeth erupt beyond age 18 years.

TYPE OF TEETH                    MILK TEETH                             PERMANENT TEETH

INCISORS                                        8                                                         8   
CANINES                                         4                                                        4
MOLARS                                          8                                                        12     
PREMOLARS                                   --                                                         8

TOTAL                                              20                                                     32

 A visit to a dentist/ pediatric dentist is recommended within 6 months of eruption of first teeth and no later than the child’s first birthday. 

The goal of an early visit is to start early prevention. A big concern is Early Childhood Caries (Rampant Decay of Milk Teeth). In India, approximately 50% children by age 5 years have tooth decay. The tooth decay is an infectious and transmissible disease. The children acquire this infection from their mothers, caretakers. Bottle feeding as well as prolong, ‘on demand’ breast feeding beyond weaning age, early teething, inadequate oral hygiene, diet with frequent sugar or starch containing items, low immunity, lack of fluoride exposure to teeth and many other factors contribute to such decay. 

A variety of dental treatments such as fillings, root canal treatments, caps (crowns), extractions, preventive and interceptive orthodontic treatments, and some preventive measures for dental caries such as fluoride applications, fissure sealants are recommended for children. 

Those children who can cooperate for the dental treatments (usually most children above age 4 years) are treated in dental clinics. For pre-cooperative or uncooperative children and some children with special care needs, hospitalization and treatment under sedation or general anesthesia is recommended. 

If a cavity (decay) or trauma has led to damage in the pulp (nerves and vessels) of a tooth, only root canal treatment can save the tooth. Even milk teeth can be saved with root canal treatment until they get replaced later. 

 Fluorides help in remineralization of outermost layer of enamel making it resistant to decay. The recent literature confirms that the use of fluoride varnish application is the best mode of caries prevention in children and safest too, when clinicians have made a decision to use a topical fluoride therapy. It is established that varnishes take less time for application, create less patient discomfort, and achieve greater patient acceptability than gel, especially in preschool children and children with special care needs. For children at moderate and high risk of dental caries, use of varnishes is recommended for children below age 6 years.