Tooth Eruption
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20 Primary (deciduous) Teeth
32 Permanent Teeth

Order of normal eruption (Bilateral):

Mandibular central incisors (6-10mo)
Maxillary central incisors  
lateral incisors (10-13mo)
first moalrs (15mo)
canines (18-20mo)
second molars (25-30mo)


Usually fully erupted by 30 months:
-Girls sooner than boys
-Black sooner than white


DELAYED ERUPTION
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If tooth eruption is delayed =6 months beyond the normal range for a particular tooth (ie, if the mandibular central incisors have not erupted by 16 months) or if there is asymmetric tooth eruption of =6 months, evaluation for causes other than normal variation may be warranted.

Delays in dental eruption can be:
-familial (eg, primary failure of tooth eruption, caused by mutations in the PTH1R gene [MIM *168468])
-Down syndrome [41], 
-hypothyroidism, 
-hypopituitarism, 
-achondroplastic dwarfism, 
-osteopetrosis, 
-rickets, or 
-chondroectodermal dysplasia. 

Delayed or abnormal tooth eruption is also associated with enamel-renal syndrome and cleidocranial dysplasia


TOOTH EXFOLIATION
------------------
typically begins around age 6 and
continues through age 12 (molars) to age 20 for 3rd molar (wisdom)


TEETHING
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Sx:
-fussiness, 
-mouthing behaviors,
-drooling. 

**If FEVER present rule out infection, if no infection present Tx with palliative care (chilled teething ring, NSAIDs) oral gels/topicals not recommended.