Explore MySmileEd
Emergency!
Where to look first when a tooth gets hurt or something urgent happens.
Ask Cozy
What would you like to learn?
TRY ASKING
Browse by topic
Growing Smiles
Roughly when adult teeth arrive. This page gives the stage ranges the AAPD publishes, with the same caution as its companion page: a timeline cannot tell you whether your child is on track.
Permanent teeth arrive over several years, overlapping with the loss of the baby teeth. The AAPD calls that overlap the mixed dentition and places it at approximately age six to eleven, when primary and permanent teeth are both present in the mouth.
After that comes what the AAPD calls the adolescent dentition, beginning at approximately eleven to twelve years, when all permanent teeth except the third molars may be erupted or erupting. Third molars — wisdom teeth — come much later or not at all.
Your grown-up teeth arrive slowly, usually starting around six. For a while you have a mix of baby teeth and big teeth at the same time, which is completely normal.
Two things parents often do not expect. The first permanent molars usually arrive at the back without a baby tooth falling out first, so they can be missed entirely. And the mixed dentition lasts about five years — a long stretch during which a child’s mouth looks uneven, and mostly should.
The AAPD sets out four stages of occlusal development, and its own wording carries the hedging: usually about, approximately. Those words are doing real work.
Again, no per-tooth months. The AAPD works in stages and monitors by examination, and this page follows that rather than inventing precision.
Three things worth knowing.
They come through at the back without a baby tooth being lost first, so families often do not notice. They are permanent teeth from the start and worth knowing about.
The AAPD places the mixed dentition at roughly five years, from about six to eleven. Uneven size, gaps and overlaps during that stretch are the ordinary state of things.
The AAPD emphasises evaluation for ectopic tooth positions in the late mixed dentition, especially canines, premolars and second permanent molars. Where a tooth is heading matters as much as when it arrives.
Ongoing evaluation, with the emphasis shifting as the stages progress. The AAPD sets out what is looked for at each one.
Timing questions belong at routine checkups, where they can be set against what has been seen before. That continuity is the point — the AAPD describes evaluation as ongoing throughout the developing dentition rather than as a single assessment.
Ring sooner if a permanent tooth is loose, if one is coming through somewhere clearly unexpected, or if there is pain or swelling.
A permanent tooth is coming through behind a baby tooth. Common enough to have its own page — see Shark teeth. It usually resolves as the baby tooth loosens, and it is worth mentioning at a checkup rather than worrying about.
The AAPD places the mixed dentition — when both primary and permanent teeth are present — at approximately age six to eleven. “Approximately” is the AAPD’s word and this page keeps it.
Worth raising at an appointment. The AAPD describes the adolescent dentition as beginning at approximately eleven to twelve with all permanent teeth except third molars erupted or erupting, but whether a particular child’s pattern needs anything doing is an assessment, not a calculation.
The AAPD describes radiographic examination in late adolescence to assess their presence, anatomy, position, inclination and development, and recommends active surveillance in the absence of disease or interference. That is a conversation for later adolescence.
Permanent teeth commonly appear less bright than the baby teeth beside them, and families often notice it during the mixed dentition. If the colour concerns you, mention it — and see White spots if there are chalky marks rather than an overall shade difference.
Also common during the mixed dentition, when adult-sized teeth arrive in a still-growing face. Raise it at a checkup if it worries you; the AAPD assesses developing occlusion over time rather than at a moment.
Every clinical statement on this page comes from the American Academy of Pediatric Dentistry documents below.
This website is for education only and does not replace care from your dentist, physician, or emergency services.