The permanent first molar tooth erupts distal to the deciduous second molar tooth before its exfoliation at around six years of age and is very similar to its adjacent teeth. The eruption of this tooth is not associated with the exfoliation of any tooth, and unfortunately, many parents are not aware of the eruption of this tooth, believing that it is a deciduous tooth. During dental visits, when the dentist shows the erupted permanent teeth and explains their care through toothbrushing or makes the parents aware of their carious lesions and the necessity of restoring them, the parents are surprised and claim that their children’s permanent teeth have not erupted yet and none of the deciduous teeth has become loose and exfoliated!!!
Some children might feel mild to moderate pain and discomfort in the overlying soft tissues during the eruption of these teeth due to the inflammation and swelling of the overlying tissues and gingiva of the semi-erupted tooth. This condition is due to the accumulation of food debris, the activity of subgingival bacteria, and the impact of the opposing teeth during mastication.
The Most Common Reasons for the Higher Vulnerability of Permanent First Molar Teeth Compared to Other Teeth
- The occlusal surfaces of these teeth usually have deep pits and fissures that are a suitable location for the retention and accumulation of food debris and the activity of cariogenic bacteria.
- The child does not have the dexterity and accuracy required for toothbrushing up to 8-9 years of age.
- Children have a great tendency toward cariogenic foodstuffs, including chocolates, biscuits, clips, etc.
- The permanent teeth are not strong enough and do not fully mature up to two years after eruption. Therefore, they are not adequately resistant to the acids produced by cariogenic bacteria.
- Parents’ unawareness of the permanent nature of these teeth due to their eruption before the exfoliation of deciduous molar teeth is an important factor, too.
Prevention and Treatment of Dental Caries in the Permanent First Molar Tooth
- A dentist should be visited every six months for a checkup.
- The parents should keep an eye on the eruption of permanent first molar teeth from six years of age.
- The child should brush his/her teeth every day with the help and under the supervision of the parents.
- It is recommended that the teeth be brushed twice every day, once after breakfast and once before going to bed.
- It is necessary to use dental floss in addition to a toothbrush. The child cannot properly and correctly use dental floss before nine years of age, and it should be applied by the parents.
- Children >6 years of age can use fluoride mouthwashes.
- Periodic fluoride therapy by a dentist is recommended to make the teeth more resistant to dental caries.
- Fissure sealant therapy has been recommended after the complete eruption of the permanent first molar tooth before it is affected by the caries process.
