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The 6-year-old molar is a special permanent tooth. By comparison, it resembles a child who is intelligent, as well as rebellious, pampered, and stubborn. The 6-year-old molar is both important and vulnerable. There is no coincidence that it is called the “rebellious child” of pediatric dentistry. Parents, grandparents, teachers, pediatricians, and all those who take care of children around the age of 6 should be well informed about this paradox, especially since it can erupt early in the age range of 5-6 years.
The mistake that many parents make is to temporarily confuse it with a baby tooth. We remind parents that the last baby tooth erupts at the latest at 2 years and 6 months. At the age of 6, the mixed dentition already begins with the eruption of the first permanent teeth: the 6-year-old molars and the lower central incisors. We consider it important to emphasize a few factors to remember the importance as well as the vulnerability of this tooth:
The importance of the 6-year-old molar:
- Angle called it the key to dental occlusion. It establishes and improves the occlusion of the “developing adult” both vertically and horizontally.
- Schudi called it the occlusion opener – due to its position and eruptive force in opposition to the lower frontals which are appreciated as its openers.
- Through its strategic position on the arch, it is obliged to withstand the greatest pressures, but only has the mechanisms to disperse them harmoniously.
- Through its early eruption, it is the only stability element during the mixed eruption.
- Being the oldest witness of the adult’s permanent occlusion, it is responsible for agreeing with the temporomandibular joint with the previous determinant of the occlusion: the incisors and the canines.
Its early loss entails the installation of morphological and functional disorders in the cascade throughout life.
Its vulnerability and receptivity to cavities:
- The process of mineralization of this tooth is done in its difficult stages of development: at birth and after birth. Any imbalance in the first years affects the mineralization of its hard structures.
- Its posteruptive maturation is done in difficult conditions – it coexists with baby teeth that are preparing for change, retain, and disfavor self-cleaning.
- The eruption of this tooth takes very long – even 1 year from the moment it appears under the gingival mucosa – which favors the deposition of bacterial plaque on it.
- The relief – the morphology of this tooth disadvantages it: it has deep dimples, deep cracks, a diagonal ridge, retentive vestibular dimples, and even tubers (Carabelli).
All of these explains its vulnerability throughout increased receptivity to cavities and force us to permanent supervision and a large volume of prophylactic-curative procedures.
Good News: Visit us and we will inform you about methods of prevention and immunization of the 6-year-old molar. Do you know about the existence of a specially designed toothbrush to take care of this tooth?
The importance of its presence on the dental arch means that its effort to maintain it should never be too big, and its extraction should be moderate for extreme cases and constitute a “dental mourning”.
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