Reference Values for Permanent-Tooth Emergence in Hungarian Children: A Cross-Sectional Study

Background/Objectives: Population-specific data on permanent-tooth eruption are essential for accurate diagnosis, treatment planning, and public health strategies. In Hungary, current clinical practice relies on outdated international eruption standards. The aim of this study was to determine the timing and sequence of permanent tooth emergence in Hungarian children and provide sex-specific eruption standards. Methods: A cross-sectional study was conducted based on dental screening records of 2948 children aged 4-15 years in Debrecen, Hungary, during the 2015-2016 school year. Probit regression was used to estimate median eruption times and percentiles, and eruption sequences were assessed by sex and jaw. Results: Girls exhibited earlier eruption than boys for all teeth except mandibular central incisors (difference: 1.9-8.9 months; p < 0.05). Mandibular teeth generally preceded maxillary teeth, though premolars in boys showed the opposite trend. Eruption sequences varied by sex, particularly in the canine-premolar region. The 5th-95th percentile eruption range was widest for second molars (4.8 years) and narrowest for maxillary central incisors (2.3 years). Conclusions: This study provides the first modern eruption standards for Hungarian children. These sex-specific reference values are clinically useful for assessing delayed eruption, guiding radiographic decisions, and optimizing the timing of preventive and orthodontic interventions.