This age group invites additional challenges that need to be monitored. With increased independence can come a rise in cavities due to greater sugar consumption and due to a decrease in healthy brushing habits. By 12-13, most primary teeth have been replaced by secondary teeth, with “wisdom” teeth usually making an appearance around age 21. Wisdom tooth removal, orthodontics, and teeth whitening are often addressed with this age group. Substance abuse, eating disorders, and sports injuries are also important considerations.