When Will My Baby Start Getting Teeth?

Children’s teeth begin forming before birth. As early as 4-6 months of age, the first primary teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. However, some children may get their first tooth by 3 months old, while others may not until after their first birthday. For most children however, 20 primary teeth usually appear by age 3, the pace and order of their eruption varies from child to child.

Why Are Baby Teeth So Important?

It is very important to maintain the health of the primary (baby) teeth. Neglected cavities can, and frequently do, lead to problems which affect developing permanent teeth. Primary teeth are important for:

• Proper chewing and eating
• Space maintenance for the permanent teeth and guiding them into the correct position
• Permitting normal development of the jaw bones and muscles
• Development of proper speech
• An attractive smile

While the front teeth (incisors) last until 6-8 years of age, the back teeth (cuspids and molars) aren’t replaced until age 9-12.

What is Baby Bottle Tooth Decay (Early Childhood Caries)?

One serious form of decay among young children is “baby bottle tooth decay”. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks. Putting a baby to bed for a nap or at night with a bottle or sippy cup with any liquid other than water can cause serious and rapid tooth decay. The liquid pools around the child’s teeth, giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle for comfort at bedtime, it should contain only water. After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. Begin brushing the teeth with a finger brush or infant toothbrush as soon as the first teeth erupt. The easiest way to do this is to sit down and place the child’s head in your lap while you gently brush. Whatever position you use, be sure you can see into the child’s mouth easily.

When should I Expect Permanent Tooth Development?

Permanent teeth begin to appear around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21. Adults have 32 permanent teeth, including the third molars (wisdom teeth).

How Do I Care for My Child’s Teeth?

Begin daily brushing as soon as the child’s first tooth erupts. A pea-size amount of fluoride toothpaste can be used after the child is old enough not to swallow it. Most children are not able to adequately brush and floss their teeth until at least 7-8 years of age. Until this time, you should supervise brushing and brush for them as well. Children may need help with proper flossing even beyond this age. However, each child is different. At your child’s routine visit, we will discuss proper brushing techniques and help guide the family on proper oral care for your child.

What is the Best Toothpaste for my Child?

Tooth brushing is one of the most important tasks for good oral health. Many toothpastes and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives which can wear away young tooth enamel. When looking for toothpaste for your child, make sure to pick one that is recommended by the American Dental Association. These toothpastes have undergone testing to insure they are safe to use.

Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. Fluorosis can cause permanent white or brown streaks on the permanent
teeth. Children who are unable to spit adequately (usually under 3 years of age) should use a fluoride-free infant/toddler toothpaste or just water on the toothbrush. When the child becomes old enough to spit out the toothpaste, a small pea-sized amount of fluoride toothpaste may be used.

How Do I Prevent Cavities?

Good oral hygiene removes bacteria and the left-over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Begin using a finger brush or infant toothbrush as soon as teeth are present. Avoid putting your child to bed with a bottle or sippy cup filled with anything other than water.

For older children, brush their teeth at least twice a day and floss daily. Also, minimize the number of snacks containing sugar and other simple carbohydrates your children consume can play a major role in the prevention of cavities. The American Academy of Pediatric Dentistry recommends six-month visits to your pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health. 

Good Diet = Healthy Teeth. Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth. Milk, juices, sodas, and other sweetened beverages can often be a major contributor to tooth decay. It is best to limit these drinks to mealtimes and to always brush afterwards. Only water or other drinks without sugar should be consumed between meals or after brushing to help keep cavities at bay.

What’s the Theory on Gum?

The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of Xylitol on the oral health of infants, children, adolescents, and persons with special health care needs. The use of Xylitol gum by mothers (2-3 times per day) starting 3 months after delivery and until the child was 2 years old, has proven to reduce cavities up to 70% by the time the child was 5 years old.

Studies using Xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This Xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.

Xylitol is widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, and lettuce. One cup of raspberries contains less than one gram of Xylitol.

To find gum or other products containing Xylitol, try visiting your local health food store or search the Internet to find products containing 100% Xylitol

What is Pulp Therapy?

The pulp of a tooth is the inner central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy is to maintain the vitality of the affected tooth following trauma or extensive decay (so the tooth is not lost early). Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment” or “baby root canal”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy, or “root canal” is required when the entire pulp is involved (into the root canals of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and in the case of primary teeth, filled with a resorbable material. Then a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

Grinding Teeth (Bruxism), Should I Be Concerned?

Parents are often concerned about the nighttime grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school, etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes, the child will grind by moving his jaw to relieve this pressure. The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be necessary. The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with Dr. Paul and our staff.

My Child Sucks His/Her Thumb, What Should I Do?

The first three years of life may cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should be encouraged to stop the habit by their third birthday to minimize lasting effects on the position of the teeth. Many children will quit the habit on their own prior to this time but some may need special encouragement. Pacifiers ultimately have the same impact as thumb sucking unfortunately. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, good news, the use of the pacifier can be controlled and modified more easily than the thumb or finger habit.

Dr. Paul and staff are more than happy to discuss ways to encourage you and help your child break the habit. There’s no need to tackle this one alone!

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Charleston's Pediatric Dentist

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