What is a pediatric dentist?
Why are primary (baby) teeth important?
When should I expect my child’s teeth to erupt (or come in)?
What should I do if my child grinds his/her teeth?
What to expect with my child’s first dental visit?
When will my baby’s first tooth come in?
What should I use to clean my baby’s teeth?
What is Early Childhood Caries (“Baby Bottle Decay”)?
What type of toothpaste is the best and when should I begin flossing?
How does diet affect the teeth?
How do I prevent cavities?
What about mouthguards?
What to do if my child has trauma to his/her mouth or teeth??
A pediatric dentist has an extra two years of specialized training after dental school and is dedicated to the oral health of children from infancy through the teenage years. Their focus is on guiding dental growth and development, special behavior management techniques and helping children, pre-teens and teenagers to maintain good oral health habits that will last a lifetime.
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 or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. While the front 4 teeth last until 6-7 years of age, the back teeth (canines and molars) aren’t replaced on average until age 10-12.
The development of your child’s teeth begins before birth. On average, the first tooth begins to erupt around 6 months of age but may occur before or after that age. The first tooth to erupt is most commonly the lower central incisor (lower front tooth) followed closely by the upper front teeth. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption can vary.
Permanent teeth begin to come in around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.
Adults usually have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).
Parents are often concerned about nighttime grinding of the teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. 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. This can be due to allergies or sinus problems. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric bruxism do not require any treatment. The good news is most children outgrow bruxism. If you suspect bruxism, discuss this with your child’s pediatrician or pediatric dentist.
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent teeth can 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 cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop. One thing to keep in mind with thumb sucking is that your child has to mentally be ready to stop the habit or else it is going to be near impossible to break.
Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, discuss this with Dr. Doss or Dr. Gold.
A few suggestions to help your child get through thumb sucking:
- Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
- Children who are sucking for comfort will feel less of a need when their parents provide comfort.
- Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
- If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. If the habit persists, Dr. Doss or Dr. Gold may recommend the use of a mouth appliance.
Dr. Doss and Dr. Gold strive to make the first dental visit as positive and enjoyable as possible. Following the guidelines from the American Academy of Pediatric Dentistry, we recommend the first visit to be at or before your child’s 1 year birthday. The first visit is an opportunity for answering any questions you may have about your child’s dental health, recommendations from the doctors regarding ways to maintain good oral health as well as allowing your child to start to adapt to a dental home. We want your child to enjoy getting to know Dr. Doss, Dr. Gold and the staff and be comfortable at all times. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits.
We will record the child’s dental and medical history, complete a comprehensive examination and discuss any findings with you. We will also review the importance of maintaining good dental health with you and your child to ensure a healthy and beautiful smile for life!
When will my baby’s first tooth come in?
The above chart shows ranges of when the teeth are expected to come in but every child is different and so the pace and timing will be different for everyone. Also see question “When should I expect my child’s teeth to erupt (or come in)?”
Cleaning of the mouth and teeth really begins very early in a child’s life. Before the baby has teeth we recommend wiping the gums with a wet, soft washcloth. When the first tooth erupts, we advise that you begin to implement brushing with a size appropriate toothbrush and water or training (fluoride free) toothpaste. There are toothbrushes with very small heads/bristles for babies and then as the child grows, so does the toothbrush. You should also make sure to find a soft bristle toothbrush and brush the teeth twice a day. You can also find finger brushes to use to clean your baby’s teeth.
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 other than water or nighttime breastfeeding without cleaning the teeth afterward can cause serious and rapid tooth decay. Sweet 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 as a comforter at bedtime, it should contain only water. If your child won’t fall asleep without the bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.
After each feeding, wipe the baby’s gums and teeth with a damp washcloth or toothbrush to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.
Tooth brushing is one of the most important tasks for good oral health. The American Academy of Pediatric Dentistry recommends brushing twice a day (in the morning and at night right before bed). It is advised to begin brushing your child’s teeth when the first tooth erupts (comes in). If your child is too young or unable to spit out toothpaste, consider providing them with fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount of toothpaste.
Flossing a child’s teeth can start as soon as they have teeth. At this stage it is more or less to introduce the young child to what flossing feels like and to incorporate it into a daily habit. When all of the baby teeth have erupted it is vital that the teeth are flossed daily to remove food and bacteria both above and below the gum line to prevent decay between the teeth and gingivitis (inflammation of the gums).
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 in order to develop properly and stay healthy. The more frequently a child snacks, the greater the chances for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth.
Good oral hygiene removes bacteria and food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See “Baby bottle tooth decay” for more information.
For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.
The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.
Dr. Doss or Dr. Gold may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.
Mouth guards help prevent broken teeth and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
If your child has suffered an injury to their mouth or teeth, these are some guidelines to follow.
Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still persists, contact us. We do not recommend placing Orajel on the gum tissue or tooth. If the face is swollen, apply cold compresses and contact Dr. Doss & Dr. Gold immediately.
Cut or bitten tongue, lip or cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.
Knocked out permanent tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk. If the patient is old enough, the tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.
Knocked out baby tooth: Contact Dr. Doss or Dr. Gold. They will determine when your child needs to be seen. This is not usually an emergency, and in most cases, no treatment is necessary.
Chipped or fractured permanent tooth: Contact Dr. Doss or Dr. Gold. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you to the dentist.
Chipped or fractured baby tooth: Contact the office during office hours. You can also give Children’s Tylenol or Motrin as needed for pain.
Severe blow to the head: Take your child to the nearest hospital emergency room immediately.
Possible broken or fractured jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.