Though your child's first set of teeth are not permanent, they are still critical to the development of healthy gums, jaws, permanent teeth, and dental hygiene habits. From first teething to the development of permanent adult teeth, you can help your child to develop and maintain strong healthy teeth and gums.
The First Teeth
The first teeth usually erupt at around 6-8 months beginning with the lower front teeth and working back towards the molars, usually in pairs. A full set of baby teeth usually appears by the age of 2.5 years and remains stable until the age of 5 or 6 when baby teeth begin to be replaced by permanent teeth.
This timeline however is not universal so don't worry if your child is either slightly ahead or behind the norm.
As these first teeth begin to push through the gum, your child may experience teething pain. Redness or rash on the cheeks, increased drooling, restlessness, irritability, and loss of appetite can all be indicators that your child is teething. If however your child also experiences fever, vomiting, or diarrhea you should take them to a physician as these symptoms are often caused by ailments other than teething.
Once you've established that your child is teething, you can ease their pain in a number of ways. Allowing your child to chew on a chilled teething rings or other cold hard objects can help numb the gums and cause the tooth to erupt sooner. Teething gels can also help reduce the pain through numbing and can be found in most pharmacies. Finally, you can also massage your child's gums with a clean finger, reducing the pain with light pressure on and around the location of the erupting teeth. Teething cookies and other food (or alcohol) based home remedies are not recommended as they may lead to tooth decay caused by food debris left in the gums or new teeth.
Teething can be a trying time for parents and child alike, but it will not last forever and there are several simple effective ways to manage your child's discomfort.
First Dental Visit
As soon as your child has her first teeth you can begin to think about scheduling a first dental appointment. The appointment should be made on or before your child's first birthday. Before the appointment you may wish to bring your child into the dental clinic for a short tour and a chance to get acquainted with the space and the staff. If you or one of your other children has an appointment, you can bring the younger child along to help get them familiar with the clinic.
In preparation for the first visit, try not to over-prepare your child or say things like "it won't be too bad" as these behaviours often just trigger fear and nervousness rather than providing comfort. When you get to the appointment, be sure to discuss an oral health plan for your child with either the dentist or dental hygienist.
Most importantly, do not wait for an emergency to bring your child to the dentist. The additional stress of pain or injury will make an unfamiliar experience even more difficult for your child.
Dental professionals often recommend that children's molars be treated with sealant to fill deep hard to reach cracks and crevices (Ahovuo-Saloranta et al., 2013). This treatment has been pivotal in the reduction of cavities over the last few generations (Siegal et al., 1997). The sealants should be applied by your dental professional as soon as the permanent molars erupt and will last several years once applied. Your dentist will check the sealants at every check-up and may replace them if needed.
Though there have been concerns about the use of bisphenol A (BPA) in dental sealants (Anderson, 2000), The American Dental Association (ADA) maintains that the risk is insignificant compared to the benefit of nearly 100% cavity prevention on the chewing surfaces of the molars (Council on Scientific Affairs, 2013 [http://www.ada.org/1766.aspx]). The ADA also notes that, on average, people are exposed to far more BPA from from food products than from dental sealants. Overall the advantage of cavity protection seems to outweigh any potential risk, but if you are concerned, speak with your dental professional and they can help you make the best decision for your child.
Most toothpastes sold today contain some level of fluoride concentration, as do the water supplies of many towns and cities. The fluoride in the water supply enters the bloodstream and helps to build strong healthy teeth before they erupt from the gums. It is most effective in children up to 14 years of age. You can ask your municipal government about the fluoride levels in your water
Topical fluoride can be applied as a toothpaste, mouth rinse, or gel either at the dental clinic or at home. This sort of fluoride application is beneficial for all ages of children and adult. Fluoride toothpastes are the simplest effective way (Walsh et al., 2010) to reap the cavity prevention benefits of fluoride treatment. If you or your child are cavity prone, you can talk to your dentist about the best combination of products for your child's dental situation.
Fluoride is a powerful tool in combatting tooth decay but there are also associated risks. In extremely high doses over a short period of time, fluoride can lead to reactions such as nausea, diarrhea, vomiting, abdominal pain, increased thirst and salivation. High doses of fluoride over a long period of time can also lead to fluorosis which can cause brown spots and staining on the teeth. Researchers have found, however, that standard use of fluoride toothpaste is not associated with increased fluorosis in children (Wong et al., 2010).
To protect your child from any complications of fluoride use, be sure to use only a small pea-sized dab of toothpaste, keep fluoridated products out of reach of children, remind your children not to swallow their toothpaste, and do not use mouth rinses on children under the age of 6 who are more likely to swallow than rinse.
Child Oral Health Concerns
Though baby teeth will be replaced by permanent teeth as your child grows, proper maintenance of their baby teeth can not only prevent child oral health concerns and ensure healthy gums and jaws but also helps to develop good oral hygiene habits that will follow your child through life.
Baby Bottle Tooth Decay
Allowing your baby to fall asleep while nursing or sucking on a bottle allows sugary liquids to pool around the teeth and may lead to extensive tooth decay. To ensure that tooth decay does not progress unnoticed you should check your child's teeth regularly for any brown spots along the gum line. Frowns or tears when eating cold, sweet, or hard foods may also be signs that your child is experiencing tooth decay.
To prevent tooth decay and other associated problems such as speech impediments, self-esteem issues, and misaligned teeth, you should ensure you clean your child's teeth everyday and make regular dental appointments from the time the the first tooth appears. You can also prevent baby bottle tooth decay by not allowing your baby to suck on a bottle for prolonged period or fall asleep while sucking a bottle. Finally, providing your child with plain water for thirst, diluting sugary drinks with water, and beginning bottle weaning by no later than the age of 1 year can all help to keep your child's teeth healthy and string.
Thumb-sucking and Pacifiers
Many children suck their thumbs as a self-comforting habit. Unfortunately, this habit can result in misaligned teeth and jaws and may even cause malformation of the palate or roof of the mouth. Most children quit sucking naturally around four years of age, but there are some techniques you can use to help ensure that thumb sucking does not become a lasting and damaging habit.
The habit can be prevented by giving your newborn a pacifier to suck instead of the thumb. The pacifier can then be removed as the child ages and thumb sucking will not have been established as a habit. When using a pacifier, be sure to select one with a rubber nipple which resembles the natural shape of a nipple so that there is no damage to the gums. Soothers should never be hung on a string around the child's neck and should not be used constantly throughout the day. The pacifier must also be regular inspected for tearing or damage to prevent your child choking on any torn off bits.
If your child persists in thumb sucking, you may wish to try behavioral methods of stopping before the child reaches school age and faces potential teasing. Reminders such as a bandaid on the thumb or rewards such as stickers on a calendar can be helpful in ending the habit, but ultimately your child must be ready to quit or you are likely to only face further resistance in trying to stop their thumb sucking. A good way to start is to have your child work on stopping thumb sucking in certain activities such as while watching television.
Once your child stops sucking their thumb during the day they may still unconsciously suck at night. To prevent this your child can wear gloves or socks on their hand to deter unconscious sucking.
If your child is still sucking their thumb when their permanent teeth begin to arrive, you should contact your dental health professional to seek help in ending the habit before it causes misalignment or malformation of jaws, teeth, and soft palate.
Just as with adults, sugary snacking habits in children can greatly increase the likelihood of cavities and tooth decay. Foods which contain high levels of sugar or which are soft or chewy and stick to the teeth are the most harmful as they cause the natural bacteria in your child's mouth to produce high levels of acid which may erode teeth. It is also important to remember that, though more nutritionally sound, natural sugars such as those in fruit can still cause dental decay if the teeth are not brushed regularly and thoroughly.
Along with healthy eating choices, you should try to reduce your child's consumption of sugary foods that are held in the mouth for a long time such as lollipops, hard candies, etc. If your child is going to eat something sugary, it is best to pair it with a meal so that the additional saliva production helps to wash the sugar off the teeth. Generally however it is best to avoid sugary foods to prevent the formation of a sweet-tooth and choose instead healthier options such as:
- Nuts & Seeds
- Plain yogurt
- Enriched or Whole-wheat bread
- Whole grain cereal
- Plain milk
- Tossed salads
- Plain muffins
Though snacks such as raisins, dried fruits, and granola bars are healthy, they tend to stick to the teeth and so are not an ideal choice for snacks.
Oral Hygiene Habits for Children
Even before your child's first tooth appears, you can and should begin an oral hygiene routine. Use a cloth to wipe down your baby's face and gums after every feeding. Once the first tooth appears, use a soft bristled brush to clean the tooth after every meal but do not use toothpaste as children tend to swallow most of it which can be harmful. If you are having difficulty brushing your child's teeth, you may want to try having your child lie down with their head in your lap, or have them stand in front of you with their back leaning against your body while holding a mirror so that both you and your child can see what you are doing.
Children require smaller brushes than adults and flossing should begin only when the teeth begin to touch each other. You child will likely not have the manual dexterity to brush and floss their own teeth until the age of 8 or 10. Establishing a good routine from the very beginning will help your child to get into a habit of oral hygiene.
Once your child begins brushing their own teeth, you may want to use a timer to ensure they are brushing for long enough as well as providing rewards such as stickers for regular brushing and flossing. The best way to get your child to adopt good oral hygiene habits is to model them yourself. If you and your child brush your teeth together ever morning and evening the practice is more likely to be kept up than if you expect your child to form the habit all on their own.
Ahovuo-Saloranta, A., Forss, H., Walsh, T., Hiiri, A., Nordblad, A., Mäkelä, M., Worthington, H.V. (2013). Sealants for preventing dental decay in the permanent teeth (Review). Cochrane Database of Systematic Reviews 2013, 3, Art. No.: CD001830. doi:10.1002/14651858.CD001830.pub4.
Anderson, K. (2000). Are sealants doing more than preventing caries? CDS Rev, 93(6), 10-4.
Siegal, W.D., Farquhar, C.L., Bouchard, J.M. (1997). Dental sealants: who needs them? Public Health Reports, 112.
Walsh, T., Worthington, H.V., Glenny, A.M., Appelbe, P., Marinho, V.C.C., Shi, X. (2010). Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2010, 1, Art. No.: CD007868. doi:10.1002/14651858.CD007868.pub2.
Wong, M.C.M., Glenny, A.M., Tsang, B.W.K., Lo, E.C.M., Worthington, H.V., Marinho, V.C.C. (2010) Topical fluoride as a cause of dental fluorosis in children. Cochrane Database of Systematic Reviews 2010, 1, Art. No.: CD007693. doi:10.1002/14651858.CD007693.pub2.