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PRIMARY (BABY) TEETH
Children’s teeth begin forming before birth. Your child may begin erupting teeth as early as four months old. The first baby teeth to erupt are usually the lower front teeth (central incisors). Next you will probably see the upper front teeth. Your child will most likely have all twenty primary teeth by age three.
For infants, use wet gauze or a 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. Begin daily brushing as soon as the child’s first tooth erupts. By age four or five, children are usually able to brush their own teeth with supervision. Proper brushing is recommended at least twice a day. Flossing removes plaque between the teeth where a toothbrush can’t reach. Flossing should begin when teeth begin to touch. You may wish to floss the child’s teeth until they can develop enough coordination to do it by themselves. Whatever it takes, it’s worth it!
WHY ARE THE PRIMARY (BABY) TEETH SO IMPORTANT?
It is very important to maintain the health of the primary 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 permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth affect the development of speech and add to an attractive appearance. While the front four teeth only last until six to seven years of age, the back teeth (cuspids and molars) aren’t replaced until your child is between ten and thirteen.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21. Most adults have 28 permanent teeth, or up to 32 if all wisdom teeth develop.
As you know, healthy eating habits also lead to healthy teeth. Your child’s teeth, their jaw bones and the soft tissues of the mouth need a well-balanced diet. Most snacks can lead to cavity formation. The more a child snacks, the greater the chance for tooth decay. The time 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. Good oral hygiene removes bacteria and left over food particles that combine to create cavities.
- Brush at least twice a day.
- Do your best to limit snacks containing sugar, sticky snacks, sucking candies and lollipops.
- If your child eats candy with sugar, avoid hard & sticky candy that stay in the mouth for a long time.
- Reduce the intake of sugary drinks including juices and sports drinks.
- As soon as your child’s teeth have developed enough to touch, begin flossing.
- Treat natural cracks in teeth by filling them with sealants.
- Our Doctors may make a personal recommendation for HOME FLUORIDE whenever they believe it is necessary.
A sealant is a tooth colored material applied by the dentist to the chewing surfaces (cracks & grooves) of the back teeth (premolars and molars). Protective sealants act as a barrier to food, plaque and acid.
Proper brushing is one of the most important factors for good dental health. Avoid toothpastes, and/or tooth polishes that are abrasive as they may damage young smiles by wearing away fragile enamel. It’s easy… make sure you buy toothpaste that is recommended by the American Dental Association. These toothpastes have undergone testing to insure they are safe.
Remember, children should spit thoroughly after brushing to avoid swallowing too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, use no toothpaste, or only a “pea size” amount of toothpaste.
Fluoride STRENGTHENS teeth. However, too little or too much fluoride can be detrimental to the teeth. Excessive fluoride taken by preschool-aged children can lead to dental fluorosis, which can lead to a chalky white or brown discoloration of permanent teeth. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis. Some of these sources are:
- Too much fluoridated toothpaste at an early age
- The inappropriate use of fluoride supplements
- Hidden sources of fluoride in the child’s diet
Two and three-year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the risk factor in the development of fluorosis.
Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatric dentist.
Certain foods contain high levels of fluoride, especially powdered infant formula, soy-based infant formula, infant dry cereals, creamed spinach and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices and juice drinks manufactured in fluoridated cities. Blending the syrup, carbonation and the city water supply often makes soft drinks at fast food restaurants – so if fluoride is in the water – this is another source. Please take the following steps to decrease the risk of fluorosis in your child’s teeth:
- Avoid giving fluoride-containing supplements to infants until they are six months old
- Place only a pea-sized drop of children’s toothpaste on the brush when brushing
- Be aware of all sources of ingested fluoride before requesting fluoride supplements
- Use baby tooth cleanser on the toothbrush with very young children
- Obtain fluoride level test results for your drinking water (check local water utilities)
Radiographs (X-rays) are a vital and necessary part of your child’s preventive dental exam. Without them, certain conditions may go undiagnosed. X-rays allow us to diagnose and treat health conditions that cannot be detected with a visual examination. X-ray’s detect much more than cavities. For example, X-rays are necessary to survey erupting teeth, diagnose bone disease, or plan ahead for possible orthodontic treatment.
Sucking is a natural reflex. Infants and young children use thumbs, fingers, pacifiers and other objects to make them feel secure and happy, or when they are feeling stressed. Keep in mind that your child finds it relaxing.
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 your child sucks on fingers or thumbs will determine if a dental problem is at risk. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
If you have concerns about thumb-sucking or use of a pacifier, please call our office. We encourage you to try the following suggestions to help you and your child get through thumb-sucking:
- Praise children when they are not using this behavior.
- Children often suck their thumbs when feeling insecure (yes, even small children worry). Focus on correcting the cause of anxiety, instead of the thumb-sucking.
- Children who are sucking for comfort may feel less of a need when they receive a lot of personal attention and comforting.
- If you know there will be a stressful family situation, pay extra attention and provide rewards. It’s easy for a child who has stopped sucking to go back to the behavior during stressful times.
Dr. Insano and Dr. Velazquez assess your child’s present developmental condition. In some cases we may recommend a special appliance made just for your child. If these approaches don’t work, you may find it helpful to put a bandage or a sock on your child’s hand at night as a gentle reminder.
Parents are often concerned about children grinding their teeth (called bruxism) when they sleep. Often, the first indication is the noise created by grinding. Or, the parent may notice wear which makes teeth look shorter than usual. One theory may have 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 (like in an airplane during take-off and landing) children may grind by moving their jaw to relieve 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 indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition. The good news is most children outgrow bruxism.
Clean the affected area thoroughly. Help your child rinse vigorously with warm water. You may need to use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the gum or on the aching tooth. If your child’s face is swollen, apply a cold compress and please call us right away! The doctors may need to examine the child or place them on an antibiotic.
For a cut or bitten tongue, lip or cheek, immediately apply ice to the area. If there is bleeding, apply firm but gentle pressure with clean gauze or cloth. If bleeding doesn’t subside after fifteen minutes, or it cannot be controlled with pressure, CALL US RIGHT AWAY and take your child to a hospital emergency room.
KNOCKED OUT PERMANENT TOOTH
First, make every effort to find the tooth. Handle the tooth by the edge/crown area. Avoid touching the root portion. You may rinse the tooth by DO NOT clean or handle it unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in it’s socket. After the tooth is in place, your child must sit very still and hold the tooth in place by biting firmly on gauze or cloth. If you cannot reinsert the tooth, gently place the tooth in a cup with either your child’s saliva, milk or a mixture of both. Call us right away. Time is a critical factor.