Teething

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.

Kids developing jaws and teeth.

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Your Child's First Teeth

Kids mouth anatomy.

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones, these teeth are called the central incisors. Then the neighboring teeth called lateral incisors will erupt too. The first molars come in next, followed by the canines (eyeteeth). And finally, the last teeth to erupt are the two-year molars. Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable.

Your infant's gums should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. As soon as the first tooth erupts, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Age one dental visit

The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday, or as early as the first tooth erupts. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, it's important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include:

Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child's teeth for maximum protection.

Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection (Watch Dental Sealant Video).

Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. In children these are called pulpotomies or pulpectomies. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment.

Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth (Watch Bonding Video).

Orthodontic Concerns

Orthodontic Problems.

By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development.

Sports & Your Child's Teeth

If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It's an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road!

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Teething.New parents sometimes anticipate their baby's first tooth with a mixture of excitement and worry. While reaching a new developmental milestone is always a cause for celebration, this particular one can come with considerable discomfort. However, teething is different for each baby, and need not be painful at all; plus, there are steps you can take to make the process easier for your baby — and yourself.

Teething refers to the process by which primary (baby) teeth emerge through the gums and become visible in the mouth. This usually begins between six and nine months of age, though it may start as early as three months or as late as one year. Usually, the lower front teeth erupt first, followed by the ones directly above. Most children have all 20 of their primary teeth by the age of 3 (View Tooth Eruption Chart).

Recognizing the Signs

Kids mouth anatomy.

Common signs that your baby is teething include:

  • Irritability
  • Biting and gnawing
  • Drooling
  • Chin rash (caused by excessive salivation)
  • Swollen gums
  • Ear rubbing
  • Decreased appetite
  • Disrupted sleep patterns

You are most likely to notice any of the above from about four days before the tooth breaks through the gums up until three days after the tooth appears.

A less common teething issue is the formation of an “eruption cyst,” a small bubble-like swelling filled with fluid that covers an erupting tooth. Eruption cysts usually do not require treatment as the tooth will simply pop the cyst when it comes through.

While there has been some disagreement as to whether diarrhea, rashes and fever are signs of teething, these are more likely to be associated with an unrelated illness and should be reported to your pediatrician.

How to Help

Teething babies get the most relief from cold and/or pressure on the affected area. This can be applied with:

  • Chilled teething rings
  • Cold, wet washcloths
  • Chilled pacifiers
  • Massaging baby's gums

Make sure not to actually freeze your baby's teething ring or pacifier because this could burn if left in the mouth for too long. The outmoded “remedy” of rubbing whiskey or other alcohol on the gums is neither effective nor appropriate. Over-the-counter medication may be helpful, but always check the correct dosage with your pediatrician or pharmacist. These, too, should not be rubbed on the gums because they can burn. Numbing agents shouldn't be used on babies under age 2 unless directed by a physician.

Remember, it's best to start dental visits by your child's first birthday to establish this lifelong health-promoting routine (View Age One Dental Visit Video).

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