Gum Injuries

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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When dental emergencies and pain occur, our attention is often focused on diseases and injuries related to the teeth. However, it's important to remember that the soft tissues of the mouth — the gums, tongue, lips and cheek lining — may also be affected. While they are tough enough to stand up to the oral environment, these tissues can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses.

First Aid for Soft Tissues

Soft tissue injuries in the mouth don't usually bleed excessively — although blood mixing with saliva may make any bleeding appear worse than it actually is. To assist someone with this type of injury, you should first try to rinse the mouth with a dilute salt water solution. If a wound is visible, it can be cleaned with mild soap and water; if that isn't possible, try to remove any foreign material by hand, and rinse again.

Bleeding can usually be controlled by pressing damp gauze (or, if unavailable, another clean material) directly to the site of the injury, and keeping it there for 10-15 minutes. If the bleeding doesn't stop, immediate medical attention will be needed. Try to see a dentist within 6 hours of the injury for evaluation and treatment. This usually involves determining the extent of the damage, performing initial restorative procedures, and occasionally suturing (stitching) the wound. An antibiotic and/or tetanus shot may also be given.

Foreign Bodies

Occasionally, foreign objects may become lodged in the space between teeth and gums, causing irritation and the potential for infection. There are a few foods (such as popcorn husks) that seem especially prone to doing this, but other items placed in the mouth — like wood splinters from toothpicks or bits of fingernail, for example — can cause this problem as well.

If you feel something stuck under the gum, you can try using dental floss to remove it: Gently work the floss up and down below the gum line to try and dislodge the object. Light pressure from a toothpick may also help work it free — but avoid pressing too hard or pushing the object in deeper. If that doesn't work, see a dentist as soon as possible. Special tools may be needed to find and remove the object, and you may be given medication to prevent infection.

Periodontal (Gum) Abscesses

Gum abscess.Sometimes called a gum boil, a periodontal abscess is a pus-filled sac that may form between teeth and gums. It is caused by an infection, which may have come from food or other objects trapped beneath the gum line, or from uncontrolled periodontal disease. Because pressure builds up quickly inside them, abscesses are generally quite painful. Symptoms may include a throbbing toothache which comes on suddenly, tenderness and swelling of the gums or face, and sometimes fever. Occasionally, pus draining into the mouth through an opening in the sac relieves the pressure and pain, but may cause a strange taste.

If left untreated, abscesses can persist for months and cause serious health problems, including infections that spread to other parts of the body. That's why it is important to see a dentist right away if you experience symptoms. He or she will find the location of the abscess and treat it appropriately. Treatment usually involves draining the pus and fluid, thoroughly cleaning the affected area, and controlling the infection.

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