Local Dental Care - New York When Do Infants Get Teeth

Pediatric Dentist and Tooth Decay FAQs

Q. Should you give a baby a fluoride supplement?

A. Babies living in areas where the water supply is fluoridated do not need fluoride supplements. If the water supply is not fluoridated, or if the baby is breastfed, the physician or pediatric dentist may recommend supplements starting at the age of six months.

Besides tap water, and often bottled water as well, fluoride also is found in juices (especially cranberry juice) and baby foods (especially chicken). These sources may provide enough fluoride without the need for supplements, so discuss the need for fluoride supplements with your child's physician and/or pediatric dentist

Q. What causes "baby bottle tooth decay"?

A. Frequent, long-term exposure of a child's teeth to sugary liquids (including breast milk, formula, and milk) causes baby bottle tooth decay. The sugars in these liquids pool around the teeth and feed the bacteria in plaque.

Q. When should an infant's oral hygiene begin?

A. Even without teeth, oral hygiene should begin soon after birth. After each feeding, wipe your baby's gums, inside the cheeks, tongue, and roof of the mouth with a clean, damp washcloth or wet gauze pad. This removes plaque, the sticky film containing decay-causing bacteria.

Q. What are the white patches sometimes found in a newborn's mouth?

A. Yeast infections in the mouth occur frequently in newborns. White patches can spot the tongue, cheeks, gums, or roof of the mouth. If they are removed, some bleeding will occur. Treatment is usually unnecessary; however, your doctor should be notified of this condition.

Q. What is the condition known as "tongue-tie"?

A. A piece of tissue connects the tongue to the bottom of the mouth, and if it's too short, a condition known as ankyloglossia results. This is common in newborns and usually resolves itself over time. The only reason to have the tissue cut is if the infant cannot nurse.

Q. When do babies start getting primary teeth?

A. The average age for the first primary tooth is five to six months; however, there is great variation.

Q. What are the signs of teething?

A. Fussiness, excessive drooling, rash, diarrhea, changes in sleep and feeding patterns, and fever can signal a baby's discomfort. However, don't assume that a fever or these changes are caused just from teething. They also can be symptoms of other health conditions. Check with your doctor to ensure your baby receives proper medical care.

Q. What remedies are recommended for teething pain?

A. Your children's dentist or pediatrician may recommend a pacifier, teething ring, or a special numbing ointment for the gums. Some teething rings and pacifiers can be chilled to extend their numbing effect. Older children will enjoy the soothing relief that popsicles provide.

Q. How can you help your child's teething pain?

A. To help your child's teeth pain, gently massage the infant's gums with a clean, wet finger, a small, cool spoon, or a clean, wet gauze pad. This often soothes the child's teeth pain and irritation. A cold rubber teething ring also helps.

Q. Can decay-causing bacteria be passed to an infant?

A. Yes, babies are exposed to bacteria from a variety of sources, such as a caregiver blowing on food to cool it, tasting food, sharing utensils, kissing the infant on the mouth, sharing a cup, or sucking on the baby's fingers. Care should be taken not to expose the infant to bacterial exposure from these sources.

Q. How should you care for a child's primary teeth?

A. As soon as the first tooth erupts, with a clean, wet washcloth or wet gauze. The gums also should be gently wiped. If a toothbrush is used, it should be an appropriate size.

Q. When should you start caring for your child's teeth?

A. As soon as primary teeth appear, they are at risk for decay and need to be brushed twice daily with a soft-bristled brush. Do not use toothpaste until your child is two years old.

Q. How can you prevent baby bottle tooth decay?

A. You can prevent baby bottle tooth decay by wiping the child's teeth and gums with a clean, moist washcloth after each feeding to remove plaque. You should never let your child go to sleep with a bottle containing a sweetened liquid. Among these are milk (including breast milk), formula, fruit juice, and other sweetened liquids. Constant use of a sipping cup containing sweetened liquids also can cause baby bottle tooth decay.

Q. Why is it important to care for primary (baby) teeth, since they will fall out anyway?

A. Primary teeth serve as the foundation for a healthy mouth, including the gums and the proper positioning of permanent teeth. They serve as natural space maintainers, holding the space open until the permanent teeth are ready to take their place.

If primary teeth become broken or decayed and are not properly treated, problems can occur with permanent teeth, which may contribute to other health problems. The result can be costly orthodontics and other pediatric dentistry treatments.

Q. Can juices hurt your child's teeth?

A. Because of the sugar content, juice and juice products have much greater potential to cause decay. Apple juice may cause staining of the teeth and should be diluted with water. Any beverage other than water has the potential to cause tooth decay, especially if the child drinks it frequently.

Q. What problems occur from baby bottle tooth decay?

A. To repair the decay, extensive treatment or extraction of the teeth may be required. Because the children are usually around 18 months to 2 years of age, hospitalization with general anesthesia is often required to perform these procedures.

Q. Is sucking harmful for teeth?

A. While sucking is a natural reflex, sucking on thumbs and pacifiers can cause problems after the permanent teeth erupt. Continued sucking after this time affects the proper growth of the mouth, alignment of teeth, and the development of the roof of the mouth that can result in the need for orthodontic treatment and other pediatric dentistry treatments in the future.

Q. How can parents encourage a child to stop thumb sucking?

A. Set a positive tone and praise the child when they're not sucking. Thumb sucking is a stress-reliever and offers comfort. Look for any factor that might be causing discomfort or anxiety and seek solutions to correcting them, rather than focusing on sucking as the issue.

Reward the child when he or she doesn't fall back into the habit, especially during stressful situations. Schedule an appointment with the child's pediatric dentist to talk about what is likely to happen if the habit continues.

Q. What can parents do if a child has difficulty breaking a thumb sucking habit?

A. Finding ways to take away the pleasure of thumb sucking reduces or eliminates the satisfaction gained from it. Bandage the thumb or put a sock over the hand at night. A pediatric dentist or pediatrician can prescribe a bitter-tasting medication to coat the thumb. A mouth appliance can be used to block the ability to suck.

The Baby Tooth - Children's Dental Care For Parents

Q. Does a woman's oral health during a pregnancy have any effect on the fetus?

A. Yes, a pregnant woman's oral health can affect the fetus. Studies have shown that women with many decayed teeth and advanced gum disease may have babies who are born underweight or prematurely.

Q. What about the juices? Can they cause baby tooth decay?

A. Juice causes 20 times more baby tooth decay than milk. Any beverage other than water will cause damage to your child's baby teeth if it is given constantly in a bottle or sippie cup.

Children whose stomachs's are full of liquid may have less of an appetite and eat less of the more nourishing foods. White grape juice contains more fluoride than the other juices. Consumption of white grape juice should be limited before four years of age.

Q. How does one know if her baby needs a fluoride supplement?

A. Fluoride supplements are necessary only if the baby is receiving no fluoride. These supplements may begin at six months of age.

If an infant is strictly breastfed, fluoride may be prescribed for optimal oral health. However, there are many sources of fluoride besides your tap water.

The following contain fluoride:

• juices
• bottled water
• baby foods, (especially chicken)

Q. If the baby receives only bottled water, should a fluoride supplement be used?

A. Bottled water may contain significant amounts of fluoride. The time of year, the source of the water, including the water table and plant from which the water was obtained, will cause fluctuations in the amount of fluoride.

Q. When should one begin brushing the baby's teeth?

A. Brushing may begin with a soft-bristled brush as soon as the first baby teeth erupt. Do not use toothpaste. Toothpaste contains too much fluoride, the taste may be unacceptable and the foaming may upset your child.

Q. Any toothbrush tips?

A. A toothbrush with a small, rounded head is safer. Bristles should be extra soft. Rinse the brush with hot water before and after brushing.

Change the toothbrush as soon as the bristles appear to be frayed. The toothbrush should also be changed after any illness.

Q. Can medicine harm baby teeth or second teeth?

A. >Tetracycline is the only antibiotic that can cause irreversible color change to the second teeth. It is no longer prescribed for children under eight years of age. Chronic illness and long-lasting high fevers may cause changes in the developing permanent teeth, but medication will not.

Children's medications are colored with dyes and have a very high sugar content to make them taste good. Some pharmacies are adding flavoring to improve the taste. The combination of the dye and sugar may cause staining of the teeth. This stain is easily removed when the teeth are polished during a cleaning by the pediatric dentist.

Q. What about injuries to the baby teeth?

A. If a baby tooth is knocked out, do not attempt to replace it in the tooth socket. This is not the same with permanent teeth.

Attempt to find the tooth. If the tooth cannot be located and your child is coughing, a chest X-ray must be performed in order to be sure that the tooth is not lodged in a lung. The baby tooth could also be intruded or pushed up into the gum and bone. This can be confirmed by an X-ray.

The baby tooth should come back into the mouth in six to eight weeks. Other treatment may be necessary, but not usually. Sometimes the permanent tooth that is developing in the bone just under the baby tooth is damaged when the baby tooth is pushed into the bone. The extent of the damage can not be predicted. When the permanent tooth erupts or comes in, the damage could range from a white spot to a dark indentation.

If the baby tooth is lost, a space maintainer with a denture tooth can be made. This may maintain the space for the permanent tooth and improve appearance, but it is not always necessary.

Q. When should my child have his or her first dental visit?

A. The American Academy of Pediatric Dentists recommends the first visit be within six months of the eruption of the first baby tooth. This is generally around 12 months of age.

Early intervention is much easier on you and your little one than an emergency visit for advanced baby tooth decay. Injury to the teeth and mouth are common as children progress through crawling to walking.

By establishing a relationship earlier with a pediatric dentist, you will not only have someone to call in the event of an emergency, but your child will be familiar with the pediatric dentist and the dental environment. Give yourself and your child the advantage of the best of oral health and schedule that first visit.

By Jane A. Soxman, DDS