Local Dental Care - When Do Baby Start Teething

Why Fix a Baby Tooth or Child's Molar

Parents are often surprised to learn that their children have dental decay. They question the need to repair or restore the baby teeth because, after all, they are going to fall out. The following information will help you to understand the need to obtain a dental examination by a pediatric dentist and pediatric dentistry team for your little one no later than two years of age and why restoring his or her baby teeth is so very important.

• Twenty primary (baby) teeth and baby molars are usually present by three years of age. Before the teeth erupt into the mouth, the bacteria that cause tooth decay are swallowed with food or saliva. The cells on the inside of the mouth are shed and constantly replaced. When the first tooth appears, usually around five to six months of age, there is now a surface for bacteria to adhere to and multiply.
• Your baby's mouth should be wiped clean after every feeding. The bacteria that cause tooth decay (dental caries) will use the food residue to form lactic acid that will eventually break down the enamel of the teeth. The enamel on primary teeth is very thin compared to the permanent teeth. Once it begins, decay will progress rapidly. Constant exposure to sugary liquids in baby bottles or sippie cups will also result in tooth decay.
• The first sign may be a white spot (demineralization) or tiny hole in the surface of the enamel. Children will not necessarily complain of a toothache even with a large cavity. As you are cleaning the teeth, look for any signs of a dark spot or hole on each tooth. See your pediatric dentist as soon as possible. Many parents delay this first visit to the pediatric dentist because they believe the child will not cooperate for treatment.
• Tooth decay is not like a cold. It will not go away without pediatric dentistry treatment. If decay is caught early, the procedure to restore or repair the tooth may be quite simple, but delay may require more extensive treatment or even an extraction. Your pediatric dentist will guide you and your child carefully through the procedure.
• The primary teeth must be present to help guide the proper path for eruption (coming into the mouth) of the permanent teeth. The eight baby molars are usually lost between 9 and 13 years of age. If a baby molar is lost too early because of decay, the permanent molar that erupts at six years of age will have no guide for its proper position. It will move forward in the jaw and block out the space for the permanent tooth that was to later replace the baby molar.
• If a child has a toothache or pain with chewing, he will not be able to eat properly. Decayed molars may affect a child's nutrition and could result in weight loss.
• Before two and a half, the upper front primary teeth (incisors) are necessary for normal speech development. The facial appearance will also be affected by the early loss of the incisors. An appliance with denture teeth can be made to replace these teeth if necessary. Your child's age and ability to cooperate will determine whether or not this appliance can be offered by your pediatric dentist.
• Abscess of the tooth may occur if tooth decay is not treated. A bubble may form on the gum near the abscessed tooth. Pus may drain from the bubble if gentle pressure is applied. Fever, pain, and any facial swelling require immediate attention and treatment. Children who have diabetes, heart defects, or who are under medical care for other conditions should also be seen by a pediatric dentist without delay when dental problems arise. In some cases, an untreated abscess could result in a hospitalization.
• The baby molars develop deep in the bone between the roots of the primary molars. Extensive decay of a primary molar may require an extraction (removal). Extraction of a primary molar in a toddler or preschooler could cause the accidental removal of the developing permanent tooth.
• Decay can spread from one tooth to the other by direct contact or by shedding into the saliva. Children who experience decay in the primary teeth are more likely to have decay in the permanent teeth. Removing the decay and restoring the primary teeth will help to decrease the number of decay-causing bacteria in the mouth.
• The permanent teeth will have had the advantage of fluoride to strengthen the enamel and by decreasing the number of decay-causing bacteria, you can make sure you child's permanent teeth have healthy start!
• The quality of your child's life may be affected by extensive decay. Growth and weight gain, school performance, behavior, and sleep patterns may be influenced.

What Can You Do?

Brush your child's teeth until he or she is six years of age. Bedtime brushing is especially important. Floss the teeth if there are no spaces between them. Use a fluoride mouth rinse after six years of age if decay is occurring. Avoid constant snacking with crackers, chips, or soft drinks. Nothing but water should be in a baby bottle other than meal time. Restrict juices except at mealtime.

Your child should be examined by his or her pediatric dentist every six months. Do not delay treatment because you believe he or she cannot cooperate or may be fearful. As in your child's medical care, prevention is so very important. Your knowledge and efforts toward good dental care will influence your child's oral health for the rest of his or her life. Let's work together to keep that beautiful little smile a healthy one!

By Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

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.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.