My Baby Has a Tooth: Now What?

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Assuring great dental health begins during pregnancy and then depends on a lifetime of appropriate nutrition and oral care. There is nothing like seeing that first tooth in the mouth of your child, usually occurring around 6 months of age. It is a predictable ballet of primary tooth ("baby teeth") emergence, completed between 2-3 years of age, followed by visits from the tooth fairy and the development of a child's permanent teeth, which are designed to last a lifetime.

Tooth Eruption Chart
Upper Teeth Tooth Emerges Tooth Falls Out
Central Incisors 6-10 months of age 7-8 years of age
Lateral Incisors 8-12 months of age 8-9 years of age
Canines 16-20 months of age 11-12 years of age
First Molars 11-18 months of age 9-11 years of age
Second Molars 20-30 months of age 9-12 years of age
Lower Teeth    
Central Incisors 5-8 months of age 6-7 years of age
Lateral Incisors 7-10 months of age 7-8 years of age
Canines 16-20 months of age 9-11 years of age
First Molars 11-18 months of age 10-12 years of age
Second Molars 20-30 months of age 11-13 years of age

Research shows that having healthy teeth is more than just aesthetically nice; it is often an indicator of overall health. Poor oral health is identified as a possible risk factor for heart disease, and other vascular diseases, including coronary artery disease and stroke. So it's important to start caring for those pearly whites as early as possible.

Don't fall for the line "They're baby teeth and they're going to fall out anyway, so who cares!" Primary tooth development is important for a number of reasons. Normal development of baby teeth is needed to chew properly, which ensures appropriate nutrition. Normal development of teeth is also required for appropriate speech development as well. But baby teeth also are needed to prime the mouth and jaw for the permanent teeth to develop normally.

In infants, good oral health begins before the primary teeth erupt, with healthy gums. Using a damp clean washcloth to wipe the gums after feedings or before naps or sleep is very important. Toothpastes and toothbrushes come later. Cleaning the gums can decrease the growth of harmful bacteria which might damage the primary teeth when they are ready to erupt.

When you first see that tooth show up (usually on the bottom gum), you can start using a soft toothbrush twice a day. Toothpaste is not recommended for all infants at this point, but if you use some, use only a "smear" of fluoridated toothpaste. When the child reaches 2 years of age, use a "pea-size" amount of toothpaste. There are great "baby" toothbrushes available with large handles and small soft brush heads. Be gentle, but make sure you brush all around the tooth. You will need to continue to brush your child's teeth until he/she is old enough to hold the brush safely (even then you will need to supervise).

Current recommendations are to see a dentist when the first tooth erupts but no later than 1 year of age. The earlier you get to the dentist the better. This should ideally be with a pediatric dentist, a dentist who has additional training in the evaluation and treatment of infants and children. The first visit to the dentist is generally an educational and screening visit but has been shown to decrease the incidence of tooth decay and cavities. It can also serve to help develop lifelong oral health habits and improve preventive care. It is also during this visit that your dentist will offer recommendations regarding fluoride supplementation needs, toothpastes, and other pearls if not already done so by the pediatrician.

Taking care of your child's teeth is as important as other pediatric preventive care. Ask your pediatrician for advice about oral health early and often. Encourage your child to maintain good oral health habits, see your dentist for routine preventive visits, and your child's teeth will remain healthy and last a lifetime, just like they were designed to.

For more information about dental care in children, visit the AAPD website http://www.aapd.org.

REFERENCE:

Clinical Affairs Committee -- Infant Oral Health Subcommittee. "Guideline on Infant Oral Health Care." Pediatric Dentistry 34.5 Sept.-Oct. 2012: 148-152.


Last Editorial Review: 8/7/2013



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