Parents have important tasks in caring for their children's health and caring their teeth is no exception. This year by year guide is to help you understand what to expect and to help you understand what you need to do.
Before you Become Pregnant.
Taking good care of yourself is the first step to having a healthy child so see your dentist regularly and maintain a good diet.
You want to make sure that any necessary treatment is completed before you become pregnant to avoid having to have work done during your pregnancy. You will much busier once you have your baby so it is almost always going to be easier to do what needs to be done now rather than later. Studies show that mothers and caregivers with cavities are more likely to have children with cavities.
Make sure that your dentist and/or hygienist is checking your gums for periodontal disease. Untreated periodontal disease can exacerbate during pregnancy and has been associated with risk of lower weight babies and premature birth.
Use fluoride toothpaste and discuss getting additional fluoride treatments at your cleaning appointments to make your teeth more resistant to caries.
During Pregnancy.
Your physician would probably want you to have your teeth cleaned during your pregnancy. Gums bleed more in response to plaque when you are pregnant so good habits and regular cleanings are very important during this time period.
Your Infant
Expect your child to get his or her lower front teeth at 5-6 months of age. The top front teeth will arrive slightly after. Most children will have all twenty primary teeth by their second birthday of slightly after. Getting teeth earlier of later than expected can be perfectly normal and doesn't correlate to anything else in your child's development. Teeth normally arrive in pairs so when you see a tooth erupt on the left the same tooth should be erupting on the right side slightly after. Pairs of lower teeth generally arrive before the corresponding pair of upper teeth.
Never put your child to sleep with a bottle in his or her mouth. This can lead your child rapidly into a state of dental decay called nursing bottle caries.
Teeth and gums should be wiped with wet gauze. When your child is old enough to grasp you can get you can buy a toothbrush shaped like a teething ring. Regular toothpaste is meant not meant to be swallowed so do not give your child fluoridated toothpaste until he or she knows how to spit.
Allow your children to watch you as you brush your teeth. This will get them excited to brush their own teeth. It will take a while for your child to master tooth brushing skills. Be sure to let them understand that you get to brush their teeth once a day too. Your children will chew them on the toothbrush so expect to replace it frequently.
Toddlers
We like to see your child for the first time right after his or her second birthday. The first visit is easy and fun for kids. We give them a “ride in the chair”, and “count their teeth”, we “shine their teeth with a special tooth brush” and paint fluoride “vitamins” on their teeth. We talk to the about the importance of brushing and eating healthy foods. We check for caries using a Diagnodent which just looks like a pen with a laser light, so there is no picking of the teeth or anything to feel apprehensive about.
A visit for a two year old child will be very brief with the parent in the room or quite possibly in the chair. Often a two year old will face their parent while sitting on their parent's lap. When it comes time for the examination the child can tip back onto the hygienist's lap and have his or her teeth checked and polished. It is a happy visit to check for early problems, get acquainted with the dental office and apply a fluoride varnish.
Children who are slightly older will sit in the chair alone. You are always welcome to come back and observe at any time from just outside the treatment room.
You may choose to take your child to a pediatric dentist where the entire office is focused around children. The children we see here are happy to be here. For most children either option is fine but it is important is that your child is comfortable with his or her dentist. If your child does feel comfortable with us I will refer him or her to a pediatric dentist. I also refer children in need of complex treatment, excessively fearful children and children in need of sedation to a pediatric dentist.
Children are naturally going to want to know everything about what is happening during their dental exams. Before we do anything we make sure that we show and tell in a way that your child will understand. If a child is apprehensive it almost always has do with the fact that the child does not understand what is going to happen. Children become more and more comfortable as they learn the routine of visiting the dentist.
5-7 year Olds
Most often the first loose tooth will be one of the lower central Incisors (biting teeth) at around six years old. Generally children will loose the four front upper baby teeth and four lower baby teeth in the first and second grades. The roots of the baby teeth are resorb due the pressure of the larger permanent teeth. When a baby tooth falls out you only see the portion of the tooth that was above the gum line. In actuality the tooth was once much longer.
The six year molars (permanent first molars) also erupt as the back of the mouth gets bigger. These often arrive unnoticed because permanent molars do not show up after a baby tooth falls out. So a six year old would have 24 teeth where a four year old will only have 20 teeth. The primary molars will be replaced by the permanent premolars. The six year molars are the largest teeth in the mouth. They have deep pits and fissures that are difficult to clean so they are the most likely teeth to get cavities. As they erupt they will absorb Fluoride ion from the saliva, drinking water and toothpaste and become harder. It is important that your child is aware of these teeth so that they can concentrate on brushing further back. The first molars should be protected with sealants at the first visit after the tooth erupts.
At seven years old is time for the first visit to the orthodontist. A panoramic radiograph will be advised to check the eruption patterns of permanent teeth and check for congenitally missing teeth. Some orthodontic procedures can be started on a child as young as seven years old other cases will start later. Often a case will be much easier if started earlier rather than later. We can refer you to more than one orthodontist who will be happy to provide a free consultation. You may prefer to have your X-rays taken here and have several copies made so that you can visit more than one orthodontist and choose the one with whom you feel most comfortable.
8-10 Year Olds
These years are the early mixed dentition. There will be a period of time when we don't expect to loose any teeth which allows for early orthodontic intervention. You might large gaps between the upper front teeth. These are usually normal and the teeth will be pushed toward the center when the permanent canine teeth erupt between 11 and 13 years old. The baby teeth still play an important role in holding spaces for the permanent teeth. If you allow a primary tooth to be lost too early, the other teeth will drift forward taking space away that the permanent teeth will need.
11-13 year Olds
Expect to see the remaining twelve baby teeth lost during the fifth through eighth grades. Often the orthodontist wants to place braces as soon as the baby teeth are gone and while he or she can take advantage of a growth spurt. If your child is into competitive sports you should consider getting a custom made mouth guard. The second molars will erupt during this period and should be sealed near the time of the first dental visit after they are fully erupted. You may also want to consider sealing the premolars as they erupt. Continued emphasis on oral hygiene is important. Adolescents are often preoccupied and tend to loose focus on brushing their teeth. It is a good time to consider an electronic toothbrush such as a Braum Oral B or a Sonicare especially if your child has braces.
Paul V. Rickard D.D.S.
(630) 851-5130