A child’s first dental examination should take place by his/her first birthday. At this visit we examine your child’s teeth and soft tissue, teach you proper oral hygiene methods, perform a decay risk assessment and provide guidance with regard to diet and dental health. Don’t worry if you don’t think your child will “sit still” for this visit! This is more like a “well-baby visit” with your pediatrician and is meant to be more educational for the parents.
A child’s teeth actually start forming before birth. Normally the first tooth erupts between ages 6 to 12 months—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies. Gums may be sore and tender during the teeth process. Rubbing sore gums gently with a clean finger or with a cold, wet cloth helps soothe the gums. Cold teething rings also work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth.
Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).
Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental checkups.
Tooth decay in infants can be minimized or totally prevented by not allowing infants to breast or bottle-feed while sleeping. A bottle containing anything other than water and left in an infant’s mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for several hours. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.
Oral home care should begin as soon as the primary teeth erupt. Newly erupted incisor teeth should be wiped off with a soft cloth at least twice a day. Once the molars start to erupt, parents and/or caregivers should use a soft toddler toothbrush to cleanse the teeth twice a day – after breakfast and before bedtime. Children under school age should have teeth brushed by an adult as they do not have the manual dexterity to be able to do a good job on their own.
The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. It is the frequency of carbohydrate exposure that can be the determining factor in decay formation. Thus we recommend that children eat three good meals a day and limit their snacking to healthy foods like fresh fruit and vegetables, cheeses, nuts and popcorn. Juices, sports drinks and sodas are high in sugar and acids and should be avoided. Fluoridated water and milk are the best choices of beverage for children and teens.
