Baby Teeth

Babies, Teething and Development Schedules

Teething, the process during which the teeth work their way through the jawbone and the gums, takes about two to three years from the first drool to a full set of pearly whites. Although a few babies are born with a tooth or two and others none until they are a year old, the first tooth usually erupts around six months of age. As early as four months, babies may begin showing symptoms, such as drooling, fussing, and chewing on anything they can grab.
The best way to deal with the discomfort of erupting primary teeth is to let the baby chew on something, such as a hard rubber ring or other firm teething object, available in many styles. The water-filled rings, which go in the refrigerator for cooling, can be very soothing. Avoid brittle toys, which can break and may cause choking. Always avoid necklace style teething rings and pacifiers. Ice chips wrapped and tied in a piece of cloth can be satisfying. Gently rubbing the gums with a finger can also ease discomfort.
The sequence of tooth eruption usually follows a pattern. The two lower central incisors are typically the first to appear. Arriving a month or two later are the two upper central incisors and the four lateral incisors (beside the centrals). By the baby’s first birthday, there are often four upper and four lower front teeth. Shortly after 12 months of age, the first four molars begin to erupt. By age two to three, the four canines (pointed teeth) and second molars will show up. A full set of primary teeth includes 20 teeth. Plan accordingly for the tooth fairy.
Around the age of six, the permanent teeth start to appear, beginning with the first molars. These permanent molars erupt behind the primary second molars, thus no baby teeth will be lost for these teeth. The permanent incisors and canines will come in as the primary teeth roots reabsorb and come out. This process occurs between ages 6 to 12. The roots of the primary molars follow the same process (ages 10-12), making space for the permanent premolars or bicuspids. The second permanent molars follow (ages 11-14), again with no loss of any teeth for these to erupt. The last teeth (third molars or wisdom teeth) to develop may or may not erupt, between the ages of 15 to 25.

Care and Feeding

Decay is the biggest threat to the health of children’s teeth. If good oral hygiene is not maintained, then plaque will form and harbor bacteria. Some of these bacteria feed off sugars and give off acid that erodes tooth enamel, causing cavities. Most parents know to avoid giving their children sweet drinks, juices and snacks, such as candy, “suckers”, cookies and cake. These items are all loaded with sugar and commonly believed to be the major cause of cavities. There are other sources of sugar that parents may not have been made aware. Sticky foods like dried fruit and starches, such as breads, crackers and chips, can be as bad or worse because they take longer than sugars to clear the mouth. Nursing decay occurs when babies are regularly put to bed with a bottle of juice, formula or milk after teeth have erupted. It is important to clean out a baby’s mouth after feeding and give them a drink of water from a bottle or cup before sleep.
Regardless of what a child eats or drinks, plaque forms and needs to be cleaned away regularly as soon as the first tooth erupts. Use a soft brush and only a small amount of non-fluoride toothpaste for babies and young children. Clean the teeth after every meal and before bedtime. A young child may be eager to brush their own teeth, but still needs help until around the age of six.
Fluoride is very effective in preventing cavities. Fluoridated water reduces the incidence of decay by 50 percent or more. By testing the main source of water for the child, it may be determined that supplemental fluoride tablets be given. Test kits are available through local health departments. Fluoride toothpaste can be used once the child can consciously spit out the toothpaste and avoid swallowing. More is not better when it comes to fluoride. The ideal concentration is one part fluoride per one million parts water, or 1ppm fluoride. If fluoride is ingested at higher levels, such as swallowing toothpaste, fluorosis may occur. Most cases of fluorosis are mild and will appear as tiny white specks or streaks that are often unnoticeable. However, in severe cases of enamel fluorosis, the appearance of the teeth is marred by discoloration or brown markings. The enamel may be pitted, rough, and hard to clean. Cosmetic dental treatments can mask the effects of fluorosis'
Around age 3 should be the first trip to the dentist. By visiting the dentist early on, your child will become comfortable with having check-ups before any problems develop. You want your child to have those teeth for a long time, so it’s definitely worth the effort and expense to take care of them from the very beginning.