Infants
The first dental appointment for children should be after the child turns 6 months of age and before their first birthday. The reason for such an early appointment is that the primary (first) teeth should have started to erupt and this is the time to detect anything of concern. Some of the issues that could cause problems are thumb sucking and baby bottle tooth decay.
Thumb-Sucking
Children find comfort in sucking a thumb, finger or pacifier. This is normal. However, if the infant or child is doing this often, it can cause malformed teeth and an irregular bite pattern.
Thumb sucking engages powerful muscles that can alter the shape of the palate. This, in turn, can affect the position of the teeth and lips. If the child continues to suck their thumb or fingers after the four anterior teeth have erupted, conditions can worsen and it may require surgery to be corrected.
It is recommended that if by 4 years of age, a child is still sucking their thumb or fingers you should seek the advice of your dental professional.
Baby bottle tooth decay
Baby bottle decay is caused by sugars found in breast milk, formula and juices. Natural sugars found in milk and 100% fruit juice will have the same effect as refined sugar on the teeth. When an infant drinks from their bottle, the bacteria in their mouth will mix with the sugars from the drink. This mixture creates a mild acid that will attack the enamel of their teeth and form cavities. We can control this damage by managing how much sugar is given to the infant and controlling how long it stays there. Children that go to bed with a bottle of milk or juice are at an increased risk of decay. The sugars will pool in their saliva and have all night to work on destroying the outer layer (enamel) of the teeth. It is also risky to give a child juice between meals as this is just a continuous coating of sugar on the teeth throughout the day. To avoid baby bottle tooth decay, do not allow a baby to nurse on a bottle of milk or juice before going to sleep. Water is also the best choice to give between meals. Do not dip pacifiers into sweet substances and, as early as possible, teach your child to drink from a cup. Baby bottle tooth decay can interfere with the proper formation of permanent teeth if it is left untreated.
Teething
Babies can begin teething as early as three to four months of age. This is a period where the teeth begin to sequentially erupt. The pain that children feel varies. Some babies can become irritable while others donʼt seem to be bothered at all. Symptoms of teething are swollen gums, drooling, crankiness, difficulty sleeping, and loss of appetite. You can help to alleviate some of the symptoms of teething by gently massaging your child’s gums with a clean finger, a small cool spoon or a wet gauze pad. A teething ring may also help. The ADA (American Dental Association) and CDA (Canadian Dental Association) also report that if your child shows rashes, diarrhea and/or fever call your physician. These are NOT normal symptoms of teething.
Primary and Permanent Teeth
Most children at three years of age have 20 ʻprimaryʼ teeth. These teeth eventually get replaced by permanent teeth by the time the child turns 12 years of age. Somewhere between the age of 17-31, the 4 permanent molars, also known as wisdom teeth, may emerge.
It is very important that a child’s primary teeth are kept healthy because they will determine the placement of the permanent teeth. If the primary teeth become diseased or do not properly erupt it can alter the growth pattern of the permanent teeth, leading to overcrowding.
Brushing
Cleaning your baby’s mouth before teeth erupt
It is important to start cleaning a child’s mouth before they even have any teeth. This is essential for two reasons. It develops a habit of keeping the mouth clean. Provides a clean and healthy environment for the primary teeth to erupt. The idea is to wipe all the gums. Firstly, with the baby in a comfortable lying position, make sure you can see clearly into the baby’s mouth. With a clean damp washcloth over your finger, wipe the babies gums. You can also buy special infant toothbrushes that fit right over your finger. Do not use toothpaste as the baby may swallow it. Once the teeth have grown through the gums you can clean the teeth with a child-size, soft-bristled toothbrush and a pea size amount of toothpaste. It is important to teach the child to spit out the paste when finished. It is recommended to avoid toothpaste containing fluoride on children under the age of two.
Proper technique for brushing your child’s primary teeth
Use a soft-bristled toothbrush with rounded edges. Make sure the toothbrush allows you to reach all the way to the back of the mouth. Hold your toothbrush at a 45-degree angle to your teeth. The bristles of the brush should be directed toward the gum line. Brush all three surfaces of the teeth, the chewing surface, the cheek side, and the tongue side. Brushing your teeth should take a minimum of 2 minutes to complete. Most people will miss the same spots repeatedly. To avoid this, change up your usual brushing pattern. The Canadian Dental Association and the American Dental Association recommend that you replace your toothbrush every three months.
Toothaches
Toothaches can be common in young children. Sometimes, toothaches are caused by erupting teeth, but they also could indicate a serious problem.
You can safely relieve a small child’s toothache without the aid of medication by rinsing the mouth with a solution of warm water and table salt. If the pain doesn’t subside, acetaminophen may be used. If such medications don’t help, contact your dentist immediately.
Fluoride
Fluoride is a mineral found in food and most drinking water systems. Fluoride is important to our oral health because it makes our teeth more resistant to decay. If your drinking water does not have acceptable levels of fluoride there are supplements that your dentist could recommend. A fluoride toothpaste sometimes is not enough. Too much fluoride can also pose a problem. Dental fluorosis, a condition that can affect the look of the tooth is the result when too high an amount of fluoride is ingested in early childhood.
Toothaches
Young children often experience toothache. This could be a result of erupting teeth. You can help to relieve a child’s toothache by rinsing the mouth with a solution of warm water and table salt. If there is no relief using this solution you can also give acetaminophen.
If the Acetaminophen does not alleviate the pain, there could be a more serious condition and you should contact the dentist immediately.
Injuries
Most children who have trauma to their mouth, jaws and teeth are due to accidental play, whether it is playing sports or putting foreign objects in their mouth. In order to prevent injury to the jaw, teeth, lips and gums it is strongly recommended that during playtime children are adequately supervised and that children wear mouth guards while participating in sports. Mouth Guards are small and fit securely around the child’s teeth and prevent injury to the whole mouth. Children’s mouth guards are small and when first inserted into the mouth they mould to the child’s teeth. In the case of a tooth that is avulsed (knocked out), hold the tooth by the crown and try to re-implant it into the mouth. Never touch the tooth by the root. Then bite on a clean cloth or gauze to hold the tooth in place and go directly to your dental office. If the tooth cannot be put back into the socket, submerge the tooth in saline, cold milk or the victim’s own saliva and go to the dental office. This is an emergency visit and you should not have to wait long to be seen. The longer you wait, the less likely it is that the tooth can be re-implanted into the socket. When there is an injury in your mouth make sure you rinse your mouth to remove any blood or particles. In order to control the swelling, place a cold cloth or cold compress on the cheek near the injury site. If the tooth is fractured, do a warm water rinse and apply a cold pack or compress. The cold pack along with Ibuprofen will help to control the swelling.
To repair a fractured tooth the dentist will first determine if the fracture is minor or severe and if the nerve is exposed or damaged. In less severe cases, it could be as simple as just adding some filling material to restore the look of the tooth and smooth out any sharp edges. In a severe case, the dentist will have to decide if the tooth can be saved. If a child has a primary (baby) tooth that is loose it is often just a case of the roots dissolving as the permanent teeth come in. These teeth usually come out on their own or when a child bites into something hard, such as an apple. If the tooth is very loose you can encourage the child to wiggle it until it falls out. Never yank the tooth as it may break and become infected. If the primary tooth is loose due to injury, apply a cold compress to the mouth and gums to lessen the pain and swelling. Contact your dentist immediately. The dentist will have to take an x-ray to determine the extent of the damage. Braces and retainers can sometimes cause irritation. Placing a small piece of orthodontic wax, gauze or cotton over the wire tip can provide relief. If a piece of the retainer or braces is stuck into the soft tissue, do not detach it yourself. Contact the dental office immediately.
Sealants
The premolar and molar teeth are the largest teeth in the mouth. They have a larger surface area and have several grooves and pits on the chewing surface. These grooves can be deep and are a prime place for plaque and acid to build up and cause cavities. It is for this reason that many dentists will suggest applying sealants, especially on young children. A sealant is a coating that is applied to the chewing surface of the teeth creating a smooth surface to act as a barricade protecting it from decay.