Early Dental Care

Early Dental CareTeething

A child’s first primary tooth erupts between 6-12 months of age. Some children will experience no discomfort with eruption, while others may encounter mild to moderate discomfort. Gums may be sore and tender, the child may be irritable. Children may also have a change in their eating patterns. If the child experiences general malaise or fever, we recommend seeing their pediatrician as these are not specific events associated with teething. To help alleviate discomfort with teething, rubbing the gums gently with a clean finger, toast, a cold spoon or teething ring may help. Avoid teething biscuits as they may contain sugar.

Baby Bottle Tooth Decay (Early Childhood Caries)

Baby bottle tooth decay is a serious form of decay among young children. This condition is caused by frequent and extended exposure of an infant’s teeth to liquids that contain sugar (milk, breast milk, formula, fruit juice and other sweetened drinks).

It is never a good idea to put a baby to bed or down for a nap with a bottle containing anything other than water as this can cause serious and rapid tooth decay. Sugar will pool around the child’s teeth, giving plaque and bacteria the opportunity to produce acids that attack tooth enamel.

A baby’s bedtime bottle should contain only water. If your child has trouble falling asleep without his or her usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.

We advise that after each feeding, you wipe the baby’s gums and teeth with a damp washcloth, a square of gauze or a “spiffy” to remove the plaque.

Eruption of Your Child’s Teeth

Did you know that children’s teeth begin forming before birth? As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed by the upper central incisors. Although all 20 primary teeth usually appear by a child’s third birthday, the pace and order of tooth eruption will differ between children.

Permanent teeth should begin appearing around age 6, starting with the first molars and lower central incisors. A person continues to get new teeth until approximately age 21. Adults have a totally of 28 permanent teeth, or up to 32 including the third molars (wisdom teeth).


Fluoride has been shown to be beneficial to teeth. Yet, too little or too much fluoride can be detrimental to the teeth. Excessive fluoride ingestion by preschool-aged children can lead to chalky white buildup or the brown discoloration of the permanent teeth. Little or no fluoride won’t strengthen the teeth and make them better able to resist cavities. To prevent your child from receiving too much fluoride, you should be aware of the sources from which they get it.

  • Young children may not be able to spit out fluoride-containing toothpaste when brushing. As a result, these children may ingest an excessive amount of fluoride during tooth brushing.
  • Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age.
  • Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juice, and juice drinks manufactured in cities that have water supplies containing flouride. Please read the label or contact the manufacturer.

Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:

  • Use no fluoridated toothpaste on a child younger than 2 years.
  • Use only a small amount of toothpaste on the brush.
  • Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
  • Check the levels of fluoride in your drinking water.

Does Your Child Grind His Teeth At Night? (Bruxism)

Parents are often concerned about their children grinding their teeth at night (Bruxism). Parents may notice noise created by the child grinding on their teeth during sleep or that a child’s teeth are getting shorter and worn down. Causes can include:

  • Stress such as new environments, divorce, changes at school, etc.
  • Inner ear pressure

The majority of cases of pediatric bruxism do not require any treatment. In the cases of excessive attrition of the teeth, night guards may need to be worn. Parents wishing to avoid night guards due to the choking hazard should be aware that most children outgrow bruxism. The grinding tends to lessen between the ages 6-9 and children tend to stop grinding their teeth between ages 9-12.

Thumb Sucking

Sucking is a natural reflex and infants and young children suck their thumbs, fingers, pacifiers and other objects to help them feel secure.

Children usually stop sucking their thumbs between the ages of 2 and 4. Thumb sucking that persists beyond the eruption of the permanent teeth, however, can cause problems with proper growth and tooth alignment. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs as the intensity of the sucking can determine the damage done.

Pacifiers are no substitute for thumb sucking as they can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit.

A few suggestions to help your child get through thumb sucking:

  • Praise a child when they are not sucking their thumb and reward them when they resist thumb sucking in difficult times, such as when they are away from their parents.
  • Limit a child’s anxiety.
  • Pediatric Dentists can talk to children about the negative aspects of thumb sucking and encourage them not to do it.
  • Bandage the child’s thumb
  • Put a sock over the child’s hand at night.

Care of Your Child’s Teeth

Begin brushing your child’s teeth daily as the child’s first tooth erupts. Begin using a small dab of fluoride toothpaste when the child is old enough not to swallow it. By age 4 or 5, children should brush their own teeth twice a day and spit out the excess toothpaste. We recommend supervising your child to make sure they are doing a good job.

Proper brushing will remove plaque from the inner, outer and chewing surfaces of the teeth.

Steps for teaching a child to brush properly:

  1. Hold the toothbrush at a 45 degree angle.
  2. Place the toothbrush along the gum line
  3. Use a circular motion to brush the outer surfaces of the upper and lower teeth.
  4. Open your mouth and repeat the same method on the inside and chewing surfaces of the teeth.
  5. Brush your tongue!

Flossing is important because it can remove plaque between the teeth where your toothbrush can’t reach. As soon as a child has two teeth the touch, they need to start flossing. A parent should floss the child’s teeth until he or she can do it alone.

Steps for teaching a child to floss properly:

  1. Use approximately 18 inches of floss. Wind most of it around your middle fingers on both hands.
  2. Use your thumbs and forefingers to hold the floss lightly and use a gentle, back-and-forth motion to guide the floss between your teeth.
  3. Curve the floss and slide it into the space between the gum and the tooth until you feel resistance from the gums.
  4. Scrape the floss gently against the side of the tooth.
  5. Repeat these same steps for each tooth.