AGES AND STAGES
While we have provided answers to everyday questions and some general guidance below, we recognize that every child is one-of-a-kind. If you have a question or concern about your child’s dental health please always contact us directly.
Should I Be Concerned About Dental Health During Pregnancy?
Yes! If you are pregnant or planning to become pregnant, it is important to see your dentist to make sure your teeth and gums are healthy. Hormonal changes during pregnancy can make your mouth more susceptible to disease. Your gums may bleed and become inflamed, and you may get a cavity or cavities even though you haven’t had one for a while. Proper dental care is especially important at this time because of risks associated with periodontal disease. Periodontal disease can lead to premature and low birth weight births and increase your risk for cardiovascular disease, diabetes and respiratory infection.
What is a board certified pediatric dentist and why should I choose one for my child?
By choosing a board certified pediatric dentist, you are choosing doctors who are committed to staying up to date with the latest recommendations in pediatric dentistry and practice at the highest standard or care. A board certified pediatric dentist means that not only did Dr. Katie complete an additional two years of residency training in pediatric dental care after dental school, but she also took the extra step to become board certified by the American Board of Pediatric Dentistry which requires a separate board exam and stringent continuing education requirements to maintain board status.
Baby Teeth, What’s The Big Deal?
Primary “baby” teeth are designed to function throughout the childhood years. Some of your child’s baby teeth are not lost until age 12. They help in the development of face and jaws and support facial structures and tissues (just imagine grandpa without his dentures on). They are also important for eating, and chewing food to aid in proper digestion through your child’s “growing” years. Another vital function of primary teeth is holding space and guiding the permanent teeth in place. Baby teeth have relatively thin enamel (hard outer-layer of teeth) and large pulps compared with adult teeth, and can become decayed and infected (abscessed) easily. Infected baby teeth can damage your child’s adult (permanent) tooth developing below them. Healthy, decay-free primary teeth create a healthy environment for your child’s permanent teeth and reduce the chance for tooth decay. Give your child a healthy self-esteem with a healthy, beautiful smile.
When Should My Child First Visit the Dentist?
You should bring your child in for a first dental visit by no later than their first birthday, or even by the time they get their first tooth, usually between 6 to 12 months old, as recommended by the AAPD and ADA.
What Can I Expect At My Child’s First Visit?
Your baby’s first visit is a simple visual exam to evaluate your child’s oral health and determine his/her risk for developing dental disease. A gentle prophy cleaning and fluoride application is performed by our child-friendly dental hygienist. Usually, no radiographs (X-rays) are taken at this appointment. Feel confident about your child’s care as our doctors also look for relatively common and uncommon oral conditions affecting infants that you may not have heard of, such as tongue-tie, missing teeth, abnormal teeth, inclusion cysts (Epstein’s Pearls, Bohn’s Nodules, Dental Lamina Cysts), natal teeth, iron stain and primary herpetic gingiva stomatitis. You’ll receive guidance to help you prevent potential problems and dental disease in your child’s future. Along the way, feel free to ask any questions you may have about your child’s new teeth and oral health. Let your infant become familiarized with the dental office setting in a positive way, before he/she gets bombarded with negative propaganda from older siblings, peers or even dental-phobic parents. Enjoy this primary prevention visit where dentistry is “fun”, and future dental disease can be prevented!
When Can I Expect My Child’s Pearly Whites?
When your baby was born, all 20 primary teeth were already present and developing in their jawbones. The first tooth to arrive is usually the lower front incisor, which usually erupts into the mouth at around 6 months of age, but could be earlier or later. There are even a very few babies born with lower front teeth, they are called natal teeth. Click here for a diagram of when new teeth should be arriving. http://www.mouthhealthy.org/en/az-topics/e/eruption-charts
What Should I Do When My Child Is Teething?
Be prepared to deal with your child’s first oral event – teething! It usually happens without problem and is a completely natural occurrence. During the time your infant’s teeth start to come out, your child may become restless and fretful. Your baby may also start to salivate excessively and exhibit the desire to put hands and fingers into his/her mouth. Relieve your baby with a clean teething ring, chilled teething ring, cool spoon, cold wet washcloth or toothbrush. If your infant has a fever, diarrhea, abdominal discomfort or other unusual problem, it may not be related to teething. In that case, consult your family physician as soon as possible to rule out any other common diseases and conditions of infancy.
What to do about Pacifiers or Thumb sucking?
Thumb sucking is a habit that often starts while your child is still in the womb. It is a natural instinct that helps prepare your infant for nursing. Infants and young children often use thumbs, fingers, pacifiers or other available objects to satisfy their sucking needs. This can give your child a sense of security, happiness, and relaxation that can even lull them to sleep.
Most children quit their thumb/pacifier sucking by age 3, or at least by school age (due to peer pressure). At this stage, any dental problems (tooth movement, jaw-shape changes) that have resulted from your child’s sucking habit will usually correct on its own. If your child’s thumb sucking or pacifier use continues past4 years of age (or when permanent teeth arrive), full self-correction is far less likely, and there are possibly other issues that are perpetuating the habit that should be explored. Stress may exacerbate the thumb-sucking problem, thus scolding your child for thumb sucking is not recommended. It is better to use positive reinforcement to motivate your child to quit the habit. Finding and eliminating the source of stress can also be really helpful.
Other helpful tips:
- Breastfeeding. Dr. Katie is happy to review oral hygiene practices for children who are breastfeeding beyond the eruption of the first tooth to decrease the risk of dental decay.
- Sippy Cup Beverages. Don’t let your child walk around with a sippy cup filled with anything but water for prolonged periods during the day.
- Juice. Don’t allow your child drink more than 4-6 oz. of juice per day.
- Pacifiers. Never dip a pacifier into honey or anything sweet before giving it to a baby.
- Cleaning Infant’s Gums. Wipe your infant’s gums after feedings with a clean damp cloth or baby finger brush even before the first teeth erupt.
- Brushing Teeth for Children up to 2 Years Old. Once teeth appear, brush your child’s teeth with a soft toothbrush twice a day (once after breakfast and again before bedtime). Use only fluoride-free toothpaste at this age. Most infants under age 2 have not yet learned to “spit out” after brushing, and excessive swallowing of toothpaste can damage the adult teeth that are at this time still growing under the gums. Baby can be placed with head on lap and legs facing outward to facilitate cleaning.
By 3 years of age, all of your baby’s 20 primary (baby) teeth are usually fully erupted. The first permanent tooth to erupt is also usually the lower front incisor and this occurs approximately at 6 years of age.
Girls tend to get their teeth slightly quicker than boys. There is not much difference, but those whose teeth erupt later tend to have somewhat higher resistance to dental decay.
What to do about Pacifiers or Thumb sucking?
Most children quit their thumb/pacifier sucking by age 3, or at least by school age (due to peer pressure). At this stage, any dental problems (tooth movement, jaw-shape changes) that have resulted from your child’s sucking habit will usually correct on its own. If your child’s thumb sucking or pacifier use continues past 4 years of age (or when permanent teeth arrive), full self-correction is far less likely, and there are possibly other issues that are perpetuating the habit that should be explored. Stress may exacerbate the thumb-sucking problem, thus scolding your child for thumb sucking is not recommended. It is better to use positive reinforcement to motivate your child to quit the habit. Finding and eliminating the source of stress can also be really helpful.
Other Helpful Tips for Parents:
- Brushing Teeth, Ages 2-5. As a preschooler, ages 2 to 5, you should brush your child’s teeth twice a day with fluoride toothpaste; once after breakfast and once at night right before bed. The last thing your child’s teeth should touch before going to bed and for the rest of the night is the toothpaste from their brush. Use only a pea-sized amount of toothpaste and smear it into the bristles with your finger to minimize swallowing toothpaste. Brush your preschooler for at least 1 minute each time. Teach your child to “spit out” the toothpaste after brushing as soon as possible.
- Proper Toothpaste. Dr. Katie is happy to review the recommendations specific to your child.
- Supervision during Brushing Teeth. Young children should always be supervised while brushing and taught to spit out rather than swallow toothpaste. You should brush your child’s teeth until they are 7 or 8 years old because your child lacks the manual dexterity to do so properly until that age. Brushing should last for 2 minutes. Once you have observed that your child can brush properly on their own, then let your child brush independently.
- Flossing. Flossing should begin when and where teeth are touching. Back molars usually begin touching at age 3 or 4. At this point, food can easily get trapped between the teeth and lead to cavities.
It’s Tooth Fairy time! Around age 6, your child will begin to lose primary teeth in the front and gain permanent teeth in the front and back. Once the teeth start to touch (could be around ages 3–5 too), you should floss your child’s teeth (flossers work well). Children typically don’t brush along the gum line or the back teeth, so pay special attention to these problem areas. However, almost 90% of cavities in permanent molars occur in the grooves. Dental sealants are a great way to protect the permanent molars and other teeth at risk of getting decay. They are a white coating that is placed over the grooves of the teeth to prevent plaque and food from getting stuck and causing cavities.
Up until your child is 7 years old, you should assist him/her while brushing because children often lack the motor skills to do it right. After that, observe your child’s technique and assist where necessary until he/she can effectively brush without supervision. Brush your teeth at the same time to help teach your child to brush by mimicking you. Although a regular children’s brush is perfectly fine for cleaning teeth, sometimes a children’s electric brush can make the experience more fun for your child, increasing motivation to brush. Once again, tooth brushing should happen twice a day – once in the morning after breakfast and right before bedtime. Brushing after snacks is ideal too. At age 6 and above, brushing should take 2 minutes each time.
When brushing your teeth and your child’s teeth, angle the toothbrush at a 45˚ angle towards the gum-line and use small circular strokes. Brush the front of the teeth, behind the teeth and the chewing surfaces. Don’t forget to brush the tongue to remove potential bad breath bacteria and other harmful microorganisms. Take 2 full minutes to brush properly.
During these ages and older, children become more active with sports, and dental injuries are very common. Ask our team about mouth guards to protect your child’s teeth during sports.
By 12-13 years of age, all of the baby teeth are usually gone, and all of the permanent “adult” teeth are in except for the 3rd molars (wisdom teeth), which most often arrive by age 21. As teens grow more independent and have further control of their diet and habits, it is common to see an increase in cavities. Soda, candy and a lack of consistent or effective brushing and flossing is typically the culprit. Self –awareness also becomes more prominent and your teen may notice if they have discolored teeth or crooked teeth. Talk with our team regarding options for both braces and whitening.
Additionally, we take a panoramic X-ray of your child’s jaws to check the development of third molars, and when indicated will refer your child to an oral surgeon for removal. Be sure to let our office know if your child is experiencing pain from their wisdom teeth. Unfortunately, substance abuse may begin during this stage (90% of adult smokers began before age 19), so monitor your child for signs of alcohol or tobacco use. Finally, eating disorders are also common, and in addition to many other serious issues, can damage the teeth. Please talk with our office regarding assistance with any of these common issues of adolescence.
During these ages, children become more active with sports, and dental injuries are very common. Ask our team about mouth guards to protect your child’s teeth during sports.
If necessary, your child can utilize our numerous, safe sedation options. Our team has extensive training in multiple options.
Developing bad bites can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.
Preventative dentistry relies on good oral hygiene and regular dental care and is important throughout your life…whatever your age.
Learn helpful tips for what to do when assessing your child’s dental emergency.
Don’t let injury or decay stand in the way of your child’s beautiful smile. Let restorative dentistry renew your child’s self-confidence and help prevent bigger, more painful, and costly repairs in the future.
If your child has special health care needs, trust that your team at Carmel Pediatric Dentistry makes sure to review your child’s condition and custom tailors the delivery of care to fit your child’s specific needs.