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Children’s teeth

Infants
Your baby’s first dental appointment should take place around their first birthday. This is generally when the first tooth comes in. Early examination and preventive care will protect your child’s smile now and in the future. Remember that children with healthy teeth can chew food more easily and speak more clearly.

Even in infancy dental problems can occur including baby bottle-related tooth decay, teething irritations, gum disease and prolonged thumb-sucking. Many people don’t realise that decay can set in from putting a child to bed with a bottle. You should also avoid using a bottle as a pacifier. Don’t let them walk around with it. Decay can even occur when your baby nurses continuously from the breast. Night time breast feeding should be avoided once the first tooth has come in.

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Baby bottle tooth decay is caused by exposing your child’s teeth to liquids containing sugars. It can destroy the teeth if left untreated. Culprits include milk, formula, fruit juice, sodas, and other sweet drinks. The sugars in these liquids pool around your baby’s teeth and gums, feeding the bacteria that live in plaque. Pacifiers dipped in honey, sugar, or syrup are just invitations to tooth decay.

Encouraging your child to drink from a cup as they approach their first birthday can ward off baby bottle tooth decay. Drinking juice from a bottle should be avoided. When juice is offered, it should be in a cup.

Children should be weaned from the bottle as soon as they can drink from a cup, but the bottle should not be taken away too soon. The sucking motion aids in the development of facial muscles and the tongue.

Brushing young teeth
Baby’s gums and any baby teeth should be cleaned daily using a soft infant toothbrush and water. Do not use a fluoride-containing tooth paste before the age of two because this can cause enamel fluorosis.

When they are old enough for fluoride, no more than a pea-sized dollop should be used and you must train your children to spit out, not swallow, the toothpaste. They must be taught to thoroughly rinse after brushing, again so that they can avoid taking in too much fluoride. Often, if too much fluoride is swallowed, your child will complain of a stomach ache.

Fluoride
Too much fluoride when young results in staining of the teeth called enamel fluorosis. However, a small amount of fluoride is needed to strengthen teeth and make them resistant to decay. Most children get enough fluoride from toothpaste and fluoridated water supplies. If you are not sure that your child is getting enough fluoride, talk to your dentist.

For more information, see the page on fluoride.

Diet
Make sure your child has a balanced daily diet, including plenty of fresh fruit and vegetables, combined with adequate quantities of food rich in protein and complex carbohydrates. Dairy products contain calcium which helps to build and strengthen teeth. Limiting sugary foods and drinks will help to protect your child’s teeth from decay.

Teething
When babies are teething, usually between the ages of four months and two and a half years, they often have sore and tender gums. The pain can usually be soothed by gently rubbing the baby’s gums with a small, cool spoon, clean finger, or wet gauze. A clean teething ring for the baby to chew on may also be helpful.

Pacifiers and thumb sucking
Thumb sucking after the age of four should be discouraged because it can cause teeth to become crowded and crooked, and could lead to bite problems. In some cases, the upper front teeth may tip towards the lip or not come in properly. A mouth appliance may be effective on children who are still sucking their thumbs or fingers when their permanent teeth arrive.

Toothache
If your child has a toothache, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Paracetamol is effective for pain, but avoid placing aspirin on the teeth and gums.

Injuries
Mouthguards are soft, plastic devices that fit over the front of your child’s mouth, protecting their teeth, lips, cheeks and gums from sports-related injuries. To be effective, the mouthguard must be a well-fitting one made by your dentist. (See the page on mouthguards)

If your child loses a tooth through injury, stay calm. If you can locate the tooth, hold it by the crown rather than the root, and carefully try to reinsert it in the socket after rinsing it thoroughly with clean water. Do not scrub the root because it has vital cells attached. If you are unable to replace the tooth easily in its socket, place it in a container with a lid and use low-fat milk, saline solution or saliva to cover it. Get to a dentist or the emergency room as soon as possible

Sealants
One modern advance that every parent should take advantage of is sealants. Best applied as soon as permanent teeth arrive, sealants fill in the crevices on the chewing surfaces of teeth, effectively protecting teeth from cavities for many years.

For more information, see the page on sealants.