Dr. Louisa Piek is a practicing dentist and mom of three children – ages 9, 7 and 5. She very kindly agreed to answer some questions about kids’ teeth and dental health for us all. The following very relevant information on tooth development and dental care for children was compiled and written by Dr. Piek.
At what age should my child visit the dentist for the first time?
The first dental visit is mostly about getting kids used to the dentist’s chair and educating parents about how to care for baby’s teeth. If your child has moved from the bottle to cup and doesn’t snack or drink in the middle of the night, you get a one-year pass, until age 2. When your child is between ages 4 and 6, expect your dentist to take a first set of X-rays to check for cavities lurking between the teeth.
At the age 1 dental visit the dentist will discuss the following with parents:
How to care for an infant’s or toddler’s mouth
Proper use of fluoride
Oral habits, including finger and thumb sucking
Ways to prevent accidents that could damage the face and teeth
Teething and milestones of development
The link between diet and oral health
After this first visit, the dentist will suggest a schedule of follow-up visits. In the past, dentists typically called for visits every six months. Now, the schedule may vary according to each child’s needs and risks.
What influence do dental cavities have on my child’s development?
Failure to identify and prevent dental disease has significant and costly long-term negative effects. Tooth decay in children is painful, just as it is in adults. Unless treated in its early stages, dental decay becomes irreversible. Tooth decay, untreated, will lead to infection of the teeth, gums and tooth loss. Tooth decay compromises the child’s ability to eat well and sleep well. The unaesthetic appearance could also compromise the child’s self-esteem and social development.
Further, many children miss school as a result of tooth decay. Children with poor oral health were more likely to perform poorly in school due to pain, lack of sleep and days absent from school.
Stages of tooth development
The following chart shows when your child’s primary teeth (also called baby teeth or deciduous teeth) should erupt and fall out. Eruption times vary from child to child. As seen from the chart, the first teeth begin to break through the gums at about 6 months of age.
Usually, the first two teeth to erupt are the two bottom central incisors (the two bottom front teeth). Next, the top four front teeth emerge. After that, other teeth slowly begin to fill in, usually in pairs — one each side of the upper or lower jaw — until all 20 teeth (10 in the upper jaw and 10 in the lower jaw) have come in by the time the child is 2 ½ to 3 years old. The complete set of primary teeth is in the mouth from the age of 2 ½ to 3 years of age to 6 to 7 years of age.
|Upper teeth||When tooth emerges||When tooth falls out|
|Central incisor (front tooth)||8 to 12 months||6 to 7 years|
|Lateral incisor (next to front)||9 to 13 months||7 to 8 years|
|Canine (eye tooth)||16 to 22 months||10 to 12 years|
|First molar||13 to 19 months||9 to 11 years|
|Second molar||25 to 33 months||10 to 12 years|
|Second molar||23 to 31 months||10 to 12 years|
|First molar||14 to 18 months||9 to 11 years|
|Canine (cuspid)||17 to 23 months||9 to 12 years|
|Lateral incisor||10 to 16 months||7 to 8 years|
|Central Incisor||6 to 10 months||6 to 7 years|
Dietary advice for parents
Tooth decay happens when plaque comes into contact with sugar in the mouth, causing acid to attack the teeth.
Foods that contain sugars of any kind can contribute to tooth decay. To control the amount of sugar your child eats, read the nutrition facts and ingredient labels on foods and beverages and choose options that are lowest in sugar. Common sources of sugar in the diet include soft drinks, sweets, cookies and pastries.
Limit the number of snacks your child eats. If they do snack, choose something that is healthy like fruit or vegetables or a piece of cheese. Foods that are eaten as part of a meal cause less harm to teeth than eating lots of snacks throughout the day, because more saliva is released during a meal. Saliva helps wash foods from the mouth and lessens the effects of acids, which can harm teeth and cause cavities.
Preschool, school age children and teenagers
~Suggested snacks for in between meals are fruit, crisp raw vegetables, sandwiches, variety of breads, yogurt, cheese, plain popcorn and scones.
~Cereals such as porridge and shredded wheat are excellent energy providers, but avoid the sugarcoated types. In general, the sugar and salt content of breakfast cereals should be checked as some breakfast cereals are high in one or the other or both.
~Milk and water are suitable to drink between meals.
~Pure juices, fruit squashes and smoothies should be consumed only at meal times.
~Drinks containing added sugars, including probiotic and yogurt type drinks, should be consumed only at meal times.
~Regular intake of carbonated drinks, including sparkling water, can lead to enamel erosion of the teeth and should be avoided.
Tooth brushing advice
~Start brushing your baby’s teeth with fluoride toothpaste as soon as the first baby tooth breaks through (usually at around six months, but it can be earlier or later). It’s important to use a fluoride paste, as this helps to prevent and control tooth decay.
~There’s no need to buy special “children’s toothpaste” brands. In fact, some of them don’t have enough fluoride in them to help prevent tooth decay.
~Children of all ages can use family toothpaste, as long as it contains 1,350-1,500 parts per million (ppm) fluoride. Check the toothpaste packet if you’re not sure, or ask your dentist.
~Children under the age of six who don’t have tooth decay can use a lower-strength toothpaste, but make sure it contains at least 1,000 ppm fluoride.
~Make sure children don’t eat or lick toothpaste from the tube.
~Below the age of three years, children should use just a smear of toothpaste.
~Children aged three to six should use a pea-sized blob of toothpaste.
Tooth brushing tips
~Brush your child’s teeth for about two minutes twice a day: Once just before bedtime and at least one other time during the day.
~Encourage them to spit out excess toothpaste, but not to rinse with lots of water. Rinsing with water after tooth brushing will wash away the fluoride and make it less effective.
~Supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it. From the age of seven or eight, they should be able to brush their own teeth, but it’s still a good idea to watch them now and again to make sure they brush properly and for about two minutes.
How to help children brush their teeth properly
~Guide your child’s hand so they can feel the correct movement.
~Use a mirror to help your child see exactly where the brush is cleaning their teeth.
~Make tooth brushing as fun as possible by using an egg timer to time it for about two minutes.
~Don’t let children run around with a toothbrush in their mouth, as they may have an accident and hurt themselves.
Finally: It is a very good idea to discuss preventative dental treatment options with your dentist. Fissure sealants are often placed on the first adult molars at between ages 6-8. These sealants can prevent decay. Your own dentist can give you good advice here.
Sand & Glitter would like to thank Dr. Louisa Piek for taking time out of her busy schedule to provide this very helpful information. Knowledge empowers parents.
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