Even though your child will eventually lose the primary (baby)  teeth they are of crucial importance. They help maintain good nutrition by permitting your child to chew properly. They guide the proper eruption of permanent teeth. Premature loss of the primary  teeth can cause expensive orthodontic problems in the future.




Tooth development begins as early as the seventh week of pregnancy  and by the time the baby is born, all twenty primary teeth and tips of  the first permanent molar teeth are present in the jawbone. Therefore, it is important that expectant mother, remain healthy during her pregnancy as any illness or intake of certain drugs can have a harmful effect on these developing teeth. Tooth eruption of the primary teeth begins
around six months after birth and continues until age three. The eruption times will vary from child to child so do not worry if your child is early or late in comparison to other children.




For most children the eruption of the primary teeth (teething) occurs without problem.  However, some children do experience some discomfort during this time and can become irritable.You can reduce some of the discomfort by wiping your child's gums with a wet gauze pad (which reduces the amount of bacteria in the mouth), allowing them to bite on a cool teething ring, and administering a non aspirin analgesic
(i.e. Tylenol). Lancing or cutting the gums is not recommended.



Oral and dental hygiene should begin at birth. After each feeding and before your child goes to bed, the gums should be wiped with a soft damp gauze or wash cloth.  Your child should be positioned on the changing table or on the bed and you should be positioned behind the child's head (similar to a dentist and a patient).  This will remove the plaque (bacterial) formed on the gums and reduce the discomfort of teething.  It will also help instill good oral hygiene habits early in life. When the first teeth erupt, a small,children's soft bristle toothbrush should be used to clean them. 


A small amount of toothpaste with fluoride (the size of a pea) may be
used, as too much ingested (swallowed) fluoride can discolor the developing permanent teeth.  If your child objects to the taste or foaming of the toothpaste, just use a wet toothbrush to brush the teeth and then rub the toothpaste on the teeth with your finger.  Children should be assisted with their toothbrushing until they show adequate manual dexterity with the toothbrush.  A good indication of this is when
they can tie their own shoelaces.  Your child's teeth should be brushed
after every meal, before bedtime, and if possible,after eating sticky or sugary foods.




Nursing decay or cavities can occur when an infant falls asleep with a bottle filled with milk, formula, fruit juice,or any liquid containing sugar  It can also occur in breast fed children if they fall asleep while breast feeding since breast milk contains sugar. To prevent nursing decay clean the teeth after each feeding and if necessary put your child to sleep with a bottle filled only with water.




Some medications can cause staining and even cavities in both primary and permanent teeth.  Tetracycline will permanently discolor unerupted teeth and therefore should be avoided by expectant mothers and young children.  Other antibiotics and medications taken for asthma can stain teeth present in the child's mouth, but the stain can be easily removed by the dentist.  Iron drops and vitamins fortified with iron not only
stains teeth but can also cause cavities due to their interaction with the enamel on the teeth.  If your physician insists that your child needs an iron supplement, make sure you wipe or brush your child's teeth after each feeding.




Fluoride, a naturally occurring substance, strengthens tooth enamel (the outermost layer of a tooth) and makes it more resistant to tooth decay.  It can be found in fluoridated drinking water, fluoride containing toothpastes, and fluoride tablets, drops, or gels.  Whether or not your child needs fluoride supplements is dependent on the amount of fluoride in your community water supply, your child's drinking habits,
and your child's cavity history.  Ask your physician or dentist for their recommendations regarding your child's fluoride intake.




Sealants are thin plastic coatings that are applied to the chewing surfaces of your child's molars, protecting them from developing cavities.  The sealants fill in the grooves and pits in the molars, creating a barrier against food and bacteria that cause decay.




Finger sucking and the use of pacifiers by children under the age of three years is normal with minor effects on the child's teeth. Children are more likely to engage in these habits when they are tired or when placed in a new or threatening situation.  Most children give up these habits by age three.  Children who continue with these habits past age three have a greater likelihood of causing future orthodontic
problems.  The most important thing to remember when trying to encourage your child to discontinue the habit is that your child must want to give up the habit.

The pacifier can be given up if you explain to your child that grown up
boys and girls don't use pacifiers and they can exchange their pacifier for a "grown up" toy.  Finger sucking is a somewhat more difficult habit to give up. 

therapy is used in children who would like to stop the finger sucking
but need to be reminded when it is occurring. A sock, mitten or bandage is placed on your child's hand.  The child is assured that this is being done as a reminder not as a punishment.  A calendar is used to keep a record of the number of days your child has successfully avoided the habit. 

At the end of the agreed upon period, the child is rewarded with a gift.
If this particular therapy is not effective and yet your child still wishes to stop the habit, then an orthodontic appliance can be placed. Children past the age of six years who do not voluntarily wish to give up the habit may have an underlying psychological need to do so and should be dealt with appropriate treatment.




NormalAmerican Acadedy of Pediatric Denstistry reccommends that your child see a dentist by his or her first birthday. At that time the dentist will check your child's teeth for cavities and early signs of developmental problems. The dentist will review your child's nutrition and feeding practices such as sleeping with a bottle or prolonged nursing which can cause extensive tooth decay.  The dentist will provide
instruction on proper oral hygiene for your child and prescribe the correct regimen of fluoride.


To allay any apprehensions your child might have about going to the dentist, trying the following:

        - Play dentist to reduce the child's fears about going to have his/her teeth checked.

        - Avoid words like "hurt", "needles", or "drilling".

        - Answer questions honestly but try not to be too specific[#Marin,11,7,Normal,].


The  dentist and the staff are trained to answer questions in a non threatening manner. 



Examine your child's mouth for the following


Treatment:  Brush and floss around the tooth.  Have your child rinse his/her mouth with water.


 HOLE IN THE TOOTH (it could be a cavity or a fractured tooth)

 Treatment:  Brush and floss around the tooth.  Have your child rinse his/her mouth with water. If the cavity is large, pack it with a small piece of cotton soaked with oil of cloves.


Keep it off the tongue because it stings.

Tylenol can be used to reduced pain.

Call your dentist during office hours.

If the gum or the face is swollen,especially with fever, you  should contact your dentist or this office immediately.



AVULSED (Knocked Out) TOOTH 

Baby teeth cannot be reimplanted.  Apply pressure to the gum with gauze until bleeding has stopped.  If bleeding has not stopped within ten minutes, call your dentist or this office. If a permanent tooth is avulsed, rinse it off gently and try to replace the tooth in the tooth socket at the site of the accident.  If that is not possible, store the tooth in saliva or milk and get to a dentist as soon as possible.  The best chance for success is if the tooth is reimplanted within 30 minutes.




    - Never place aspirin directly on gums or teeth !
    - Do not let your child swallow fluoride toothpaste !
    - Do not let your child fall asleep with a bottle !


Written by Steven Schwartz, D.D.S., Fellow American Academy of Pediatric Dentistry    .