• Most children get their lower front teeth by the age of six to eight months.
• These are followed by the two upper front teeth. The rest of the teeth should appear within the next 18 to 24 months.
• At two to three years, all 20 of your child’s baby teeth should have erupted.
• The first adult teeth usually start to erupt by around age six.
• These include molars behind the baby teeth and the bottom front teeth.
• Most children will continue with this process until around the age of 14.
• Since all children are unique, the timing of eruption may vary from child to child.
• Variations in the time frame of eruption and tooth loss are common.
• If you have any concerns, feel free to talk to our office.

Ask your pediatric dentist to evaluate your child's drinking water fluoride levels. If the fluoride intake is insufficient, supplemental fluoride may be recommended. Fluoride can be obtained from other sources in your child's diet, so during your child's visit, fluoride intake will be discussed.

Formerly known as baby bottle tooth decay or nursing caries, Early Childhood Caries results from excessive consumption of sugary liquids. Severe cases are usually caused by putting a child to bed with a bottle of juice, soda, or milk, or allowing them to "graze" with a sippy cup. Another major cause is excessive breast feeding following the introduction of solids into their diet. Early Childhood Caries can lead to tooth decay and the need for significant dental treatment, and if untreated, may also harm adult teeth.

By following the guidelines listed below, you can prevent baby bottle tooth decay from occurring.

• Help your child start learning to drink from a regular cup by their first birthday.
• If your child “grazes,” only allow water in any bottles or sippy cups used.
• Clean your baby’s gums with a fresh gauze pad after each feeding.
• Begin brushing as soon as you see the first tooth.
• Never give your child a pacifier coated in sugar or dipped in honey.
• The bacteria that causes caries is transmissible, avoid sharing drinks or kissing your baby close to the mouth, especially if you have not seen your dentist for regular appointments.

• Before your child receives his or her first tooth, clean the gums after each feeding with a soft, damp washcloth
• As soon as the first tooth erupts, you can begin using a toothbrush. Be sure to use a brush with soft bristles and a small head.
• You can purchase toothbrushes specifically designed for infants at your local department store.
• Regular tooth brushing will remove plaque and bacteria that can lead to decay. Use the toothbrush twice a day at least once before bed.

For babies with their first tooth, use a small smear of fluoridated toothpaste. At age three, increase to a pea-sized dollop, and supervise brushing to ensure appropriate amounts. Excessive fluoride can cause tooth staining, so be cautious.

Certain bacteria live in the mouth of each person. When these bacteria come in contact with sugary food, they produce acids which dissolve the enamel of the teeth. The resulting holes in the teeth are called cavities.

Children who are actively involved in sports should wear a mouth guard. If your child plays a high-intensity sport such as basketball, hockey or football, ask us about obtaining a custom mouth guard to protect the lips, teeth and gums from injury. Make sure your child always wears a helmet when riding a bicycle to avoid damage to the head and oral structures.

Although many children suck their thumbs or fingers as infants, most grow out of the habit by the age of three without causing permanent damage. Pacifiers should be discontinued by the age of two. A pacifier habit is easier to discontinue than a thumb-sucking habit. If your pediatric dentist notices damage occurring to the teeth or oral structures, make every effort to help your child stop sucking his or her thumb or fingers by the age of three or sooner. If your child continues sucking after adult teeth have come in, we may recommend a retainer appliance to help your child break the habit.

Baby teeth serve multiple functions. Several of these are listed below.

• Baby teeth help the child chew his or her food well and to eat a balanced diet. Children whose baby teeth are suffering from multiple cavities may become underweight from an inability to eat a healthy diet. Cavities can cause toothaches that prevent a child from chewing certain foods.
• Fillings are important to repair cavities in baby teeth and help protect the development of the adult teeth below. Cavities that are left unattended will eventually reach the core of the tooth and destroy the nerve. The nerve will become inflamed and will eventually die. The result is a dental abscess that often results in the loss of the tooth and can damage the developing adult tooth below. The most severe cases will require emergency hospitalization. To help prevent abscesses, cavities in baby teeth should be cared for promptly.
• To help protect a child's self-esteem, it's important to give them the gift of a beautiful smile. Missing teeth or teeth with spots can have a negative impact on a child's outlook in life.
• Baby teeth serve as placeholders for permanent teeth. Children who lose teeth prematurely are at risk of having their adult teeth come in crooked or misplaced.
• General health in all people is influenced by the heath of the teeth and gums. Thus, it is very important to maintain a healthy oral structure in your child's mouth.

Your child should visit the dentist once every six months to prevent the formation of cavities and other dental problems. We may recommend more frequent visits if your child’s oral health requires more attention than average.

The single most important thing you can do as a parent to prepare your child for this first visit is to have a positive attitude. Children are remarkably adept at picking up attitudes from those around them and will tune in if you are nervous. If you make negative comments about dentists or dental visits in the child’s hearing, your child will anticipate a negative experience.

To help prepare your child for the visit, show your child a picture of the office and the dentist on the office’s website. Tell your child how important it is to have healthy teeth and that the dentist will help you in this goal. Consider a library visit to check out some children’s books on teeth, dentists and good dental care. If you wish, you can call us for suggestions. Remember that our pediatric dentist is specially trained in relieving the fears and anxieties of patients and that our staff is equally experienced at putting children at ease.

Sealants fill in the deep crevices on the chewing surfaces of each tooth. They block food particles from coming in contact with the teeth and causing cavities. Sealants are simple to apply and are an effective method of cavity prevention. We recommend sealants as a safe and effective way to prevent cavities in your child’s mouth.

The frequency of dental x-rays will depend on the health of your child’s mouth. Once the baby teeth in the back are able to touch one another, we recommend a series of x-rays to detect any cavities. We also recommend another set yearly dependent on if your child is at a high risk of developing dental problems, we may recommend more frequent x-rays.

Dental x-rays pose very little risk for children. Pediatric dentists are extremely careful about the amount of radiation to which their patients are exposed. Lead aprons and digital machines are used in our office to ensure the safety of the children and to minimize the amount of radiation to which your child is exposed.

Pediatric dentists are skilled in helping children feel at ease in the dentist’s chair. However, some children suffer from anxiety and may panic. In these cases, we will recommend nitrous oxide to help calm the child. If the child is especially fearful, we may recommend sedation or general anesthesia to ensure a safe and effective delivery of the necessary treatment.

The most important thing to do when a child knocks out a permanent tooth is to remain calm. Locate the tooth and hold it by the crown. Rinse the tooth with salt water or milk to remove debris, but do not use water. Be careful to avoid contact with the root. If the root is intact, you can try to reinsert it into the socket. If you are unable to do so, place the tooth in a glass of milk and take your child to the dentist immediately. If your child knocks out a baby tooth, don’t try to reinsert it; you may damage the developing adult tooth below it. You should still take your child to see the dentist for an evaluation as soon as possible if he or she knocks out a baby tooth.

If your child is suffering from a toothache, rinse the affected area with warm water and use floss to remove any food from the surrounding gum areas. If necessary, give your child Children’s Tylenol or Motrin according to package instructions to control the pain. Never place aspirin directly on teeth or gums. If the child’s face is swollen, call our office immediately. A swollen face indicates a serious infection requiring immediate attention.