Dr. Vaishali Katke

Though your child's first set of teeth are not permanent, they are still critical to the development of healthy gums, jaws, permanent teeth, and dental hygiene habits. From first teething to the development of permanent adult teeth, you can help your child to develop and maintain strong healthy teeth and gums.

THE FIRST TEETH

The first teeth usually erupt at around 6-8 months beginning with the lower front teeth and working back towards the molars, usually in pairs. A full set of baby teeth usually appears by the age of 2.5 years and remains stable until the age of 5 or 6 when baby teeth begin to be replaced by permanent teeth

TEETHING PAINS

As these first teeth begin to push through the gum, your child may experience teething pain. Redness or rash on the cheeks, increased drooling, restlessness, irritability, and loss of appetite can all be indicators that your child is teething. If however your child also experiences fever, vomiting, or diarrhea you should take them to a physician as these symptoms are often caused by ailments other than teething.

Once you've established that your child is teething, you can ease their pain in a number of ways. Allowing your child to chew on a chilled teething rings or other cold hard objects can help numb the gums and cause the tooth to erupt sooner. Teething gels can also help reduce the pain through numbing and can be found in most pharmacies. Finally, you can also massage your child's gums

with a clean finger, reducing the pain with light pressure on and around the location of the erupting teeth. Teething cookies and other food (or alcohol) based home remedies are not recommended as they may lead to tooth decay caused by food debris left in the gums or new teeth.

Teething can be a trying time for parents and child alike, but it will not last forever and there are several simple effective ways to manage your child's discomfort.

FIRST DENTAL VISIT

As soon as your child has her first teeth you can begin to think about scheduling a first dental appointment. The appointment should be made on or before your child's first birthday. Before the appointment you may wish to bring your child into the dental clinic for a short tour and a chance to get acquainted with the space and the staff. If you or one of your other children has an appointment, you can bring the younger child along to help get them familiar with the clinic.

In preparation for the first visit, try not to over-prepare your child or say things like "it won't be too bad" as these behaviours often just trigger fear and nervousness rather than providing comfort. When you get to the appointment, be sure to discuss an oral health plan for your child with either the dentist or dental hygienist.

Most importantly, do not wait for an emergency to bring your child to the dentist. The additional stress of pain or injury will make an unfamiliar experience even more difficult for your child.

CHILD ORAL HEALTH CONCERNS

Though baby teeth will be replaced by permanent teeth as your child grows, proper maintenance of their baby teeth can not only prevent child oral health concerns and ensure healthy gums and jaws but also helps to develop good oral hygiene habits that will follow your child through life.

BABY BOTTLE TOOTH DECAY

Allowing your baby to fall asleep while nursing or sucking on a bottle allows sugary liquids to pool around the teeth and may lead to extensive tooth decay. To ensure that tooth decay does not progress unnoticed you should check your child's teeth regularly for any brown spots along the gum line. Frowns or tears when eating cold, sweet, or hard foods may also be signs that your child is experiencing tooth decay.

SNACK CHOICES

Just as with adults, sugary snacking habits in children can greatly increase the likelihood of cavities and tooth decay. Foods which contain high levels of sugar or which are soft or chewy and stick to the teeth are the most harmful as they cause the natural bacteria in your child's mouth to produce high levels of acid which may erode teeth. It is also important to remember that, though more nutritionally sound, natural sugars such as those in fruit can still cause dental decay if the teeth are not brushed regularly and thoroughly.

Along with healthy eating choices, you should try to reduce your child's consumption of sugary foods that are held in the mouth for a long time such as lollipops, hard candies, etc. If your child is going to eat something sugary, it is best to pair it with a meal so that the additional saliva production helps to wash the sugar off the teeth. Generally however it is best to avoid sugary foods to prevent the formation of a sweet-tooth and choose instead healthier options such as:

• Popcorn
• Vegetables
• Fruits
• Nuts & Seeds
• Meat
• Cheese
• Coleslaw
• Pizza
• Plain yogurt
• Eggs
• Enriched or Whole-wheat bread
• Whole grain cereal
• Plain milk
• Tossed salads
• Plain muffins

Though snacks such as raisins, dried fruits, and granola bars are healthy, they tend to stick to the teeth and so are not an ideal choice for snacks.

ORAL HYGIENE HABITS FOR CHILDREN

Even before your child's first tooth appears, you can and should begin an oral hygiene routine. Use a cloth to wipe down your baby's face and gums after every feeding. Once the first tooth appears, use a soft bristled brush to clean the tooth after every meal but do not use toothpaste as children tend to swallow most of it which can be harmful. If you are having difficulty brushing your child's teeth, you may want to try having your child lie down with their head in your lap, or have them stand in front of you with their back leaning against your body while holding a mirror so that both you and your child can see what you are doing.

Children require smaller brushes than adults and flossing should begin only when the teeth begin to touch each other. You child will likely not have the manual dexterity to brush and floss their own teeth until the age of 8 or 10. Establishing a good routine from the very beginning will help your child to get into a habit of oral hygiene.

Once your child begins brushing their own teeth, you may want to use a timer to ensure they are brushing for long enough as well as providing rewards such as stickers for regular brushing and flossing. The best way to get your child to adopt good oral hygiene habits is to model them yourself. If you and your child brush your teeth together ever morning and evening the practice is more likely to be kept up than if you expect your child to form the habit all on their own.

How They Work

A dental implant is basically an artificial tooth root (typically made from titanium) that is anchored in place of a missing tooth. A temporary protective cover screw is placed on the implant while it fuses with the jawbone (a process called osseointegration). This process can take up to six months to complete, but creates an incredibly stable, durable prosthetic. After completed osseointegration, the protective cover is replaced by a temporary crown. This serves as a template around which the gum grows and shapes itself in a natural way. The process is completed when the temporary crown is replaced by a permanent crown.

(Read more about dental implants)

A dental bridge is in some ways less invasive and other ways more invasive than a dental implant. Unlike implants, bridges do not replace a tooth root. Rather, a bridge uses one or more surrounding teeth as a support on which to attach a crown that can fill the missing tooth space. The treatment process is not nearly as long as the implant process (which requires osseointegration); though in some ways it is more invasive because it requires the permanent alteration of adjacent teeth to support the bridge. As the name implies, a dental bridge literally bridges the gap between teeth resulting from a missing tooth. The restoration therefore must be anchored to one or more adjacent teeth, which must first be filed down in order to function as a support.