Let Me Ask You, Doc (for children 0 - 2 years)
Let Me Ask You, Doc (for children 0 - 2 years)

This parent section is part of a book written by A/Prof. Richard P. Widmer and Professor Emeritus Gerald Z. Wright for the 20th Congress of the International Association of Dentistry Congress, Sydney, Australia. It was produced with support of the Colgate Palmolive Company. The material is not IAPD-endorsed nor does it reflect IAPD policies.

1) When does the first tooth come in?

2) When should I start cleaning my baby's teeth?

3) What is the best way to clean a baby's mouth?

4) When do you think my child should give up the bottle?

5) What age should a child have the first dental check up?

6) Do you think it is O.K. to use a pacifier?

7) Could my child's temperature be from teething?

8) What do you recommend for teething?

9) Why do some children get tooth decay before they are two years old?

10) What can be done about my child grinding teeth at night?

11) Are baby teeth important?

12) Do injuries to the first teeth affect the second teeth?


1) When does the first tooth come in?
The first tooth usually comes in around 6 months of age. Most often it is a lower front tooth. Our experience, however, is that the tooth eruption timing of primary teeth is more variable than for permanent teeth. The front 8 teeth (4 on top and 4 on bottom) usually have come in by 9 months of age.


2) When should I start cleaning my baby's teeth?
The simple answer is that teeth should be cleaned as soon as they first appear. Parents should not limit the cleaning only to teeth. The gums also need to be cleaned.


3) What is the best way to clean a baby's mouth?
Different methods have been recommended. The popular technique nowadays is to use a clean, small gauze pad. If non-sterile ones are purchased they are much less expensive. Alternately, a clean dry wash cloth can be used. The teeth and gums are firmly wiped to remove liquid and food debris. This is done before bedtime. Once the child has back teeth, a small, soft toothbrush can be used to clean the grooves on the chewing surfaces of the molars.


4) When do you think my child should give up the bottle?
For those babies not being breast fed, there is general agreement that around one year of age is a good time to wean baby from the bottle. Paediatric dentists like to see children give up bottles as soon as possible. That is because they see an alarming number of toddlers with Nursing Bottle Decay. This type of decay, which begins on the front teeth, is only seen in toddlers. It results from prolonged use of a milk or sweetened liquid bottle that is put into bed with the baby.

Weaning from the bottle seems to follow two paths. The first is stopping the bottle suddenly. It is a "cold turkey" approach. The second method is a gradual reduction in the usage of the bottle. Reduction usually begins during the day when baby is able to drink from a cup. The last and most difficult bottle to be discontinued is the bottle before bedtime.


5) What age should a child have the first dental check up?
Early examination procedures have been recommended strongly in the past decade to help reduce the number of infants and children who suffer from preventable tooth decay.

Ideally we like to see children have their first dental check up by their first birthday. Why? Seeing the child early gives the dentist the opportunity to examine the mouth and confirm normal oral development. Most importantly, the teeth can be examined for cleanliness. It gives the dentist the opportunity to provide advice on prevention and make the best care plan for your child. It also gives parents the chance to discuss feeding practices, teething and mouth habits.


6) Do you think it is O.K. to use a pacifier?
Sucking is a basic instinct of infants. Over the years there have been numerous debates as to the usefulness of pacifiers. The benefits attributed to them seem to outweigh any potential shortcomings for children. If it helps to comfort your baby then use the pacifier. Be certain to use pacifiers with a large flange that sits on the outside of the mouth and an oval shaped teat. This type of pacifier is recommended for safety and better dental development.


7) Could my child's temperature be from teething?
For years many thought that teething caused fever and general sickness. Teething has been blamed for many things! Research into the problems of teething has shown that some children become irritable, have increased drooling and sometimes a facial rash. However, for most children the effect of teething is teeth! It is a normal part of development. If your child has a high temperature that worries you, it is unlikely to be caused by teething and you should consult your physician.


8) What do you recommend for teething?
Many remedies have been suggested over the years. There are non medical things that can help. Teething rings have been found to be helpful for some babies. The biting pressure seems to relieve some discomfort especially if the teething ring is chilled. We generally do not recommend pain relief tablets. The treatment can be managed by local measures. For example, special local anaesthetic medicines are available to be placed on sore gum areas. Only use medicines intended for this purpose should be used.


9) Why do some children get tooth decay before they are two years old?
About 1 in 10 children experience tooth decay before they are two years old. The most common cause is when a baby is placed in the crib at night with a bottle of milk or sweetened liquid. The contents of the bottle cling to the teeth all night. Tooth decay begins! The same effect can occur with a sweetened pacifier. In rare circumstances, babies who are breast fed throughout the night over a long time are also at risk. The decay experienced by these toddlers has a typical pattern. It usually is evident near the gum line of the upper front teeth. Because of the age of these children, treatment becomes a major problem sometimes requiring general anaesthesia. Parents need to be alert and keep the teeth healthy.

Occasionally when illness or some other disturbance affects growing teeth, the quality of the enamel is poor. These teeth can decay early and more easily. A dental examination around one year of age helps identify these problems.


10) What can be done about my child grinding teeth at night?
Some children grind their teeth at night. It is a habit called bruxism. It is not unusual in the early years. We know that this really worries parents but in our experience it rarely requires treatment.

The grinding habit can be minor or a child can wear teeth severely. If the habit persists in later years and there is damage to the second teeth, some form of treatment may be indicated. Some suggestions for treatment have been minor tooth adjustments, the use of mouth splints, relaxation techniques and sedation at night.


11) Are baby teeth important?
For years the importance of baby teeth was underrated. Once their importance was recognized, adult teeth improved. There are the obvious reasons why baby teeth are important - chewing, speaking, and appearance. Baby teeth do more. They conserve the space in the jaws for permanent teeth. If baby teeth are removed ahead of their natural time to fall out, space for the second teeth may be lost.


12) Do injuries to the first teeth affect the second teeth?
Many children have unfortunate accidents and can damage their mouths and teeth. A wide range of injuries can occur. Sometimes the damage to the baby teeth are of little concern and sometime they are severe and teeth can be moved about or knocked out. The more serious injuries can cause damage to the second teeth that are still forming in the jaws. The amount and type of damage depends on the age of the child as this reflects the stage of development of the underlying second tooth. The amount of injury will not be seen until the second tooth comes into the mouth.