Early Dental Care
Teething
Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth.
While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant's mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child's teeth for long periods, covering the teeth in acids.*
*Some text in this article first appeared on Dentaly.org
Infant's New Teeth
The primary, or "baby," teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6.
Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental checkups.
A Child's First Dental Visit
A child's first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent's lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.
Why Primary Teeth Are Important
Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.
Good Diet and Healthy Teeth
The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.
Infant Tooth Eruption
A child's teeth actually start forming before birth. As early as 4 months of age, the primary or "baby" teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.
Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).
Preventing Baby Bottle Tooth Decay
Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child's mouth.
Sedation Dentistry
Some children are just too fearful to receive necessary dental care. In that type of situation, we may recommend conscious sedation with nitrous oxide to help make your child's experience of dental treatment stress-free.
Nitrous oxide, a colorless gas with a slightly sweet odor, has been used in medicine for about a century. It's a safe and effective method of administering conscious sedation, which means that a child (or adult) will stay awake during the procedure, but feel completely relaxed — even happy. All bodily functions remain normal during the administration of nitrous oxide, and its effects wear off quickly afterwards.
How Is Nitrous Oxide Administered?
As a form of conscious sedation, nitrous oxide is inhaled through a small mask that fits comfortably over a child's nose. The gas is mixed with oxygen as it is being delivered, and both gases are always kept at a level that is safe for the body. In just a few minutes, the patient may start to experience a floating sensation, and perhaps some tingling in the hands and feet. That's a sign that the sedation is working. Once it has been verified that your child is calm and comfortable, and that the dose is correct, the dental procedure can begin.
Nitrous oxide itself isn't a substitute for a local anesthetic in children or adults as it's considered an anxiolytic, which means it makes anxiety disappear. However, for some pediatric procedures, a child receiving nitrous oxide may not need an anesthetic injection. Even if they do need a numbing shot, they won't mind at all while under sedation with nitrous oxide. Yet they won't be asleep — they'll be able to speak, be aware of what's going on, and they will remain in control during the procedure. In fact, the dose can be fine-tuned to just the level of sedation they need to make them comfortable yet alert.
When the procedure is over, the flow of nitrous oxide is decreased to zero, and the oxygen will be increased. After resting in the chair for a few minutes, the child will feel completely normal.
Who Can Benefit From Nitrous Oxide?
Any child whose anxiety would otherwise keep them out of the dental chair can benefit from conscious sedation with nitrous oxide. Before beginning treatment, we will take a complete medical history, including any medications your child is taking. We will make sure that your child is safe and comfortable. In fact, we sometimes create a fantasy of your child being an airplane pilot wearing their flight mask to encourage their imagination so that they have a good time during treatment. Afterwards, they will likely not remember a thing.
