How to Prevent Tooth Decay in Your Baby

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Baby teeth are important. If baby teeth are lost too early, the teeth that are left may move and not leave any room for adult teeth to come in. Also, if tooth decay is not prevented, it can be costly to treat, cause pain, and lead to life-threatening infections. 

Tooth decay (called early childhood caries) is the most common chronic infectious disease of childhood. Tooth decay may also be called nursing caries or baby bottle tooth decay. 

Healthy dental habits should begin early because tooth decay can develop as soon as the first tooth comes in. Here is information for parents and caregivers from the American Academy of Pediatrics (AAP) about causes of tooth decay, signs of tooth decay, and how to prevent tooth decay. 

Causes of Tooth Decay in Babies

Tooth decay develops when a baby’s mouth is infected by acid-producing bacteria. Parents and caregivers can pass bacteria to babies through saliva. For example, bacteria is spread by sharing saliva on spoons or cups, testing foods before feeding them to babies, and cleaning off a pacifier in the parent’s or caregiver’s mouth.  

Tooth decay also develops when the child’s teeth and gums are exposed to any liquid or food other than water for long periods or frequently throughout the day. Natural or added sugars in the liquid or food are changed to acid by bacteria in the mouth. This acid then dissolves the outer part of the teeth, causing them to decay. 

The most common way this happens is when parents put their children to bed with a bottle of formula, milk, juice (even when mixed with water), soft drinks (soda, pop), sugar water, or sugared drinks. It can also occur when children are allowed to frequently drink anything other than water from a sippy cup or bottle during the day or night. Milk should be served only with meals and not offered throughout the day, at nap time or at bedtime. Although extended and frequent breastfeeding alone does not cause tooth decay, all breastfeeding mothers should be aware of and follow oral hygiene, fluoride, preventive dental care, and healthy diet recommendations.

Signs of Tooth Decay in Babies

Tooth decay might first appear as white spots at the gum line on the upper front teeth. These spots are hard to see at first—even for a child’s doctor or dentist—without proper equipment. A child with tooth decay needs to be examined and treated early to stop the decay from spreading and to prevent further damage. 

How to Prevent Tooth Decay in Babies

Take the following steps to prevent tooth decay: 

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  Take good care of your own oral health even before your baby is born. It is important and OK to see a dentist for oral care while you are pregnant.
• 
  Whether you choose to breastfeed or bottle-feed, it is important to take good care of your baby’s teeth.
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  Birth to 12 months: Keep your baby’s mouth clean by gently wiping the gums with a clean baby washcloth. Once you see the first teeth, gently brush using a soft baby toothbrush and a smear (grain of rice) of fluoride toothpaste.
• 
  12 to 36 months: Brush your child’s teeth 2 times per day for 2 minutes. Use a smear of fluoride toothpaste until your child’s third birthday. The best times to brush are after breakfast and before bed.
• 
  Never put your child to bed with a bottle or food. This not only exposes your child’s teeth to sugars but can also put your child at risk for ear infections and choking.
• 
  Do not use a bottle or sippy cup as a pacifier or let your child walk around with or drink from one for long periods. If your child wants to have the bottle or sippy cup in between meals, fill it with only water.
• 
  Check to see if your water is fluoridated. Your child will benefit from drinking water with fluoride in it. If your tap water comes from a well or another non-fluoridated source, your child’s doctor or dentist may want to have a water sample tested for natural fluoride content. If your tap water does not have enough fluoride, your child’s doctor or dentist may prescribe a fluoride supplement. He or she may also apply fluoride varnish to your child’s teeth to protect them from decay.
• 
  Teach your child to drink from a regular cup as soon as possible, preferably by 12 to 15 months of age. Drinking from a cup is less likely to cause liquid to collect around the teeth. Also, a cup cannot be taken to bed.
• 
  If your child must have a bottle or sippy cup for long periods, fill it with water only. During car rides, offer only water if your child is thirsty.
• 
  Limit the amount of sweet or sticky foods your child eats, such as candy, gummies, cookies, Fruit Roll-Ups, or cookies. Sugar is in foods like crackers and chips too. These foods are especially bad if your child snacks on them a lot. They should be eaten only at mealtime. Teach your child to use his tongue to clean food immediately off the teeth.
• 
  Serve juice only during meals or not at all. The AAP does not recommend juice for babies younger than 6 months. If juice is given to babies between 6 to 12 months, it should be limited to 4 ounces per day and should be diluted with water (half water, half juice). For children 1 to 6 years, any juice served should be limited to 4 to 6 ounces per day.
• 
  Make an appointment to have your child see the dentist before the age of 1. If you have concerns, the dentist can see your child sooner. Find a pediatric dentist in your area on the American Academy of Pediatric Dentistry Web site or insurekidsnow.gov​. If no dentist is available to see your child by age 1, your pediatrician can look inside of your child’s mouth, apply fluoride varnish, and talk with you about how to keep her healthy.

Remember

Tooth decay can be prevented. Talk with your child’s doctor or dentist if you see any sign of decay in your child’s teeth or if you have questions about your child’s teeth. With the right care, your child can grow up to have healthy teeth for a lifetime of smiles. 

The AAP recommends that: 

• All infants receive oral health risk assessments during well-child visits starting at 6 months of age and periodic fluoride varnish application from the time the first tooth erupts through 5 years of age.
• All children should be referred to a dentist as early as 6 months of age to establish a dental home. If a dentist is not available, talk with your pediatrician about how to maintain your child’s oral health and find a dental home.
• All children in their early toddler years should have a thorough initial dental examination and regular dental care whenever possible.
• Parents should limit food and drink exposure over the course of the day to 3 meals and 2 snacks (with healthy food choices and limited juice).  More frequent exposure to sugars in foods and drinks makes it more likely that children will develop decay.
• Parents should brush their children’s teeth with fluoride toothpaste as soon as they can see the first tooth coming in (erupting).  

Additional Information:

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Teething – Kids Plus Pediatrics

Teething is the process children go through as their teeth form, grow, and finally erupt through the gums.

The average age for a teething child’s first tooth to erupt is about 7 months old, but that’s highly variable. Sometimes a tooth may be present already at birth, and some kids don’t get their first tooth until well after 12-15 months. There is a genetic component to tooth eruption, so if a child’s older sibling got her teeth early or late, the younger sibling may get his early or late as well.

The order that teeth come in is also highly variable. The most common teeth to come in first are the bottom middle teeth, followed by the top middle teeth, but it can be normal if other teeth come in first. After the front eight teeth erupt, the first molars typically come next, and then the canines (or eye teeth) appear. The second set of molars, the “two year molars,” make their appearance usually after the second birthday, completing the 20 baby teeth. Again, while this is the most common pattern, it is completely normal for all sorts of variations on when teeth come in to occur.

Treatment for Teething

As a tooth starts to come in, the gums may swell and become tender. Having a baby chew on teething rings may help his discomfort. You’ll want to make sure they’re large enough that babies won’t swallow or choke on them accidentally. You can also use acetaminophen (Tylenol) to help with pain. For children 6 months and older, ibuprofen (Motrin, Advil) works well too. Topical numbing medicines (Orajel, etc.) are very popular, but are potentially dangerous when overused or used for prolonged periods.

Myths of Teething

Except for colds, there are more misconceptions and fairy tales associated with teething than anything else I can think of in pediatrics. Here are a few teething myths, and the real facts that go with them:

 #1: “My baby is drooling a lot and chewing on everything, they must be teething.”

Not necessarily. Babies start drooling around 3 months, and drool even more as they get older. That happens if they’re teething or not.  Same thing for chewing — babies love to chew on toys, toes, anything they can get their hands on — and they’ll do this at 4-6 months old whether they’re teething or not.

#2:  “Teething causes fevers.”

Teething may make a child a little warm, but it doesn’t cause fevers; much of that is coincidence. At the age children are teething, that’s the same age their maternal antibodies are diminishing, and that they come in contact with lots and lots of germs. So teething or not, kids get sick frequently at that age, which often gets confused with teething.  Also, many experts think that when teeth are coming through, babies are more susceptible to infections, because germs can get through the newly created holes in the gums. Any temperature above 100.5 F is an infection, not teething.

#3: “Teething causes diarrhea.” 

Not necessarily. Because babies are salivating and drooling a lot, their stools are sometimes looser at this age. But true watery diarrhea is typically a sign of something else, not just teething.

#4: “Teeth cut through the gums as they erupt.”

Interestingly, they don’t. The body actually produces hormones that help break down the surface of the gums on top of the teeth, which then creates a hole for the erupting teeth to grow through.

#5: “Frozen teethers are soothing for a baby’s gums.”

Actually, a totally frozen rock hard object will probably be uncomfortable on those tender swollen gums. A nice cold teether will be much better. For example, a wet washcloth placed in the freezer for 15-30 minutes will get nice and cold, but will soften nicely in a baby’s mouth. (Just make sure to use clean washcloths each time!)

If you have other teething questions or concerns, you can always feel free to call the office, or post questions on our Facebook page.

Dr. Albert Wolf, a proud Kids Plus Doc since 2000, is a Senior Partner and Chief Financial Officer of the practice.

Teeth Eruption Timetable

Teeth eruption timetable

When do primary teeth erupt (come in) and fall out?

This chart shows when primary teeth (also called baby teeth or deciduous teeth) erupt (come in) and fall out. Remember that eruption times can vary from child to child, and this is a general guide.

You can see from the chart, the first teeth begin to break through the gums at about 6 months of age. Usually, the first two teeth to erupt are the two bottom central incisors (the two bottom front teeth).

Next, the top four front teeth emerge.

After that, other teeth slowly begin to fill in, usually in pairs — one each side of the upper or lower jaw — until all 20 teeth (10 in the upper jaw and 10 in the lower jaw) have come in by the time the child is 2 ½ to 3 years old.

The complete set of primary teeth is in the mouth from the age of 2 ½ to 3 years of age to 6 to 7 years of age.

Other primary tooth eruption facts:

• A general rule of thumb is that for every 6 months of life, approximately 4 teeth will erupt.
• Girls generally precede boys in tooth eruption.
• Lower teeth usually erupt before upper teeth.
• Teeth in both jaws usually erupt in pairs — one on the right and one on the left.
• Primary teeth are smaller in size and whiter in color than the permanent teeth that will follow.
• By the time a child is 2 to 3 years of age, all primary teeth should have erupted.

Shortly after age 4, the jaw and facial bones of the child begin to grow, creating spaces between the primary teeth. This is a perfectly natural growth process that provides the necessary space for the larger permanent teeth to emerge. Between the ages of 6 and 12, a mixture of both primary teeth and permanent teeth reside in the mouth.

If baby teeth fall out after a couple of years, why is caring for them important?

While it’s true that primary teeth are only in the mouth a short period of time, they play a vital role in the following ways:

• They reserve space for their permanent counterparts.
• They give the face its normal appearance.
• They aid in the development of clear speech.
• They help attain good nutrition (missing or decayed teeth make it difficult to chew causing children to reject foods).
• They help give a healthy start to the permanent teeth (decay and infection in baby teeth can cause dark spots on the permanent teeth developing beneath it).

Permanent teeth eruption chart

The following chart shows when permanent teeth emerge.

In some children, the first permanent molars are the first to emerge; in others, the incisors are the first to emerge. By the age of 13, most of the 28 permanent teeth will be in place. One to four wisdom teeth, or third molars, emerge between the ages of 17 and 21, bringing the total number of permanent teeth up to 32.

Teething 101: Is my baby teething?

It is completely normal for the growth and eruption of baby teeth to cause some discomfort.

Experiencing your child’s firsts can be magical. The first smile. The first word. The first step. However, not all firsts are as much fun – the first tooth (and second, and third…) can be a tough time for parents and bubs alike.

Parents often have a lot of questions surrounding baby teething, from queries about what the warning signs are to home remedies, and everything in between. The most frequently asked question is typically, “is this normal?” Here’s a guide to what to expect when your baby is teething.

Is my baby teething?

In babies, tooth eruption, which occurs when the tooth breaks through the gum, is called teething.

Your child’s baby teeth will appear any time from birth to 27 months. There is no “normal” when it comes to the timing of baby teeth. All children are different. The order teeth appear is more important than the time they appear.

A general guide to when baby teeth should appear can be seen in the diagram below.

Signs and symptoms of teething to look out for include:

• Red swollen gums
• Irritability and restlessness
• Flushed cheeks or fever
• Dribbling
• Finger or fist sucking.

Teething usually takes about eight days, which includes four days prior and three days after the tooth comes through the gum. If you see a blue-grey bubble on the gum where the tooth is about to appear, do not panic. This is an eruption cyst, which will usually disappear without treatment.

Remedies: What can you do to help your child?

It is normal for your baby or toddler to experience some pain and irritability during teething. Often teething symptoms can be managed without medication. Here are some strategies to try.

Massage – gently rubbing your child’s gums with clean fingers is the easiest way to ease teething pain.

Chewing objects – allowing your baby to chew on objects such as crusts of bread, rusks or a teething ring can provide comfort. You can chill (not freeze) teething rings or rusks, as pressure from cold objects can help relieve discomfort. Follow the manufacturer’s instructions when cleaning teething products. Unsweetened teething rusks or sugar-free teething biscuits should only be given to infants over six months who have started eating solids.

Dry the drool – drooling often occurs when your child is teething, causing the skin around the mouth and chin to become irritated. Gently clean the skin with a soft cloth throughout the day.

Pain-relieving medication – Parents should speak to their GP or child health nurse about whether pain-relieving medication, like paracetamol, is needed for your child.

Teething necklaces are a choking and strangulation hazard and are not recommended for children. Other methods mentioned above, are safe and effective.

If pain persists and causes sleepless nights seek further advice from your pharmacist, GP or child health nurse.

Taking care of baby teeth

While teething is a normal stage of your child’s development, it can be challenging at times. But never fear, it won’t last forever! Most children have their full set of 20 primary teeth by three years of age.

Tooth care is important from when your baby’s first tooth arrives. Find out how to look after baby teeth and make dental care a daily routine for the whole family.

When Do Babies Start Teething?

It can be difficult to tell when your little one’s new teeth are starting to come in.

So many changes happen in an infants’ first year it can be hard to know which milestones are causing which side effects.

Especially if this is your first baby, you might be having trouble working out what’s going on.

Are those baby teeth coming in, or is your baby experiencing something else?

Read on to find out some common side effects of baby teething, and about when you can expect tooth eruption to begin.

When do babies start teething?

It’s always important to remember that all infants are different.

This means when one baby begins teething won’t necessarily be the same as when another baby begins.

Even if you have twins (or triplets) their baby teeth might start to come in at different times.

It’s important for parents to focus on individual children and look at their signs separately.

When do babies start teething on average?

Individual differences between babies means all children reach their milestones at different times.

And that certainly applies to teething.

Teething is what we call the process when your baby’s teeth grow or break through the gums.

Some children get their first tooth a lot earlier than others, and that’s fine.

Having said that, you can usually expect the first tooth to appear within the first 12 months.

Some infants are born with some baby teeth! Although it is rare, it’s also normal and nothing to be worried about.

Some babies don’t begin teething until they’re around 12 months old. This is also normal.

The average age for babies to have their first tooth appear is about 6 months.

Can babies start teething at 2 months?

Although around 6 months old is the average time for children to begin to grow teeth, the actual signs of teething can start a lot earlier.

If you start to notice symptoms of teething in your 2-month-old, you can probably expect baby teeth to start popping up in the next month or two.

The American Academy of Pediatrics says that between 4 months old and 7 months old is the average age for teething to begin, so expect symptoms a couple of months before that.

Around 2 to 4 months old is a normal time to begin to see symptoms of teething.

Teething baby symptoms

If you’re a seasoned parent, you might be used to the signs of teething by now.

Nevertheless, they’re not always easy to spot and, as mentioned before, every baby is different.

This means that even if you’ve had babies before, their teething symptoms might have been different from what you’re seeing now.

Even personality can play a part, as some children are naturally more sensitive or fussy.

Although all babies are different, there tend to be some symptoms that most babies experience during or before teething.

These are some of the most common signs and symptoms:

Drooling

Drooling can be stimulated by teething. For most babies, it starts between about 10 weeks and 4 months of age and can continue for as long as your baby’s teeth continue to come in.

You can place a bib on your baby to keep his shirt from getting wet. This will also keep him clean and comfortable.

Teething Rash

As the baby’s first teeth come in, a rash might appear.

A rash isn’t necessarily something you’d expect as one of the symptoms of teething.

Many parents worry, around this time, that the rash is a sign of some more serious condition; in fact, it’s one of the normal teething symptoms.

It’s never a bad idea to get a rash checked out, though, so if your baby develops a rash, ask your pediatrician for a check-up.

Teething rashes are most likely to show up around the mouth, especially on the chin or cheeks. Other common areas affected are the neck, chest, and tummy.

The cause of the rash is the skin being wet from drool. Constant drooling can cause chapping, chafing, redness, and rashes around the baby’s mouth, chin, neck, and chest.

A good way to prevent or treat it is to keep a bib on your child and pat the skin dry if it becomes wet.

You can also add a moisture barrier to the affected areas. Avoid petroleum-based lotions, and choose instead pawpaw or coconut oil, or any gentle, unscented skin cream.

Find out more about soothing your baby’s teething rash.

Chewing on things

The pressure from the tooth that’s poking under the gums causes discomfort or teething pain. It can be relieved by applying counter-pressure like biting and chewing.

That’s why babies who are teething tend to chew on whatever they can get their gums on. This might include crib gates and stroller guards, toys and rattles, their own hands, your fingers, and your nipples when you’re breastfeeding.

Other symptoms

These are other signs your baby is teething:

• Redness or soreness on the cheeks
• Sore or swollen gums
• Fussiness
• Crying
• Biting
• Waking up at night
• Sleep regression
• Not wanting to eat
• Clutching the ears.

For more information, check out Teething Symptoms – 10 Signs Baby Is Teething.

If you begin to notice some of these symptoms, your baby could be teething.

Signs of teething in breastfed babies

One particular sign of teething – chewing, or biting – might be especially obvious if you’re breastfeeding.

Teething might cause your baby to bite your nipple.

If this happens, you can gently tell your baby ‘No’, and if it continues, replace your nipple with something else that he can chew.

He might not be hungry at this time but is just looking for something to chew.

For more information, read our article Biting When Breastfeeding – 5 Tips To Stop It.

How long does teething last?

If you’re deep in the trenches with a teething baby, you might wonder how long it will last.

Usually, teething can continue until all the major baby teeth are through, which means until 2 years of age.

Your little one might have some breaks from teething symptoms during this time.

What can I give my 2 month old for teething?

Teething signs start before teeth appear. This can leave parents wondering what to do when their 2 month old is teething.

A baby of 2 months of age will benefit from different methods of soothing, compared with a baby of 8 months. You can gently massage the gums with a clean finger or run a cold washcloth over the inflamed area.

A 2 month old baby isn’t ready for food, so using frozen fruit cubes, or something similar, isn’t recommended.

How to soothe a teething baby

The methods of soothing you use when your little one is showing signs of teething will vary, depending on your baby’s age.

Some of the ways you can help with the discomfort of teething pain:

• Give your child a toy to chew on. A baby’s gums are likely to be sore during this time and the counter-pressure can help. Teething relief products like bumpy rubber toys, teething rings, your clean finger, and a soft, wet toothbrush – without toothpaste – rubbed on the baby’s gums can also help
• Keep chewing toys and washcloths in the fridge. You might find the coolness will help soothe the discomfort or pain of symptoms
• Put soft healthy foods in a mesh bag that your little one can chew on. This method provides the benefits of healthy food without the risk of choking
• Hold your child. Sometimes teething babies just need to feel some loving care from mama or daddy when they’re feeling discomfort or pain. Babies are similar to adults; sometimes they just want someone to understand and be there for them
• Offer a teething necklace. Although some experts recommend against teething necklaces, amber teething necklaces have been used by many parents to soothe their children.

What helps a teething baby sleep?

Another of the signs that a new baby tooth is coming is sleep regression.

For some babies, this is one of the biggest symptoms. For others, their sleep is never affected.

It’s important to remember the discomfort or pain of tooth eruption is likely to be the cause of this regression.

It’s easy to be frustrated when babies start to sleep through the night and then return to waking up regularly.

Your child’s gums are probably causing him pain and he needs comfort.

Try using the methods listed above.

Do pacifiers help with teething?

What works for one infant during teething symptoms might not help with another.

Try different things with your child to see what soothes the discomfort in the gums.

Babies of a younger age might be used to being soothed with a pacifier; an older child might prefer cold food in a mesh holder.

A chilled pacifier is recommended for incoming front teeth. It doesn’t reach too far into the back of the baby’s mouth. You simply dip the pacifier into cold water and place it in the freezer to chill.

Make sure you supervise your baby when he’s using a pacifier.

Babies are more likely to chew on pacifiers if they’re teething. You should inspect the pacifier regularly for signs of wear or damage.

You can also try dipping a face washer in cold water and letting it freeze. Always supervise your babies when they are chewing anything – especially clothes. They could be a choking hazard once they begin to thaw.

Experiment with different methods, and see what works for your child and his teeth.

Baby teething at 3 months

It’s important to take care of your baby’s mouth and teeth, whenever he begins teething.

The American Academy of Pediatrics recommends washing your child’s mouth twice a day as early as he has his first bath.

You can start by wiping around the inside of your baby’s mouth with a clean finger, and when he’s used to that, clean the gums with a clean washcloth.

It’s recommended you take your baby for his first pediatric dentist visit when the first tooth appears.

The front teeth (central incisors) are likely to appear first.

The bottom front teeth typically come through first, and then those on the top.

When a baby’s first tooth starts to come through, you can use a soft baby toothbrush to clean the baby’s mouth and gums.

Later, you can use a small, soft-bristled toothbrush or a clean, damp washcloth to clean your baby’s gums and teeth.

At this point, use a very small amount of non-fluoride toothpaste. You’ll want to avoid dental fluorosis until you start brushing your baby’s teeth with fluoride toothpaste.

This study found that only 40% of parents wash their baby’s mouth. The ‘Brush, Book, Bed (BBB)’ method is suggested for remembering to brush baby teeth daily.

Is it safe to rub whisky on a baby’s gums?

The use of brandy or whisky to soothe teething pain was a traditional remedy in past generations of parents. It’s no longer recommended you use this remedy for teething pain.

There’s no safe amount of alcohol for infants, so do not put alcohol into your baby’s mouth.

If your little one is having a particularly difficult time with the symptoms of teething, speak with a pediatrician.

Your care provider might suggest over-the-counter teething gels, but they aren’t usually recommended.

Too much of the numbing products they contain can cause your baby’s throat to be numbed and could lead to problems with swallowing.

If possible, try more gentle home remedies, as a better option.

Common questions about teething at 3 months, answered

Can your baby be teething at 3 months old? While most infants get their first teeth between 4 and 6 months old, it’s still perfectly normal for teeth to erupt sooner. In fact, although rare, babies can actually be born with teeth!

It’s not unusual for teething symptoms to begin at 3 months old. And when it starts, you’ll likely observe the same side effects: excessive drooling, chewing or gnawing on fists or toys, crankiness and lack of sleep (as if that’s not already an issue!). You might even see a little tooth bud weeks or even months before anything erupts. But, what if teeth actually come in at this age?

“If an infant is getting teeth at three months, it is likely due to heredity and what the child may be doing with the mouth,” says Diane Bahr, MS, CCC-SLP, CIMI and author of “Nobody Ever Told Me (or My Mother) That!” For example, “if the child is doing a lot of biting and chewing on fingers and toys, teeth may emerge early,” she adds.

Parents and caregivers dealing with their baby’s new pearly whites often have questions about how that cute new grin can affect things like breastfeeding or starting solid foods. Here are a few answers to ease your concerns:

How your little one deals with teething really depends on them. According to Danelle Fisher, MD, pediatrician and vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, Calif., “[Teething] can take weeks to months and can cause some babies a great deal of pain where others take it in stride.” Topical anesthetics are tempting to caregivers who want to help ease the baby’s discomfort, but Dr. Fisher and the American Academy of Pediatrics (AAP) warn this isn’t a good idea.

“Parents should avoid any product such as gel with the ingredient bupivacaine or lidocaine in it, as these can be dangerous for children less than one year of age, causing a blood disorder,” says Dr. Fisher. “[Your] baby can use a teething ring with liquid or gel inside that has been refrigerated (the freezer is too cold). Also, some natural remedies or homeopathic remedies can help.”

Nevertheless, consult your pediatrician if these remedies don’t seem to do the trick.

How will teething affect my breastfeeding?

Some moms’ first inkling that their baby is teething comes with a firm and unexpected clamp down on their breast. Whether it happens when he’s teething at 3 months or later down the road, it will happen eventually. Congrats, you’re officially a teething toy!

A rude awakening, for sure, but your natural reaction is actually the best solution for your little chomper: Take him off the breast with a firm, “Ouch!” or, as Dr. Fisher suggests, “No bite!” before letting him resume feeding. It may happen several times, even before his teeth fully emerge, but it will work. Be sure to use the same words and tone each time so he knows you’re serious. If you continue to experience breastfeeding problems you believe are connected to teething, Bahr suggests seeing a lactation consultant.

If you were planning to breastfeed only until your baby’s teeth erupt, however, speak to your pediatrician about how to wean successfully and what type of formula is best for him.

Does early teething mean early solids?

Although there’s some conflicting research of late, the AAP still suggests starting your baby on solids at no younger than 6 months old. Those early teeth do cause her to chew more, but her little belly isn’t quite ready for solid food. Provide lots of safe toys to nibble on and keep an eye out for signs she’s ready for solids.

Will early teething affect mouth development?

Bahr says, “Parents should take the child to a pediatric dentist to evaluate the health and development of early emerging teeth.” She cautions that some activities and issues can affect development, too. “Excessive pacifier use and thumb-sucking [that goes beyond 10 months] can inhibit the developmental mouthing and teething process. ” Bahr has an extensive interview on her website that delves into mouth development during the baby’s first year and how to avoid common problems.

A special note for parents and caregivers who bottle-feed or use pacifiers: While your baby is teething, keep an eye out for nipple wear. Babies often gnaw on the nipples of their bottle/pacifier, and the tip can become separated and pose a choking hazard. If there is any noticeable wear on either, replace it right away.

This article is for general informational purposes only. It is not intended nor implied to be providing medical advice and is not a substitute for such advice. The reader should always consult a health care provider concerning any medical condition or treatment plan. Neither Care.com nor the author assumes any responsibility or liability with respect to use of any information contained herein.

Teething Timeline: When Do Babies Start Teething

Teething Timeline: When Do Babies Start Teething | TYLENOL®
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Is your baby teething?

Find out what to expect as your baby
approaches the solid food frontier.

Your baby’s teething timeline could begin as early as three or four months old, and last through toddlerhood. By age three, all 20 primary teeth should have managed to emerge from your toddler’s gums. There are several stages of teething to overcome before you and your baby reach the pearly white finish line. Here are some of the symptoms you can expect, and ways you can get through this experience together! If you have any questions or concerns, be sure to talk to your pediatrician.

How to tell if your baby is teething

She’s a drooling machine
You might notice your teething baby drooling more than usual, which could result in a small facial rash. Fear not! Your pediatrician can suggest some options to help moisturize your baby’s face.

He’s chewing on EVERYTHING
Don’t be alarmed if your baby appears to have a newfound interest in putting things in his mouth. Chewing on hard objects, toys, or teething rings can help teething babies relieve painful pressure from their gums.

She’s fussier than usual
You’d cry too if you had tiny teeth trying to break through your gums! Gently rub your baby’s gums with a clean finger, or firm rubber pacifier to help take some pressure off.

He has a slight fever
As long as it doesn’t break 101°F, a teething fever is totally normal. Call your pediatrician if your baby experiences a high fever or diarrhea.

Infants’ TYLENOL^® works differently than other pain and fever medicines to relieve your teething toddler’s pain, while staying gentle on the tummy. If your child is under 2 years of age, be sure to ask your doctor before giving your child Infants’ Tylenol^®.

*If you have any questions, talk to your pediatrician.

For more information about Infants’ TYLENOL^®

Know how to help your little one when the first tooth appears.

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90,000 Infant Teething Syndrome: A New Look at an Old Problem | Zaplatnikov A.L., Kasyanova A.N., Maikova I.D.

The article presents an analysis of the literature on the problem of teething in infants. The use of topical drugs to reduce teething discomfort in infants is discussed. Presented the characteristics of the gel for topical application

In recent years, most researchers and pediatric practitioners have been of the opinion that teething syndrome in infants is a diagnosis of exclusion [1–5].However, despite this, there are still cases when children of the first year of life under the guise of “teething” miss the debut of such formidable diseases as pyelonephritis, pneumonia, meningitis. It should be especially noted that late diagnosis of these pathological conditions leads to a severe course, the risk of complications and, in extreme cases, can cause an unfavorable outcome.
In this regard, when discussing this problem, one should always draw the attention of pediatricians to the need for a careful analysis of anamnestic data, detailing clinical manifestations, as well as active monitoring of the child’s condition over time.At the same time, indeed, during the period of teething in children, along with local symptoms (hyperemia and swelling of the gums), there may be general symptoms (anxiety, irritability, decreased appetite, sleep disturbance, fever, etc.), but they are nonspecific. and are found in various infections and inflammatory diseases. Taking this into account, when a child develops fever during the dentation period, it is first of all necessary to exclude infectious and inflammatory processes, and only in their absence can one stop at the diagnosis of “teething syndrome” [2–5].It should be noted that this syndrome in the International Classification of Diseases and Related Health Problems, 10th revision (ICD-10) is indicated in the section “Diseases of the oral cavity, salivary glands and jaws” under the code K00.7 [6].
Teething is one of the stages of tooth development. Milk teeth begin to calcify already in the fetus by the 4th month. pregnancy and further develop up to about 6 months. pregnancy [1, 5, 7]. In the vast majority of cases, in children between the age of 6 months.and in the 2nd year of life, 20 milk teeth erupt. The central incisors appear first; the latter are the upper second molars. The scheme of milk teeth on the upper and lower jaws includes 2 central incisors, 2 lateral incisors, 2 canines and 4 molars (Fig. 1) [8].

The lower central incisors usually appear first, between the 4th and 6th months. the child’s life, the upper incisors appear a little later – between the 5th and 7th months. life. The eruption of the central and lateral incisors on the upper and lower jaws is most often completed during the 1st year of the child’s life.
On average, the eruption of milk teeth occurs in the following terms:
central and lateral incisors – from the 3rd to the 12th month;
first molars – from the 12th to the 19th month;
canines – from the 18th to the 24th month;
second molars – from 24th to 32nd months.
Permanent teeth in the amount of 32 begin to erupt at the age of about 6 years with the appearance of the lower molar. The process of eruption of permanent teeth is long, it can last 18–20 years, ending with the eruption of the third molar, better known as the “wisdom tooth” [1].
The greatest difficulties for children and their parents, as well as for a pediatrician, are caused by the eruption of milk teeth. The idea that milk teeth are only a temporary organ, which will be replaced by permanent teeth, as well as that their diseases and loss do not entail any consequences, is deliberately incorrect

…
The appearance of milk teeth allows the child to switch from liquid food to semi-liquid, and then solid. Moreover, the position of the deciduous teeth ensures the correct development of the dental arches, they act as guides for the permanent teeth, leaving them with sufficient space for proper growth and adequate positioning in the oral cavity [1, 8, 9].It has been established that milk teeth not only provide mechanical processing of food and play an important role in digestion processes, but are also an important marker of the child’s health [10]. For example, according to the condition of the teeth, you can suspect a child with malabsorption syndrome or a violation of mineral metabolism. Sometimes teeth can serve as the primary source of infection, which can then spread to other tissues by hematogenous route.
The appearance of the first teeth is a physiological process.In most cases, teething does not cause problems, despite developing local and even systemic disorders (Table 1). Among the most common localized symptoms of teething, gum swelling can be noted, which makes it more sensitive, causing a feeling of discomfort. As a result, the child’s desire to suck, chew and bite increases, and the production of saliva (sialorrhea) increases, which, being released in large quantities from the oral cavity, can cause skin irritation with the development of perioral dermatitis.Systemic symptoms include fever or general discomfort with increased anxiety, decreased appetite and sleep disturbance [11, 12]. At the same time, I.N. Zakharova et al. (2016) noted that the clinical features of the teething process may depend on the type of constitution of the child [4]. So, in children with a lymphatic type of constitution, the eruption of milk teeth, as a rule, occurs with a delay and in the wrong order. At the same time, there are often expressed anxiety, crying, violation of the nature of the stool, swelling and soreness of the gums, profuse salivation.In cases of neuro-arthritic constitution, the first teeth in children usually appear on time. However, their eruption is often accompanied by severe pain, excitability, episodes of crying and sleep disturbance. In addition, there is a refusal to eat, regurgitation, vomiting and an increase in body temperature may occur [4].

In a study by M. Memarpour et al. (2015) analyzed the frequency of the most common symptoms in children with teething of deciduous teeth. The study included 270 children aged 8 to 36 months.The most common teething symptoms were salivation (92%), sleep disturbance (82.3%) and irritability (75.6%). Moreover, these symptoms were more pronounced in children with low birth weight. In addition, low birth weight children were more than 2.5 times more likely to develop diarrhea [OR = 2.90, CI 95% (1.56–5.40), p = 0.001]. The authors also found that eruption of canines was accompanied by loss of appetite more often than eruption of incisors (p = 0.033) or molars (p = 0.014) [13].
Meta-analysis by S.Massignan et al. (2016), including 16 studies on teething syndrome in children under the age of 36 months. from 8 countries (Australia, Brazil, Colombia, Finland,
India, Israel, Senegal, USA), showed that only 30% of children had no symptoms of teething, while 70% of children had different clinical manifestations [14]. Among them, swelling of the gums, irritability and pronounced salivation were most often noted – in 86.8%, 68.1% and 55.7% of cases, respectively.In addition, the process of eruption of deciduous teeth in a number of children was accompanied by loss of appetite, restless sleep, nasal congestion and a slight increase in body temperature. At the same time, it was found that usually these symptoms were noted for a short time [14].
Similar results were obtained by M. Macknin et al. (2000), who showed that in the vast majority of children, symptoms of discomfort may appear 4 days before the eruption and, as a rule, stop within 3 days after the appearance of the tooth [18].
In the last decade, it has been established that pro-inflammatory cytokines play a key role in the development of various symptoms of teething. According to the literature, in the gingival fluid during primary teething, the concentration of inflammatory cytokines such as interleukins (IL-1, IL-2, IL-8) and tumor necrosis factor α (TNF-α) increases, which may explain the clinical manifestations associated with with teething [19–21].
Thus, L. Shapira et al. (2003) studied the relationship between teething, the content of inflammatory cytokines (IL-1, IL-2, IL-8, TNF-α) in the gingival fluid and clinical symptoms.The study included 16 healthy children aged 5 to 14 months. (average age – 9.8 months), which were examined 2 times a week for 5 months. Analyzing the results obtained, the authors came to the conclusion that the period of teething was accompanied by a significant increase in the levels of IL-1β, IL-8 and TNF-α in the gingival fluid. It was noted that there was a direct positive correlation between an increase in the concentration of certain pro-inflammatory cytokines and specific symptoms of eruption.Thus, it was found that with an increase in the level of IL-1β in the gingival fluid, fever, gastrointestinal disorders, sleep and appetite disturbances were observed much more often. At the same time, it was noted that an increase in the concentration of IL-8 was more often accompanied by gastrointestinal disorders, while an increase in the level of TNF-α was more characteristic of the appearance of fever and sleep disturbance [19].
Various medications are used to reduce the severity of local teething symptoms in infants.However, some drugs designed to relieve the symptoms of teething discomfort contain lidocaine. However, due to the lack of a clear dosing and possible swallowing of the drug, the likelihood of an overdose of lidocaine and the development of systemic effects increases. Given the high risk of severe side effects, it is currently recommended to limit the use of drugs containing lidocaine for teething and stomatitis in children [22]. FDA experts also warn about the inappropriateness of the use of homeopathic medicines, i.because their safety and effectiveness have not been evaluated. In this case, homeopathic preparations containing belladonna can be especially dangerous [23]. In this regard, among the means intended for the relief of local symptoms of teething, Kamistad ^® Baby is of particular interest [24].
Kamistad ^® Baby does not contain lidocaine; its active ingredients are chamomile flower extract and polidocanol [24]. The positive therapeutic effect of chamomile flower extract in various inflammatory diseases of the oral cavity is well known [25–28].Thanks to the extract of chamomile flowers, which is part of Kamistad ^® Baby gel, when using it, the severity of local symptoms of teething decreases, as well as antiseptic and regenerating effects are achieved. In turn, the presence of polidocanol in the composition provides anesthetic, cooling and distracting effect [29]. Taking into account the combined mechanism of action and good tolerance, Kamistad ^® Baby can be recommended for use in infants for effective and efficient use.
dangerous relief of local symptoms of teething.Kamistad ^® Baby is available in the form of a gel, which is recommended to be used 2-3 times a day (preferably after meals and before bedtime), applying it, lightly rubbing, on the gum surface [24].
Thus, given the low specificity of the clinical symptoms detected during dentition, teething syndrome is a diagnosis of exclusion. At the same time, to reduce the manifestations of discomfort in infants, it is necessary to use only safe and effective means, one of which is Kamistad ^® Baby.

.

Age of eruption of permanent teeth in different regions Text of a scientific article in the specialty “Clinical Medicine”

© D. V. DENISENKO, L. M. YANOVSKY – 2006

AGE OF CUTTING PERMANENT TEETH IN DIFFERENT REGIONS: MODERN ASPECT

D.V. Denisenko, L.M. Yanovsky.

(Irkutsk State Medical University, rector – Dr.MD, prof. I.V. Malov, Department of Dentistry

children, head. – Doctor of Medical Sciences, Prof. V.G. Vasiliev)

Summary. The analysis of works devoted to the study of the age of eruption of permanent teeth in children has been carried out. The survey techniques used by various authors are presented. Uniform criteria for evaluating the process of eruption of permanent teeth are proposed. Keywords. Children, permanent teeth, teething.

Population health is an indicator of external and internal social well-being, as well as an indirect indicator of national security. To create a healthy society, first of all, it is necessary to pay special attention to the child population – the most important reservoir of productive forces [27].

Recently, the health of the population of Russia is characterized by negative indicators: morbidity and mortality have increased, at the same time, life expectancy has decreased [17].

It is generally accepted that preventing disease is more cost-effective than treating it, both materially and socially. In Russia, there are a number of laws that give priority to preventive medicine: Federal Law of July 27, 1993, No. 5487-1 “Fundamentals of the legislation of the Russian Federation on the protection of public health”; orders of the Ministry of Health of the Russian Federation: dated 6.10.1999, No. 295 “On improving the activities of bodies and health care institutions in the field of hygienic training and education of the population of the Russian Federation”, dated 7.05.1998, № 151 “On temporary industry standards for preventive work with children aged 4 to 18 years.”

The effectiveness of preventive programs is possible with the full functioning of all its links, starting from the moment of birth and continuing until the entrance to adulthood. But, unfortunately, preventive programs in Russia are not consistent enough; they do not provide for continuity between specialists in various fields, and in particular between a dentist and a pediatrician.There is no unified medical record, regional characteristics, social factors are not taken into account, there is no way to track the consequences of past diseases, the genetic relationship between relatives is not studied [33].

One of the most common human diseases is dental caries. Complications of dental caries (chronic odontogenic foci of infection) contribute to the appearance of diseases of internal organs: the gastrointestinal tract, kidneys, and also contribute to the allergization of the body.For more effective preventive measures against dental caries, its early diagnosis is necessary, which cannot be complete without knowing the age of teething [18,38].

The content of mineral substances in the enamel of an adult’s teeth reaches 96.5-97%, in the tissues of an erupting tooth, the content of mineral salts is only 25-30%. Also, during the period of enamel maturation, high porosity is noted, which is about

puts 3-6%, and in a mature tooth only 0.1-0.2% [7.36].Their caries resistance depends on these states of hard tissues of teeth [18,38].

Clinical observations indicate that caries of permanent teeth develops most intensively in the short term after eruption – in the period of immature enamel. The maturation of tooth tissues continues for 5-6 years from the moment of eruption, and it is during this period that permanent teeth require the most thorough protection from an aggressive environment and cariogenic agents.In this regard, the greatest anti-vocary effect of fluorides is observed during the period of mineralization and maturation of dental hard tissues [18, 19].

The age of eruption of permanent teeth is an important indicator for determining the physiological age of a child, which may differ from the calendar one under the influence of environmental conditions, social and other factors, as well as due to past diseases. There are differences in the age of eruption of permanent teeth in children in rural and urban areas [5,13,25].

Along with other health indicators, the timing of teething is used in the clinic of medical expertise, forensic medicine, pediatrics, age physiology, developmental physiology, anthropology, etc. To a certain extent, it indicates the physiological maturity of an individual organism [30].

The terms of eruption of permanent teeth given by different authors have significant differences [1,2,3,6,8,14,16,20,21,35,38].This is due to the fact that the study does not pay due attention to the description of the examination technique and the criteria for assessing the fact and degree of eruption of a permanent tooth, as well as statistical processing of the material [26,28,35]. Analysis of the works gives reason to note the lack of a unified approach to collecting information. This is how different age groups are composed, there is no common understanding and definition of the fact of teething: from the visual appearance of a tooth or its part protruding more than half of the crown above the edge of the gum, or to complete placement in the dentition and inclusion in contact with the antagonist.The concepts of the beginning and end of eruption are equated to the age of the appearance of the first tooth of a certain category or its presence in all 100% of the examined children, without taking into account possible retention or adentia. Most authors take for an erupted tooth one in which at least one tubercle or incisal edge has broken through the mucous membrane of the gums [8,9,12,14,26,28,29,35].

Thus, there is a wide variety of indicators used by various authors to characterize the dynamics of teething.Works where a detailed study of this process with the derivation of regional age-sex standards has been carried out are sporadic. Most often, fragmentary data are presented according to one or two criteria [38].

When examining children of 6-7 years of age in Vilnius, three age groups were identified: children of 6 years of age were considered all children from 5 years 9 months 0 days to 6 years 2 months 29 days; 6.5 years of age – from 6 years 3 months 0 days to 6 years 8 months 29 days and 7 years of age – from 6 years 9 months 0 days to 7 years 2 months 29 days.Thus, the age of 6 years, 6.5 years, 7 years was the average in the study groups. The differences in the timing of the eruption of permanent teeth in boys and girls and the number of these teeth are indicated. So at six years old, the average number of permanent teeth in girls is 2.5, and in boys – 1.8; at 6.5 years – 4.77 and 3.87 teeth, respectively, and at seven years the difference reaches one tooth – the number of permanent teeth in girls is 6.6, and in boys – 5.6. However, the author does not specifically indicate the category of the studied teeth, although it is known that at this age the first molars and central incisors erupt.A significant relationship was noted between the indicators of the body’s maturity – pulse rate, muscle strength and the age of eruption of permanent teeth, i.e. the age of eruption of permanent teeth is one of the important indicators of a child’s development and gives an idea of ​​the morphological maturity of the organism [29].

Analysis of the relationship between physical development and the total number of permanent teeth in children shows that the degree of influence of physical development on the processes of eruption of permanent teeth decreases with increasing age of children.The greatest influence is observed at the age of 7 [10].

When studying the age of eruption of permanent teeth in children of the Arctic, the fact of an accelerated rate of eruption in girls compared with boys is confirmed. Improved nutrition and the associated accelerated physical development reduce the age at which the eruption of permanent teeth begins [3].

The age periods of eruption of permanent teeth in the village of Kakhovka, Volgograd region, different from those described above, were determined.It is noted that the eruption of the first permanent molars begins at the age of four. They appear first in the oral cavity, when the incisors are still absent; at the age of five, erupted central incisors are observed in 21.5% of children. In all cases, the lower teeth erupt earlier than the upper ones, and in girls earlier than in boys [4].

A comparative analysis of the age of eruption of permanent teeth in children of the city of Karaganda with the data of the textbook by A.A. Kolesova showed earlier dates [15,20].

On the basis of the material obtained when comparing the timing of the eruption of permanent teeth between boys and girls in Alma-Ata, uneven growth of teeth was revealed – there are phases of acceleration and deceleration. The phases of increased tooth growth correspond to 6-7 and 1011 years of age. Indicators of physical

of whom development and, despite the fact that they are higher in boys, their teething goes with some lag behind the indicators in girls.The data on the average timing of the eruption of permanent teeth in boys and girls, in which there are no data on the age of eruption of the second premolar, are presented [8].

Activation of eruption of permanent teeth occurs during periods of active growth of the whole organism [23]. It is known that teething has its own physiological patterns: the age of teething, order, pairing and a certain sequence [13,32].

The teething process is generally the same for both boys and girls.In Kiev, the simultaneous eruption of the first lower incisors and the first lower molars was noted. The sequence of eruption of permanent teeth on both jaws was determined. It was found that the sequence of the appearance of permanent teeth on the lower jaw differs from that on the upper one. In the lower jaw, the first permanent molars and central incisors erupt simultaneously, while in the upper jaw in children, molars appear first. In addition, on the lower jaw, the canines erupt after the first premolars, and on the upper jaw after the second.Very important proposals have been made in the study of the process of teething: the term teething time has been defined – this is the period from the moment of perforation of the crown of the tooth of the mucous membrane to its inclusion in the occlusal contact [21, 22].

When examining children of the Kyrgyz group, it was revealed that the lower central incisors and the first permanent molars erupt simultaneously. The examination material was developed separately not only for the upper and lower jaw, but also for the right or left side of each jaw.It is noticed that in the process of a child’s growth there are periods of slow and accelerated development. It also confirms the generally accepted opinion about the earlier teething of permanent teeth in girls, which is especially significant at the age of 11. Earlier eruption of permanent teeth in girls is associated with a faster rate of their somatic development and puberty. The duration of the growth period for each category of teeth was determined, which ranges from 2 years 1 month to 5 years 7 months in girls and from 2 years 0 months to 5 years 9 months in boys.In our opinion, the age groups of children created by the author do not meet modern requirements: this is how children from 5 years and 6 months to 6 years 5 months and 29 days were classified as six years old [11].

When studying the sequence of eruption of permanent teeth in children from Chita, significant differences were found from the data obtained in Kiev by L.B. Leporskoy and E.V. Udovitskaya (1978). In children of Transbaikalia, the canine on the lower jaw erupts simultaneously with two premolars, and in children of Kiev, the canine on the lower jaw erupts after the first premolars, and on the upper – after the second [34].

In the literature, there are data on differences in the timing of the eruption of permanent teeth in children of different nationalities, but living in the same region. When examining 1283 Russian schoolchildren and 696 Karelian children in the Arkhangelsk region aged from 7 to 17 years, a tendency for an earlier incision was noted –

more permanent teeth in Karelian children than in Russians. Thus, in nine-year-old Karelian girls, the total number of permanent teeth is on average 14.12, and in Russians – 13.24.In boys, differences are noted at the age of 7: 8.37 in Karelian and 6.85 in Russians. Also differences were found at 12 years of age. In other age groups, no significant differences were found in boys [12].

The analysis shows that there are differences in the timing of the eruption of permanent teeth in children in the same region, but examined in different years and by different authors [2,20].

Most authors studying the age of eruption of permanent teeth note different periods of eruption between boys and girls [1,21,31, 37,38].However, there are indications of the absence of this difference by a small number of researchers [35].

Analysis of a large number of reviewed works leads to the conclusion that it is necessary to develop unified criteria for assessing the stages and timing of the eruption of permanent teeth. So the number of works in which due attention is paid to physiological processes: the division of the age of eruption of permanent teeth in persons of different sex, age, belonging to the upper or lower jaw, right or left side – is single [13,38].There is the only work in the Russian literature in which the timing of the eruption of permanent teeth is indicated in months, and not rounded in years, this work is devoted to the study of the process of eruption of permanent teeth in children from the city of Irkutsk [38]. Most authors use old research methods that were used as early as the beginning of the twentieth century.

When studying the timing and patterns of the process of eruption of permanent teeth, it is necessary to develop a unified methodology for examining children and processing the data obtained.Thus, the Central Research Institute of Dentistry recommends that a tooth be considered an erupted if a whitened area of ​​the gingival mucosa is found in the area of ​​the proposed eruption site; when this area is probed, hard tooth tissue is felt [30].

It is rational to propose to distinguish three stages of the state of eruption of a certain category of teeth:

– age is taken as the beginning of eruption, in

in which a tooth of a certain category erupted in 5% of the examined children;

– the average period of eruption, the age at which a tooth of a certain category erupted in 50% of the examined children;

– the end of the eruption, the age at which a tooth of a certain category erupted in 95% of the examined children.These criteria are used by some authors [2,11,32,38].

It is recommended to study the age of eruption of permanent teeth separately in girls and boys, to indicate the age of eruption not in whole years, but in months of a certain year of life. The study should be carried out separately on each jaw and on both sides. When compiling age groups, it is advisable to indicate the actual age of the surveyed children in years and months. When detecting deviations in the age of eruption of permanent teeth, one should pay attention to the state of the child’s body, his nutrition, and previous diseases [38].

Attempts to bring the data obtained by different authors to a unified system for assessing the process of teething were encountered earlier [5,10,24,32]. However, in spite of this, in some modern works, these proposals are not given due importance [35]. But only when the process of teething process is brought to a unified standard, the practical value of the research will increase, and it will be possible to fully compare the data obtained by different authors, in different regions and in different years.

Thus, the study of the age of eruption of permanent teeth in children is a topical issue. Considering the fact that Russia has a huge territory, different climatic, geochemical and social conditions, there is an urgent need to evaluate data on the age of eruption of permanent teeth according to uniform criteria, in order to study the influence of various factors of the external and internal environment on this process. In the field of dentistry, the ultimate goal of such a study is to determine the age for preventive measures in relation to different categories of teeth in different sex groups of children in different environmental conditions.

THE PROBLEM OF STUDYING TEETH-ERUPTION AGE IN DIFFERENT REGIONS

D.V. Denisenko, L.M. Yanovski (Irkutsk State Medical University)

The work gyves the analysis of the articles, written by different authors, and devoted to different aspects of eruption of permanent teeth. It also describes methods of examining, used by different authors for studying this problem.The work offers common criteria for investigating the process of eruption of permanent teeth, which give an opportunity to compare the data got by different authors.

REFERENCES

1. Agapov N.I. Pediatric clinical dentistry. – M 1953. – S.31-32.

2. Alimsky A.V., Shalabayeva K.Z., Dolgoarshinnykh A.Ya. The timing of the formation of a permanent bite in children born and permanently residing in the region located near the former nuclear test site // Dentistry.- 1999. – No. 5. – S.53-56.

3. Baziyan G.V., Alimsky A.V., Estrin D.S., Kuryakina N.V. On the age of eruption of permanent teeth // Dentistry. – 1971 – No. 4. – P.50-54.

4. Buvaltsev N.T. Teething of permanent teeth in preschool children // Dentistry. – 1973. -No. 4. – P.78.

5. Volyansky N., Yarosh E. Relationship between genetic factors, environmental conditions, sequence and age of eruption of permanent teeth in children // 9th scientific.conference by age morfol., fiziol. and biochem. – M., 1969 .– T. 2, Part 1. – S. 162-168.

6. Vorobiev V., Yasvoin G. Anatomy, histology, embryology of the oral cavity and teeth. – M .: Biomedgiz, 1936. – P.242.

7. Golubev B.G. The content of some microelements in the teeth of the population of the Arkhangelsk region: Author’s abstract. dis. … Cand. honey. sciences. – Arkhangelsk, 1970 .– 20 p.

8.E.I. Goncharova Features of the eruption of permanent teeth in children of different sex // Dentistry. – 1976. – No. 1. – P.69-72.

9. Goncharova E.I. Evaluation of teething in light of

90,000 5 myths about bite correction in adults

IN ADULTS, THE TEETH ARE NO LONGER MOVING: THE GROWTH IS COMPLETE, THE BONE HAS BEEN STRENGTHENED

They say that teeth need to be straightened in adolescence, but in adults this is no longer possible.Is it worth it to fix the bite, because nature has long “put everything in its place”? What to do: wear braces or leave it as it is? Belgravia Dental Studio’s orthodontists answer questions.

Moving teeth is possible at any age. Even if an adult is not wearing braces, teeth can still move. For example, the eruption of third molars (wisdom teeth) can cause teeth to move – the appearance or increased crowding.

Or, suppose there was a loss of one chewing tooth, in which case the antagonist tooth (on the opposite jaw) moves forward. And the teeth-neighbors begin to shift or tilt, trying to fill the void.

If you put braces in adulthood, your teeth will move as the orthodontist intended.

BRACES ARE VERY HURTING

Not really. And only at the moment of getting used to it.There are two reasons for temporary discomfort: at the beginning of orthodontic treatment, a bracket is fixed to each tooth, which touches the mucous membrane of the cheek and lip (when installing external braces) or the tongue (if these are lingual braces).

During chewing, swallowing, talking, the protruding elements of the bracket system can rub. In response to irritation on the mucous membrane at the point of contact with the braces, a protective stratum corneum (like a callus on open skin areas) forms, and the sensitivity gradually decreases.

For comfort in the first days after the installation of the bracket system, you can glue the bracket with orthodontic wax, and apply a special gel to the mucous membrane.

The second reason for discomfort at the beginning of treatment is the work of the arch inserted into the groove of the braces. It is the arcs that start the mechanism for moving the teeth and control their position in three planes. At the beginning of treatment, shape memory arches are used – they tend to return to their original position, thereby affecting the position of the teeth and gradually giving the dentition an ideal shape.

The mechanism of movement of teeth and restructuring of bone tissue begins with stretching or compression of the ligaments that hold the teeth in the bony sockets. The ligaments of the upper teeth adapt in 3–5 days, while on the lower ones the bone tissue has a high density, so the habituation can last up to 7–10 days.

The arcs in the bracket system change at regular intervals, after changing the arc, the discomfort (according to the reviews of most patients) is 2-3 times weaker – the ligaments are already accustomed to light tension.

IF MOVING TEETH IN AN ADULT IS NOT STABLE, EVERYTHING WILL RETURN TO ORIGINAL POSITION

The stability of the position of the teeth depends on how tightly the upper and lower teeth meet each other, meeting the coinciding surfaces. In the language of dentists, this is called “occlusal contacts”.

It is in this position that the teeth keep each other from displacement. To avoid tilting and turning the front teeth, a thin non-removable arch called a flex retainer is fixed on the inner surface.

According to the protocol, the time of using non-removable retainers is on average equal to two periods of treatment with braces.

In some cases, the orthodontist prescribes a removable retainer – a transparent cap or plate. They must be worn for 10-12 hours (in the evening and at night) within 6 months after removing the braces. The task of the mouthguard is to maintain the shape of the dental arches until the bone has acquired a “new memory”.

In addition, removable retainers prevent the anterior teeth from moving if the flex retainer comes loose from one or more teeth.

ADULT TEETH MOVEMENT IS ALWAYS VERY LONG

The movement of teeth inside the bone tissue occurs at a certain speed: on the upper jaw – 0.8 mm per month, on the lower jaw – 0.3 mm per month. Orthodontists use these data to predict the timing of treatment. On average, it is 2 years for an adult patient.

ADULT BRACES ARE NOT AESTHETIC

Adult patients are often embarrassed to wear metal braces.Now you can put ceramic and sapphire braces – they almost merge with the enamel of the teeth.

And if you choose lingual braces, no one will notice them at all – they are attached to the inside of the teeth.

There are also aligners – an alternative to traditional braces. Teeth with clear aligners look polished after hygienic cleaning.

The main symptoms of wisdom teeth

The eighth teeth or wisdom teeth can bring a lot of problems.Appearing last, they try to free up as much free space as possible for themselves, thereby causing considerable pain. The easiest way out, as a rule, is to remove such a tooth, sometimes, even at the stage of its eruption. But do not make a hasty decision to remove the eighth tooth. First you need to understand all the intricacies and nuances of this issue.

For everyone, the appearance of the eighth tooth occurs in different ways, for each person everything is very individual, starting from the age at which the eruption of the eighth teeth begins, ending with the duration of this process.Sometimes the first tooth of “wisdom” can appear even at the age of sixteen, but there are times when this moment is delayed until forty years. Most often, the eighth teeth appear at the age of sixteen to twenty-five years. Deviations in one direction or another from middle age are not a sign of a disease. But, if by the age of twenty-five years of life, the “eight” have not appeared, you should seek the advice of a dentist. At an appointment with a specialist, you can find out whether the rudiments of the eighth teeth have formed and whether they are growing correctly.

Symptoms of “eights” eruption

Symptoms can be completely different. Symptoms may simply be absent, or they may be manifested by severe pain and increased body temperature, everything will depend on the individual characteristics of the human body.

The main symptoms of the appearance of wisdom teeth:

• painful sensations in the jaw, which may indicate the eruption of molars through the bone tissue and through the gum;
• Soreness during swallowing may be due to gum inflammation;
• swelling of the gums in the place where the tooth appears;
• formation of the so-called “hood”, which covers the emerging wisdom tooth;
• increase in body temperature.

If you find these symptoms, you should immediately seek the advice of a specialist. Lack of timely assistance can lead to various complications. As a rule, the procedure of excision of the gingival “hood”, which interferes with the eruption of the “figure of eight”, helps to facilitate the appearance of the “wisdom” tooth.

Signs such as increased body temperature and the appearance of puffiness may indicate the development of pericoronaritis, i.e. the inflammatory process in the gingival tissues surrounding the eruption site.If you do not take any measures, an abscess may appear in the place of the gingival “hood”, which can provoke blood poisoning. Therefore, if any symptoms are found, you need to go to an appointment with a specialist. The dentist will make sure that the eighth tooth is erupting correctly and its effect on the roots of nearby teeth.

Features of the appearance and growth of the eighth teeth

The appearance of problems associated with the growth of the eighth teeth is quite frequent, since the process of the appearance of the “figure eight” begins when the entire rest of the dentition has long been formed and each tooth has taken its place.In addition, with age, the jaw itself changes its size, it becomes a little smaller and narrower. Therefore, one of the most common problems is the lack of space for the growth of a new tooth, which is the main reason for the formation of pericoronaritis. If untreated, so-called fibrous tissue can form, further interfering with the growth of the eighth tooth, which in turn can lead to surgical intervention.

Very often the eighth tooth does not erupt completely, i.e.That is, partially or does not appear at all. This phenomenon is called retention, which is provoked by improper growth or incorrect subgingival position of the tooth. If a tooth in the gum has grown horizontally, it will not erupt at all, and in the future can negatively affect the roots of adjacent teeth. In such a situation, such a tooth requires extraction.

It is impossible to accelerate the growth of the eighth tooth, but it is possible to reduce the pain that occurs during its eruption. The first thing to do is to exclude heating of the gums and cheeks in the area of ​​the “wisdom” tooth.Heat can spread the infection, so do not warm your cheek or rinse your mouth with hot solutions.

In case of severe pain, you can take pain relievers that can temporarily relieve pain. But no medicines will help in solving this problem, so you need to immediately contact a specialist.
Thus, almost every person experiences unpleasant sensations in the process of erupting a wisdom tooth, but this does not mean that it needs to be removed, it may be enough to carry out any treatment.

Lip and tongue frenulum – “Dental clinic No. 19”

Lip bridle

The attachment of the lips to the jaw is provided by special folds of the mucous membrane that run along the midlines of the inner surface of the lips. If the size of the fold is proportional, then the lip completely covers the teeth when they are closed and has sufficient mobility.

However, in some patients, the frenum of the lip is shortened or attached too low to the jaw. In this case, its functions are violated.The shortened frenum of the lip is a congenital defect, the causes of which have not yet been established with certainty.

While the child is still small, the short frenum of the lip usually does not cause him any inconvenience. This defect does not affect the formation of the facial skeleton, therefore, for the time being, it is left without medical intervention. Problems can appear during the period of milk teeth change. If, after the eruption of the upper central incisors, the frenum of the upper lip is wedged between them, then even with straight teeth, an ugly gap (diastema) will remain between them, which does not adorn a smile.The cosmetic issue is not the only drawback of a shortened lip frenum. Its low attachment creates an increased load on the teeth, as a result of which, over time, the bone tissue in this area becomes thinner. This often leads to the development of periodontal disease in older patients.

Correction of such a defect as a shortened bridle is possible only by surgery. Such an operation is not indicated in all cases, usually it is performed only on the recommendation of an orthodontist.Plasty of the upper lip frenum is permissible only after the upper lateral incisors have completely erupted.

The frenum of the lower lip is also a common source of dental problems. The short frenum of the lower lip can cause gum recession, exposing the roots of the anterior teeth of the lower jaw. In addition, the short frenum of the lower lip provokes periodontal disease and the occurrence of malocclusion.

The optimal age for the correction of the frenum of the lower lip is 6-7 years.Most often, this procedure must be performed before orthodontic treatment (occlusion correction). For adults, plastic surgery of the frenum of the lower lip is often combined with the operation of deepening the vestibule of the oral cavity before dental prosthetics.

A similar operation is performed on an outpatient basis, under local anesthesia. The surgeon excises the folds of the mucous membrane, and then sutures it. The operation takes no more than 15-20 minutes, the postoperative sutures dissolve on their own.The use of a laser scalpel eliminates the need for anesthesia, and the healing process is also much faster.

However, you should be aware that plastic surgery of the frenum is only a preparatory stage for orthodontic treatment, since the gap between the teeth will not decrease by itself. Correction of the dentition can be started only after the final resorption of the sutures. It is also possible to carry out such an operation at a later age, but the procedure for orthodontic treatment will undoubtedly take longer.

Frenum of tongue

If you raise the tongue up and gently pull it back, on the lower surface you can clearly distinguish a cord running along the central line from the mucous membrane of the tongue to the very bottom of the oral cavity and ending almost at the surfaces of the lower incisors. This strand is called the frenum of the tongue, its normal length in an adult ranges from 27 to 30 mm.

It also happens that the end of the frenum of the tongue is located not on the mucous membrane, but practically at its tip. If the tongue is pushed out, it barely covers the lower lip; a shortened bridle interferes with its further advance.True, it is not always shortened, sometimes the mobility of the tongue is limited due to improper attachment of the frenum, but more often it is indeed 12-15 mm shorter than the norm.

Is the inability to stick your tongue out of your mouth really a serious problem that needs to be discussed? Imagine yes!

The problem of a short frenum is quite serious, for example, even in infancy, it can become an obstacle to normal sucking. The child becomes restless, he does not gorge himself, is capricious, cries, and loses weight.In such cases, the operation to excision the frenum of the tongue is carried out immediately. Immediately after the operation, the baby is given a breast, which helps to develop the tongue and make it more mobile.

A shortened frenum of the tongue can make itself felt at a later age. At the same time, the tongue is located between the dentition, making it difficult for the breathing process and interfering with the pronunciation of a number of sounds. This leads not only to impaired diction, but also to the formation of dentoalveolar anomalies, which in turn requires correction of the bite.Moreover, orthodontic treatment requires time and money. Usually, for children of primary school age, an operation to excision of the frenum is performed on the recommendation of a speech therapist. After the operation, a special gymnastics for the language is prescribed, in addition to which the child undergoes a course of treatment with a speech therapist, aimed at preventing, and even more often correcting, diction defects.

For adults, the short frenum of the tongue also causes a lot of trouble. It can significantly interfere with normal chewing of food, wearing removable dentures.But nevertheless, usually the plastic of the frenum of the tongue is carried out much earlier than natural teeth have to be replaced with prostheses. The fastest healing of the excised frenum occurs in infancy, however, in primary school, and even in adolescence, such an operation is very effective, and complications in the postoperative period are extremely rare.

90,000 Teething – causes, symptoms, diagnosis and treatment

Teething – the physiological process of the emergence of the coronal part of the tooth on the surface of the alveolar process of the jaw and gums.Teething of milk teeth is accompanied by local symptoms (redness, swelling and itching of the gums, profuse salivation) and general symptoms (anxiety, loss of appetite, sleep disturbance). To facilitate the process of teething, you can give your child special teethers, massage the gums, use anesthetic gels, and make applications with medicinal herbs. If your general health worsens, it is advisable to consult a pediatrician or pediatric dentist.

General information

Teething is a stage in the development of the dentition, characterized by the appearance of deciduous or permanent teeth in a child. Teething and changing teeth are natural processes that, on the one hand, are determined by the development and growth of the child’s body, and on the other, reflect the level of his somatic health, passport and biological age. Teething occurs at a specific time; at the same time, in the course of this process, even in healthy children, individual deviations can be observed.During a person’s life, the full cycle of teething occurs twice: milk (temporary) teeth appear at 6 months – 24-30 months; at the age of 5-14 they are replaced with permanent teeth.

Currently, there is a tendency in pediatric dentistry to shorten development times and earlier teething, which is associated with general acceleration. The assessment of the correct course of teething in a child can be given by pediatric specialists – pediatricians and dentists.

Teething

Timing of teething

Criteria for physiological teething are certain terms, a certain order and pairing (simultaneous appearance of teeth of the same name in the right and left half of the jaw).

Newborns have no teeth in the mouth; the mucous membrane covers the edge of the alveolar process, forming a dense ridge. Nevertheless, the process of setting teeth begins as early as 6-8 weeks of embryogenesis. By the time of birth, each child’s jaw already contains 10 temporary and 8 permanent follicles (tooth rudiments), which are at different stages of development and mineralization.The rest of the rudiments of permanent teeth are formed in the jaws after birth.

Teething of milk teeth in children, on average, begins at the age of 6-7 months, when the formation of the crown of the tooth ends and its root begins to develop. The lower central incisors appear first in the oral cavity, then (at 8-9 months) – the upper central incisors. The eruption of the upper lateral incisors occurs in a child at 9-11 months; lower lateral – at 11-13 months. Then, at about 1-1.5 years, the first upper molars (molars) appear, followed by the first lower molars.Then the canines are sequentially erupted on the upper and lower jaw (at 16-20 and 17-22 months, respectively). The eruption of deciduous teeth ends at the age of 2-2.5 years with the appearance of the second lower and upper molars.

Thus, the milk bite in children has 20 teeth; there are no premolars in it. In pediatrics, for a rough estimate of the number of teeth in a child under one year old, the formula is used: N – 4, where N is the age in months. The timing of teething in normally developing children can shift in one direction or another: for example, in some, milk teeth appear at the age of 4 months.- 2 years old; for others – from 8-10 months. up to 3.5 years.

Immediately after eruption, milk teeth have porous and rough enamel, which contains few microelements. Therefore, in case of non-observance of proper hygienic dental care, diet, dental prophylaxis (sealing fissures, application of fluoride preparations, deep fluoridation), there is a high risk of developing caries in milk teeth. The consequence of intrauterine underdevelopment of tooth tissues can be enamel hypoplasia.

The timing of the eruption of permanent teeth usually coincides with the timing of the loss of milk teeth. As a rule, already after the loss of a temporary tooth, tubercles or part of the incisal edge of a permanent tooth are visible in the hole. The eruption of permanent teeth begins with the first molars at the age of 5-6 years. Permanent central incisors (lower, then upper) appear at 6-8 years of age; behind them, at the age of 8-10, the lateral incisors change. Teething of canines, first and second premolars (small molars) occurs at the age of 10-12 years.The latter, by the age of 13-14, erupt the second molars. By the age of 17-25, wisdom teeth appear (sometimes they do not erupt at all).

Children’s permanent teeth differ significantly from the teeth of an adult in their anatomical features. In particular, in permanent teeth in children, the volume of the tooth cavity and pulp is much larger, and the amount of hard tissues is less, therefore, various exogenous factors can easily cause caries and pulpitis. Therefore, it is so important from the very beginning to provide proper care, regularly undergo professional hygiene, and dental treatment with fluoride preparations.

Factors affecting the timing of teething

The timing and characteristics of teething are influenced by hereditary and environmental factors. Among the latter, the leading role is assigned to a burdened perinatal history: toxicosis of pregnancy, Rh-conflict, intracranial birth trauma, prematurity, infectious diseases of the neonatal period, etc.

In such children, the timing of teething can be delayed by about 2 times. Later teething is also noted in children born to mothers with heart defects who have had herpes infection, toxoplasmosis, etc.diseases.

The correct formation of the dentition largely depends on the development of the child in the first year of life. So, it is noticed that the timing of the eruption of milk teeth is violated with congenital hypothyroidism, and the time and order – with rickets. Violations of the processes of teething and changing teeth can be noted with pathology of the pituitary gland, complete refusal of breastfeeding, sepsis of a newborn, frequent acute respiratory infections, pneumonia, etc. In turn, a violation of teething can lead to the formation of an incorrect bite in children.

Some scientists note that firstborns have teeth erupting earlier than subsequent children; in boys later than in girls, and in children of young parents – later than in late-bearing children. There are cases of the birth of children with already erupted teeth (more often the central lower incisors). The reasons for intrauterine teething are unknown, but we can definitely say that prematurely formed teeth are defective in structure and have roots that are not fully formed.Such teeth must be removed soon after eruption. Otherwise, while sucking, they will constantly injure the mother’s nipple, which can lead to the development of mastitis. Intrauterine teeth are deciduous, therefore, after their removal, permanent teeth will appear only at the age of 6-7 years.

Symptoms of teething

Despite the strong belief that teething in infants is inevitably accompanied by “toothache” (fever, vomiting, diarrhea, skin rashes, episodes of seizures), pediatric dentists insist on the falsehood of such ideas.Being a physiological process lasting for 2.5 years, teething cannot and should not be accompanied by any pathological manifestations.

Most of the symptoms observed during this period are not directly related to teething, but are a manifestation of a general infection or malnutrition. This is due to the introduction of complementary foods, the exclusion of the protective effect of breast milk, vitamin deficiency and other factors that increase the child’s susceptibility to various infections.Often, the period of teething chronologically coincides with ARVI, acute intestinal infection, viral stomatitis, sore throat, rhinitis, tonsillitis, otitis media, a reaction to vaccination, or with the appearance of a new product in the child’s diet.

At the same time, teething in most infants is accompanied by the same type of manifestations, which allows us to consider them as symptoms of this particular condition, and not background diseases. Usually, the precursors of teething appear 3-5 days before the apex of the tooth leaves the gingival mucosa and immediately after that they subside.Local signs of imminent teething are swelling and redness of the gums. Sometimes 2-3 weeks before the eruption of a tooth, a hematoma appears on the gum in the form of a small cyanotic tumor. Usually, the presence of a hematoma does not require intervention, however, with its increase in size, an incision of the mucous membrane is performed and the contents are evacuated. Sometimes the eruption of a tooth is accompanied by minor bleeding from the gums.

A consequence of the mechanical irritation of the sensory nerves of the gums by erupting teeth is the so-called “itching” of the gums, which is expressed in the fact that the child begins to pull various objects into his mouth, gnaw and bite them with gum rolls.For the same reason, when teething occurs, increased salivation is noted. Abundant salivation is partly due to a new seated position for the child, as well as an insignificant depth of the oral cavity and the inability to swallow saliva in time, thereby regulating its amount. Drooling may cause irritation and a rash in the mouth, chin, cheeks, and chest.

General symptoms of teething can be an increase in body temperature above 37.5 ° C, not associated with other causes; vomiting caused by swallowing saliva; cough due to saliva entering the airways.In children, sleep may be disturbed, appetite may decrease (up to refusal to eat), irritability and tearfulness may appear.

Teething assistance

In case of significant deviations in the timing of teething (if by the year the child does not have a single tooth), you should consult a pediatric dentist. In this case, an orthopantomogram will be required to assess the condition of the tooth buds and exclude adentia.

It is possible to alleviate the condition of the child during teething by surrounding the baby with parental care and affection and regularly carrying out simple procedures.To relieve itching and pain, special gels with a local anesthetic effect are used, which can be rubbed into the gums several times a day. You can treat the gums with a solution of soda, a decoction of sage, chamomile or oak bark. With severe pain syndrome, the use of painkillers (ibuprofen, paracetamol, etc.) is permissible. If the child does not tolerate teething, you can visit a pediatric homeopath in advance, who will recommend individual homeopathic remedies.

During the period of teething, it is advisable to use the so-called teethers – special toys made of soft plastic that the child can chew without risking damaging the gums.A special massage of the gums with a finger wrapped in gauze dipped in cold water can help the baby.

Dental care after teething

A child’s prophylactic visit to the dentist should take place shortly after the eruption of the first teeth or at the age of 1 year.During the consultation, the specialist will assess the structure of the maxillofacial apparatus, the condition of the frenum of the tongue and lips, and recommend proper dental care. In the future, visits to the pediatric dentist should become regular – 2 times a year to prevent caries.

The first baby teeth should be brushed 2 times a day using a piece of gauze or a silicone brush on your finger, without using toothpaste. From 1 year old you can clean with a dry toothbrush, and from 2 years old you can use baby toothpaste.

The health of permanent teeth largely depends on the condition of the milk teeth. Various lesions of deciduous teeth can damage the rudiments of permanent teeth, therefore, the treatment of caries in milk teeth is mandatory. For the correct course of the enamel mineralization process, it is necessary to enrich the diet with foods rich in phosphorus, calcium, vitamin C; limiting the use of sweets.

Teeth (fissure) sealing in children

The essence of the method

Teeth sealing is the sealing of fissures. This is the name given to natural depressions on the chewing surface of the teeth. For some children, they are too deep and convoluted, which reduces the effectiveness of hygiene procedures. In addition, the enamel in this area is the thinnest, and mineralization occurs at least 2 years after the eruption of molars. Therefore, it is important to take action as early as possible to prevent fissure caries.

Indications for sealing fissures in children

After the eruption of the 6th permanent teeth (molars), bring your child to an appointment with our dentist. Fissure sealing is not recommended for all children, and only a doctor can establish its necessity. The procedure is generally recommended in the following cases:

• The depth of the physiological grooves is too deep.
• Incomplete mineralization of enamel in a completely erupted tooth.
• The initial stage of fissure caries.
• In some situations, the doctor does not recommend this procedure.

Main contraindications

Usually, teeth sealing is not performed for children on those molars and premolars whose “age” has exceeded 4-5 years. If by this time signs of caries are not observed, then the fissures are sufficiently cleaned and it is not necessary to seal them.

Sealing is not done even if the furrows are wide and plaque does not accumulate in them. Contraindications also include carious lesions of the interdental spaces, incomplete eruption of molars, and some individual features of the structure of the teeth.

We remind you that only a doctor can determine that there is no need to fill the fissures with a sealant or that there are contraindications to it.

Stages of the procedure

Fissure sealing does not cause fear in children, since all manipulations are painless.

The main steps of this preventive procedure are:

• Etching. A special preparation is applied to the chewing surface of molars and premolars.