When do babies start teething. What are the early signs of teething in infants. How can parents soothe teething discomfort in babies. Is it possible for babies to teeth at 6 weeks old. What remedies are effective for teething symptoms in young infants.

The Timeline of Baby Tooth Development

The journey of a baby’s dental development begins much earlier than many parents realize. Tooth formation actually starts during pregnancy, with the basic tooth substance forming at just 6 weeks of gestation. This early development sets the stage for the eventual emergence of baby teeth, also known as primary teeth.

By the time a baby is born, they already have 20 primary teeth hidden beneath their gums. These teeth will gradually emerge over the first few years of life, playing a crucial role in the child’s ability to eat, speak, and smile.

When Do Baby Teeth Typically Emerge?

While the average age for teething to begin is around 6 months, there’s a wide range of what’s considered normal. Some babies may start teething as early as 4 months, while others might not see their first tooth until 12 months or later. It’s important to remember that every child develops at their own pace, and the timing of tooth emergence can vary greatly from one baby to another.

• Average teething age: 6 months
• Early teething: As early as 4 months
• Late teething: Up to 12 months or later

Can Babies Really Teeth at 6 Weeks?

While it’s extremely rare, some babies can indeed show signs of teething as early as 6 weeks. This phenomenon, known as neonatal teeth or natal teeth, occurs in approximately 1 in 2,500 newborns. These early teeth are typically the lower front incisors and can sometimes be present at birth.

It’s important to note that teething at 6 weeks is not the norm and should be evaluated by a pediatric dentist to ensure proper development and rule out any potential complications.

What Causes Early Teething?

Early teething can be attributed to various factors, including:

• Genetics
• Maternal nutrition during pregnancy
• Certain medical conditions
• Environmental factors

If you suspect your baby is teething unusually early, it’s best to consult with your pediatrician for proper evaluation and guidance.

Recognizing the Signs and Symptoms of Teething

Teething can be a challenging time for both babies and parents. Recognizing the signs and symptoms can help you provide appropriate care and comfort to your little one. Common teething symptoms include:

1. Increased drooling
2. Swollen or tender gums
3. Irritability or fussiness
4. Difficulty sleeping
5. Loss of appetite
6. Mild temperature elevation (not to be confused with fever)
7. Chewing on objects

It’s important to note that severe symptoms such as high fever, diarrhea, or excessive rashes are not typically associated with teething and may indicate other health issues. Always consult your pediatrician if you’re concerned about your baby’s symptoms.

Teething Fever: Myth or Reality?

The relationship between teething and fever has been a topic of debate among parents and healthcare professionals for years. While many parents report that their babies experience fever during teething, scientific evidence on this matter is mixed.

Does Teething Cause Fever?

Most experts agree that teething may cause a slight increase in body temperature, but it doesn’t typically result in a true fever. A true fever is generally defined as a body temperature of 100.4°F (38°C) or higher.

If your baby has a temperature above this threshold, it’s more likely due to an unrelated illness rather than teething. Always consult your pediatrician if your baby has a persistent fever or seems unwell.

Effective Remedies for Teething Discomfort

While teething is a natural process, it can cause discomfort for your baby. Fortunately, there are several safe and effective remedies to help soothe your teething infant:

• Teething rings or toys: Offer your baby a clean, chilled (not frozen) teething ring to chew on.
• Gentle gum massage: Use a clean finger to gently rub your baby’s gums.
• Cold washcloth: A damp, chilled washcloth can provide relief when your baby chews on it.
• Teething biscuits: For older babies, sugar-free teething biscuits can offer relief.
• Over-the-counter pain relievers: Consult your pediatrician about using appropriate pain relief medications like acetaminophen or ibuprofen.

It’s important to avoid teething gels or tablets containing benzocaine, as these can be harmful to infants. Always supervise your baby when using teething remedies to prevent choking hazards.

The Importance of Early Dental Care

Establishing good oral hygiene habits early in life is crucial for your child’s long-term dental health. Even before the first tooth emerges, you can begin caring for your baby’s oral health:

• Clean gums: Wipe your baby’s gums with a soft, damp cloth after feedings.
• Introduce a toothbrush: Once the first tooth appears, use a soft-bristled, infant-sized toothbrush.
• First dental visit: Schedule your baby’s first dental check-up by their first birthday or within six months of the first tooth appearing.
• Avoid bottle decay: Don’t put your baby to bed with a bottle of milk or juice, as this can lead to tooth decay.

By starting early and maintaining consistent oral care routines, you’re setting the foundation for a lifetime of healthy smiles.

The Complete Baby Teeth Eruption Timeline

Understanding the typical timeline for baby teeth eruption can help you anticipate your child’s dental development. While individual variations are common, here’s a general guide to when you can expect each set of teeth to emerge:

1. Lower central incisors: 6-10 months
2. Upper central incisors: 8-12 months
3. Upper lateral incisors: 9-13 months
4. Lower lateral incisors: 10-16 months
5. First molars: 13-19 months
6. Canine teeth: 16-23 months
7. Second molars: 23-33 months

Remember that this timeline is just a guide, and it’s perfectly normal for teeth to appear earlier or later than these ranges. By age 3, most children will have all 20 of their primary teeth.

Transitioning from Baby Teeth to Permanent Teeth

As your child grows, their baby teeth will gradually be replaced by permanent teeth. This process typically begins around age 6 and can continue into the early teenage years. Here’s what you need to know about this transition:

When Do Baby Teeth Start Falling Out?

The process of losing baby teeth and gaining permanent teeth is called exfoliation. It usually follows a pattern similar to the eruption of baby teeth, with the lower central incisors often being the first to go. Most children begin losing their baby teeth between ages 5 and 7.

The Eruption of Permanent Teeth

As baby teeth fall out, permanent teeth will emerge in their place. This process continues until all 32 permanent teeth (including wisdom teeth) have come in, typically by the late teens or early twenties. Here’s a general timeline for permanent tooth eruption:

• First molars: 6-7 years
• Central incisors: 6-8 years
• Lateral incisors: 7-9 years
• Canine teeth: 9-12 years
• Premolars: 10-12 years
• Second molars: 11-13 years
• Third molars (wisdom teeth): 17-21 years

It’s important to maintain good oral hygiene habits throughout this transition period to ensure the health of both baby and permanent teeth.

Promoting Healthy Tooth Development

Ensuring proper nutrition and care is crucial for healthy tooth development, starting from pregnancy and continuing through childhood. Here are some key factors that influence dental health:

Nutrition During Pregnancy

A mother’s diet during pregnancy can significantly impact her baby’s tooth development. Essential nutrients for dental health include:

• Calcium: Found in dairy products, leafy greens, and fortified foods
• Vitamin D: Obtained through sunlight exposure and fortified foods
• Phosphorus: Present in meat, fish, and eggs
• Vitamin C: Abundant in fruits and vegetables

Pregnant women should also avoid certain medications that can affect fetal tooth development. Always consult with your healthcare provider about safe medication use during pregnancy.

Infant and Toddler Nutrition

After birth, continue to focus on providing a balanced diet rich in nutrients that support dental health. Breast milk and formula provide essential nutrients for the first months of life. As solid foods are introduced, include foods that promote strong teeth and gums:

• Cheese and yogurt (calcium-rich foods)
• Fruits and vegetables (vitamin C and fiber)
• Lean meats and fish (phosphorus and protein)
• Whole grains (B vitamins and minerals)

Limit sugary foods and drinks, as they can contribute to tooth decay. When offering sweet treats, try to do so with meals rather than as frequent snacks throughout the day.

Fluoride and Dental Health

Fluoride plays a crucial role in strengthening tooth enamel and preventing decay. Most communities in the United States have fluoridated water, which provides an excellent source of this mineral. If your water supply isn’t fluoridated, talk to your pediatrician about fluoride supplements.

Around your child’s first birthday, you can start using a small smear of fluoride toothpaste (about the size of a grain of rice) when brushing their teeth. Increase this to a pea-sized amount when they’re able to spit out the toothpaste, typically around age 3.

Common Concerns and Questions About Baby Teeth

Parents often have questions and concerns about their baby’s dental development. Here are some common issues and their explanations:

Delayed Tooth Eruption

While most babies get their first tooth around 6 months, it’s not uncommon for some to start teething later. If your baby hasn’t developed any teeth by 18 months, consult with your pediatrician or a pediatric dentist to rule out any underlying issues.

Teeth Coming in Out of Order

Although there’s a typical order for baby teeth to emerge, some variation is normal. As long as all the teeth come in eventually, the order isn’t usually a cause for concern.

Gaps Between Teeth

Spaces between baby teeth are often normal and can even be beneficial, as they may provide room for larger permanent teeth to come in later.

Discolored Baby Teeth

Slight discoloration of baby teeth can occur due to various factors, including medication use during pregnancy or early childhood, trauma, or certain medical conditions. If you notice significant discoloration, consult your pediatric dentist.

Thumb Sucking and Pacifier Use

While these habits can be soothing for babies and toddlers, prolonged thumb sucking or pacifier use may affect tooth alignment. Most children naturally give up these habits by age 4. If the habit persists beyond this age, consult your dentist for guidance.

When to Seek Professional Dental Care

Regular dental check-ups are essential for maintaining your child’s oral health. Here are some guidelines for when to seek professional dental care:

First Dental Visit

The American Academy of Pediatric Dentistry recommends scheduling your child’s first dental visit by their first birthday or within six months after their first tooth appears. This early visit helps establish a dental home and allows the dentist to check for any potential issues.

Regular Check-ups

After the initial visit, plan for regular dental check-ups every six months, unless your dentist recommends a different schedule based on your child’s specific needs.

Signs That Warrant Immediate Attention

While most dental issues can wait for a scheduled appointment, some situations require prompt attention. Seek immediate dental care if your child experiences:

• Severe tooth pain
• Trauma to the mouth or teeth
• Signs of infection (swelling, fever, or pus)
• A knocked-out permanent tooth (time is crucial for reimplantation)

By staying vigilant and maintaining regular dental visits, you can help ensure your child’s oral health throughout their developmental years and beyond.

Baby Teeth: When Do They Come and Go

Baby Teeth: When Do They Come and Go

Developing healthy teeth begins during pregnancy. Your baby teeth begin developing while you are still in mommy’s tummy!  It is important for mom to get proper nutrition and avoid certain medications even before you are born to make sure you have a beautiful and healthy smile. 

The basic tooth substance begins to form at an amazing age of only 6 weeks, meaning the teeth are forming before many women have even realized that they are carrying a baby. By the time baby is ready to meet mommy, their teeth are also ready to emerge. 

It is rare and usually pretty surprising for mommy, but in some cases (about 1 in 2,500) baby is born with a tooth already showing! 

Most of the time babies will begin teething around 6 months old, but not every child is the same.  Some can start as early as 4 months and some wait until 12 months or later. Baby teeth usually almost always come in twos.   Typically the gums will look bumpy, red, and swollen right before those shiny teeth show themselves. The bottom two middle teeth are then the first to show. Next, sometime between 8 and 13 months, the upper middle teeth and the teeth directly to the right and left of this pair will appear as well.

Once you are one year old, you could have anywhere from one to ten teeth! It is around this time that most dentists recommend you have your first dentist visit. Your dentist wants to be sure that your teeth are coming in healthy and strong. He can also explain to you and mom the best way to take care of your teeth. For example, we recommend switching to a cup around a year old because bottles can cause liquid to pool around your teeth. You can also start using a small smear of fluoride toothpaste as early as one year old.

There are twenty total baby teeth that will come in and they will continue to come through until about 2 1/2 or 3 years old. The last teeth to come will be the lower and upper second molars, which are the very back teeth. Your new teeth will help you chew your food, talk correctly, and show your happiness through a beautiful smile.

Eventually, your permanent teeth will begin to push your baby teeth out. This process takes a lot longer than getting your baby teeth in. It takes about six years for all of your baby teeth to fall out and the permanent ones to grow in their places. In some cases it takes even longer! Normally around 6 years old, the first permanent teeth, molars, will begin to come through the gums. These teeth are very important because they help the rest of your adult teeth align correctly and become your main teeth for chewing.

Around this same time, about five years old or in some cases even earlier, you may begin to notice some of your teeth are loose! This is an exciting time which is usually celebrated throughout the world as a great milestone in our children’s lives. A good thing to keep in mind is that the earlier the teeth came in, the earlier they will likely fall out. As early as 4 years old, or as late as 7 years old, your first tooth will fall out. The baby teeth fall out in roughly the same order that they came in. This means the lower middle teeth will fall out first, followed by the top two middle teeth.

Your permanent teeth will continue to come in and by the time you are around 13 years old, you should have around 28 permanent teeth. The last four teeth, your wisdom teeth, usually come in anywhere from 17 to 25 years old.  By the time all of your teeth have finished coming and going, you will have 32 teeth and will already be in adulthood. These are the last teeth you will have. It is important to take good care of your teeth from the time the baby teeth start appearing so your permanent teeth are healthy and strong for as long as possible.

Baby’s teeth | Institut national de santé publique du Québec

Illustration: Bertrand Lachance

Don’t immediately assume that your baby’s fever, diarrhea, and red bottom are related to teething. Even if these symptoms occur at the same time, they are often caused by something else. For more information, see Fever, Diarrhea, and Redness on the bottom (diaper rash).

Your baby’s teeth start to form during pregnancy. At birth, she has 20 baby teeth, or primary teeth, that are still growing under the gums.

The formation of baby teeth and permanent teeth is influenced by diet in early childhood and by the mother’s diet during pregnancy.

Teething

Teeth grow gradually until they break through the gums. It is known as tooth eruption.

Baby teeth generally appear at around 6 months. But they can come in earlier or later, even as late as 12 months. The lower front teeth (incisors) usually break through first.

Teething may go unnoticed or may cause discomfort. When your baby is teething, she may drool more and feel the need to chew on something.

Your baby may also have red or irritated skin on the face and may fret more than usual or refuse to eat.

In some babies a blue swelling (known as an eruption cyst) appears on the gum up to two months before the tooth breaks through. This cyst usually needs no treatment.

What to do during teething?

If necessary, give your baby a clean washcloth soaked in cold water or a teething ring. You can cool the teething ring in the refrigerator, but don’t freeze it: your baby could injure her mouth.

You can also rub her gums with a clean finger.

Give her acetaminophen, if needed (see First choice: acetaminophen).

If your child is in serious discomfort, contact a health professional. You can also call Info-Santé at any time by dialing 8-1-1.

Products to avoid

Teething necklaces, syrups, and gels pose serious risks to your baby’s health.

Various products are available to relieve the discomfort of teething. However, they have not been shown to be effective and can be dangerous:

• Teething necklaces: Babies can choke on the wooden beads or other parts of a teething necklace, or can strangle themselves with it.
• Teething syrups and gels: These products contain an ingredient that can increase the risk of developing a serious blood condition. They also increase the risk of choking.
• Natural and homeopathic health products (e.g., belladonna): The exact contents of these products are not always clearly indicated on the packaging.
• Teething biscuits: These products do not relieve your baby’s discomfort. What’s more, they contain sugar and can therefore cause tooth decay (see Tooth decay).
• Certain pieces of raw fruit or vegetables can also be a choking hazard if given to baby to chew on (see Choking risk: Be extra careful until age 4).

Using a fluoride toothpaste helps prevent cavities.

Brushing

The purpose of brushing is to clean your baby’s teeth as well as possible using a fluoride toothpaste.

As soon as the first teeth appear, brush them at least twice a day. Brushing before bed is the most important time to brush.

Photo: Anne-Marie Turgeon

As soon as the first teeth start to appear, brush them at least twice a day.

Before bed is the most important time to brush your baby’s teeth. Ideally, a toothbrush should be the last thing to come in contact with your baby’s mouth before bedtime. There is less saliva in your baby’s mouth when she’s sleeping, which means tooth decay can develop and progress more easily.

If your child wants to brush her teeth herself, encourage her, and then do a final brushing. Since children love to imitate, you can also brush your teeth at the same time.

Toothbrush

• Use a children’s toothbrush with soft bristles. Change it as soon as the bristles start to bend.
• Rinse the toothbrush after every use.
• Let it air dry upright. Do not put a cap on it.
• To prevent the spread of germs, make sure it doesn’t touch other toothbrushes.
• Make sure your child has her own toothbrush and doesn’t share it with anyone.

Toothpaste

Use only a small amount of fluoride toothpaste: the size of a grain of rice is enough

Photo: Gouvernement du Québec, 2019

As soon as you start brushing your child’s teeth, you can use the toothpaste of your choice as long as it:

• Contains fluoride, an effective protection against cavities
• Is recommended for children under 6

Since children tend to swallow toothpaste, use only a very small amount, about the size of a grain of rice.

To prevent children from ingesting too much toothpaste, store it out of their reach.

Sugar

Sugars occur naturally in fruits, juices, and milk (e.g., breast milk, commercial infant formula, and cow’s milk). Sugar is often added to drinks, food, and drugs for children.

The more your child’s teeth are in contact with sugar, the more your child risks developing cavities.

Baby bottle

Prolonged contact between your child’s teeth and her bottle contain

Don’t let your baby drink from or suck on her bottle for long periods of time. Don’t let her sleep with or carry around a bottle or sippy cup containing juice or any other liquid except water.

If your baby has gotten into one of these habits, gradually dilute the contents of the bottle or cup with water until it contains nothing else. To reduce the risk of tooth decay, it’s best to wean her off the bottle when she’s about a year old.

Pacifier

Don’t dip your baby’s pacifier in honey, corn syrup, or any other sweet product.

Tooth decay

Tooth decay (also known as cavities or dental caries) can occur when your child is small, even before age 2. Once it appears, it can quickly get worse. The decay is caused by bacteria producing acid that attacks the structure of the tooth. It can cause pain and may interfere with your child’s sleep or feeding.

If you see dull white, yellowish, or brownish stains on your child’s teeth, it is advisable to see a dentist or dental hygienist. It could be the start of tooth decay. It’s important for the health of young children to have tooth decay treated, even though they will eventually lose their baby teeth.

Visits to the dentist

It’s a good idea to schedule a first visit to the dentist for your child after her first birthday.

Régie de l’assurance maladie du Québec covers the cost of dental exams and some treatments for children under 10.

Dental care during pregnancy: pros and cons

Microorganisms that multiply in the oral cavity during caries and inflammation of the gums can spread throughout the body and lead to the following consequences:

• intrauterine infections,
• exacerbations of inflammatory diseases of the upper respiratory tract,
• indigestion,
• weakening of general immunity,
• increased risk of toxicosis and other complications of pregnancy,

not to mention bad breath, plaque, dryness and cracks in the oral mucosa.

Is it possible to treat teeth during pregnancy?

Most likely, the tooth will collapse during this time (the bulk of the minerals goes to build the body of the fetus), damage the neighboring ones, and also become a focus of infection for the newborn. Let’s add a change in the properties of saliva, which, due to its increased viscosity, cannot fully wash and protect the teeth, weak mineralization.

The answer is clear: cure. To do this, you need to choose the right time, place, specialist and materials. Specialists at SM-Dentistry treat patients very carefully and choose only safe methods of treatment.

What to pay attention to when treating teeth during pregnancy

Not every doctor will undertake dental treatment during pregnancy. However, an experienced dentist knows what determines the success and safety of treatment.

At what stage of pregnancy to treat

1 trimester (6-12 weeks). Treating teeth is contraindicated. All organs and systems of the baby are laid, the hemato-placental barrier is not formed. Manipulations in the oral cavity can lead to the spread of infection and disrupt the development of the fetus. The ban on treatment especially applies to X-ray studies.

The exception is diseases in which the main symptom is acute pain. Then minimal intervention is made to alleviate the condition.

The dentist must be informed about pregnancy, possible allergic reactions, concomitant diseases.

2nd trimester (13-27 weeks). An ideal time to deal with dental problems. During this period, it is good to carry out the following procedures:

• preventive measures, rehabilitation of potential foci of caries or periodontitis. For example, professional teeth cleaning;
• treatment of gingivitis (inflammation of the gums), which often develops due to hormonal changes and leads to bleeding gums.
• caries treatment using safe modern materials that do not cross the placenta.
• extraction of teeth. If the tooth is already destroyed and its removal is indicated, then the procedure is carried out as carefully as possible.

3rd trimester (from 28 weeks).

Let’s switch to the most gentle mode again. First, the risk of preterm birth increases. Secondly, sitting in a dentist’s chair, even in the most comfortable one, is no longer very comfortable. The load on the cardiovascular system also increases, which can cause fainting, a drop in pressure, or vice versa, its sharp increase.

Is it possible to take x-rays of teeth during pregnancy

X-rays should be avoided during pregnancy. If you cannot do without it, it is better to carry it out with the help of modern equipment (radiovisiograph), such as in SM-Dentistry. The study involves dosed and point exposure. At the same time, irradiation is 10-15 times less than with standard x-rays. Reliable lead aprons are always used to protect mother and child.

Can anesthesia be used during pregnancy

Dental treatment without anesthesia is a lot of stress, so it is better to choose a safe and effective pain reliever than to worry. The latest generation drug articaine with a reduced content of adrenaline acts pointwise at the injection site, does not penetrate the placental barrier.

Anesthetics with a high concentration of adrenaline are strictly prohibited, so you should remind the dentist about your situation.

Which dental interventions are contraindicated during pregnancy

Whitening, implantation and extraction of teeth will have to be postponed to the postpartum period, as these are stressful interventions.

Teeth whitening procedures are not recommended during pregnancy and lactation.

Implantation requires the use of drugs that are not compatible with pregnancy. Engraftment requires additional forces from the body, which are already limited.

Prevention of teeth during pregnancy

1. Treatment of carious teeth and foci of periodontitis before pregnancy.
2. Careful care of teeth and oral cavity. In addition to the obligatory brushing of teeth 2 times a day with high-quality toothpaste, the use of dental floss and rinsing is recommended to prevent gum disease. You can use gels that restore enamel mineralization, reduce sensitivity and stop caries in the initial stage.
3. Nutrition should be complete, you can supplement it with vitamin and mineral complexes on the recommendation of an obstetrician-gynecologist who is pregnant and a trusted dentist.
4. Preventive check-ups every trimester. Professional cleaning is usually carried out 2 times a year.

Finding your dentist is just as important as finding your gynecologist. When you trust a specialist, any manipulations will be easy and positive, which will definitely have a positive effect on the health of both mother and child.

Teen dentistry

Patients of teenage dentists are the owners of the so-called interchangeable dentition, that is, those children whose milk teeth have begun to change to permanent, or molars. And the essence of teenage dentistry lies in the treatment, on the one hand, permanent, on the other hand, still children’s teeth, which have some differences in structure from the teeth of an adult. Firstly, the roots of permanent teeth in children are not yet fully formed, and the apical foramina (tops of the canals of the teeth) are expanded. Secondly, these teeth have a very wide and massive coronal pulp, the horns of which are located close to the hard tissues of the tooth – dentin and enamel.

Only with time, in adulthood, does the final formation of the tops of the roots occur, strengthening (due to mineralization) of the internal tissues of the teeth and enamel, and due to this, the “reduction” of the crown pulp. And since there are features in the structure of the teeth, then a special approach is needed in their treatment …

Age of adolescent dentist patients

It is important to understand that in the case of “adolescent dentistry” we are not talking about the period of puberty as such, that is, the actual adolescence. We are talking about the period of interchangeable bite, when milk teeth gradually change to permanent ones.

Thus, adolescent dentistry begins at the age of 6. It is at this age that the first permanent teeth appear. If up to this point a pediatric dentist has dealt with the problems of milk teeth, then with the advent of the first molar (and the first problems with it), the baby should visit two doctors – a child, while there are still milk teeth in the mouth, and a teenager, under whose “jurisdiction” fall erupted permanent. The complete change of bite is completed by the age of 13. And at the age of 14, a teenager passes into the hands of already adult doctors.

Main problems and features of treatment

Even in six-year-old children, we have to deal with a situation where a newly erupted permanent tooth is already affected by caries, as well as complications of this disease – pulpitis and periodontitis. In these cases, it is necessary to partially remove the root pulp and temporarily (!) Fill the canals with medical paste. In the future, we observe such a tooth in dynamics: perhaps, after some time, the root of the tooth will be completed and the apical opening will begin to narrow, and we will obturate the root canals with a permanent filling material.

But in difficult cases, such teeth must be removed. And this is due to the fact that it is impossible to obturate and create hermetism in the root canal with incomplete root formation, and this can lead to further complications. Just imagine: in the canal of the 6th chewing tooth, the inflammatory process continues due to poor sealing, as a result of which a cyst is formed, which can seriously affect the germ of the neighboring 7th tooth, causing inflammation there as well. As a result, the baby may lose both teeth involved in the act of chewing. To prevent this, we have to remove the “troublemaker”. However, after a child’s tooth is removed, an orthodontist comes to the rescue: he is able to “move” the permanent 7th and 8th teeth, which will erupt later, to the place of the lost “six” and thus completely restore the dentition.

Chewing (permanent) teeth, such as the 6th, are most susceptible to caries – they are the very first to erupt and the first to become victims of the carious process. This is due, first of all, to difficult hygiene, which is often characteristic even of an adult, and often with its complete absence, since babies still cannot or are too lazy to brush their teeth themselves. As we said at the very beginning, in “baby” molars, the coronal pulp is located too close to the hard tissues of the tooth. Because of this, rapidly developing caries quickly turns into pulpitis, that is, into inflammation of the nerve.

In general, the occurrence of complications of caries is, of course, the mistake of parents. The cause of caries is non-compliance with hygiene and timely prevention, and pulpitis and periodontitis are the result of a running process. It is obvious that the child is not yet able to control and assess the problems that have arisen on his own, he cannot go to the doctor for a medical check-up, etc. And this responsibility, of course, parents must take upon themselves …

All like adults

Erupted molars – quite large with a large nerve, affected by pulpitis – disturb children no less than adults, as they say, in full. Pulpitis causes terrible pain, does not allow you to eat, sleep at night, brush your teeth …

Another misfortune that most often concerns little fidgets. In the process of active games and sports, children receive various injuries, including dental injuries – breaking off the crown part of the tooth, fracture of the root, chipping with the opening of the tooth pulp. In these cases, we resort to sparing methods of treatment with preservation of the pulp. A therapeutic pad is placed on the opened pulp horn, and then we observe in dynamics how the process of formation of replacement dentin will proceed. In general, in children, the pulp tends to regenerate quickly. But it is very important that an infection does not get into the open, unprotected pulp. That is why the success of the application of this technique is very much influenced by the time frame. For example, the best results can be achieved if the child is brought to the appointment within 24 hours of the injury.

But if more than two days have passed since the injury, then you will have to completely extract the coronal and root pulp (that is, remove the nerve). And further treatment will depend on the age of the child. If the canals of the tooth are not yet fully formed, then we fill them with temporary paste and observe how the process will go in the future. It is likely that in the future, if the channels form correctly, we will be able to replace the temporary paste with a permanent material. If the apical foramen is sufficiently formed (at a later age) and we have the opportunity to obturate the canal well, we immediately use permanent materials that are used in adult dentistry. In case of an injury, the rule applies: the earlier you go to the dentist, the easier it is to save such a tooth, and in case of a late visit, the more unfavorable the prognosis for the future awaits you.

Adolescent orthopedics

In adult dentistry, treated and pulpless teeth are necessarily covered with a crown. Likewise with teenagers. The main task is to preserve the root of the tooth, so if the crown part has been destroyed by more than 50%, such a tooth must be covered with a crown.

However, there are some temporary exceptions in adolescent dentistry. For example, if a patient is preparing for orthodontic treatment, then we often make a temporary restoration of the tooth with the help of filling material. This allows the orthodontist to put a bracket system and completely correct the bite. And after that, a stump tab is made and the tooth is covered with a crown.

Yes, this whole process stretches for a long time, sometimes for several years, but it is impossible to put a bracket system on “crowned” teeth. The fact is that an artificial crown is placed half a millimeter under the gum in order to completely cover the crown part of the tooth. And when the teeth begin to move under the influence of the bracket system, this will inevitably affect the condition of the gums, the edge of the crown may be exposed. As a result, after correcting the bite, you will have to make a new crown and … again spend money on orthopedic treatment. And this, you see, is inappropriate.

Peculiarities in the extraction of permanent teeth

The main difficulty lies in the preservation of the rudiments of the permanent teeth that have not yet erupted adjacent to the affected tooth. Therefore, the most non-traumatic, careful handling of surgical instruments is necessary, since excessive force can damage the adjacent germ.

It also happens that the resulting cyst borders on the germ of an adjacent tooth or deep and serious ones have arisen in the bone tissue. In this case, you need a particularly thorough, literally jewelry, work. If the cyst has reached a very large size, then the child has to be sent to the hospital.

And of course, after removal, if necessary, antibiotic therapy is prescribed, if the diseased tooth has been removed, we necessarily observe the germ of the adjacent tooth in dynamics until we make sure that everything is in order with it. If the tooth germ develops normally, then a normal healthy tooth will subsequently grow.

What should be done at the mixed dentition stage to avoid dental caries and more severe complications?

First of all, thorough oral hygiene is necessary: ​​it involves proper brushing of teeth (How to brush your teeth correctly!) 2 times a day – in the morning and in the evening. This is very important, because their health depends on the technique of brushing your teeth. Even if you brush your teeth for 5-7 minutes, but do it without observing the necessary rules, plaque will still accumulate in the cervical area and enamel will be affected. There will be its demineralization and the formation of caries. Therefore, it is very important to brush your teeth well, but not to overdo it. If, on the contrary, too much effort is applied, then non-carious lesions of the teeth occur: a wedge-shaped defect, abrasion in the neck of the tooth and exposure of the internal tissues (dentin) of the tooth. What can we say, not even all adults are fluent in this seemingly uncomplicated “art” … All our doctors, regardless of the age of the patient, will be happy to show and tell you how to do this.

It is equally important to choose the right toothbrush. In general, the stiffness of the brush depends on the structure of the enamel. As for children and adolescents, we advise you to purchase, like adults, a medium-hard brush, provided that the teeth are normally mineralized and the enamel is strong and healthy. But in the presence of fluorosis (excessive amount of fluorine), the enamel becomes very fragile, in which case soft toothbrushes should be used. In childhood and adolescence, you should not use electric toothbrushes – the child, in fact, does not get along very well with the usual one either. And an electric brush, if used improperly, can only cause harm: it will damage the enamel in the cervical region, which will lead to erosion. Again, the doctor should help make the right choice.

For teenagers, ordinary adult pastes are used, which must be chosen taking into account the structure of the enamel. For example, with fluorosis, it is recommended to use a paste with calcium.

Regular visits to the dentist

Regular check-ups can detect caries in its early stages or even prevent its development. For example, if we notice teeth in a child’s mouth with deep, already pigmented fissures (and often even newly erupted teeth can be pigmented), then in this case, in order to prevent the development of caries, we perform invasive or non-invasive fissure sealing, that is, we clean the fissures and fill them with special sealant. Such procedures are carried out every 3-6 months (since the sealant tends to crack) depending on the condition of the teeth and . .. hygiene at home. If the child himself cannot cope with brushing his teeth at home, then you also need to visit a hygienist for professional teeth cleaning once every 1-3 months. If the baby has learned to thoroughly brush his teeth and he does not have a tendency to carious lesions, then it is enough to visit the clinic once every six months.

Parents can identify the first signs of caries themselves. Try to sometimes look into the baby’s mouth – in the truest sense of the word. We saw changes in the color of tooth enamel – run to the doctor! After all, caries can already be hidden under pigmentation. The less started the process, the easier it will be to prevent its further development.

In addition, regular check-ups of the child at the dentist also allow you to track any changes in the bite. If the pathology of the bite is sufficiently pronounced, the teenage dentist himself can see, for example, a too narrow jaw, and a lack of space for permanent teeth, etc. We immediately refer such a patient to an orthodontist. However, we recommend visiting this specialist for all children without exception. What a therapist or surgeon does not see is certainly not hidden from the experienced eye of a bite specialist. And only in his power to prevent its incorrect formation in the initial “imperceptible” stages.

We also mandatory examine the baby for the presence of short bridles. For example, with untimely excision of the short frenulum of the upper lip, a diastema (gap between the teeth) may form. And this is an aesthetic defect that we are trying to prevent. To trim the bridles, a laser bloodless method is used without suturing. The wound heals itself within two weeks with appropriate antiseptic treatment and the use of ointments.

Peculiarities of communication with adolescents

Of course, finding a psychological approach to the baby is a separate art. It will be very difficult for a doctor who has not worked with children to see teenagers. There is a special line here – this little man seems to be still a child, but already “half-adult”, you understand? There are children capricious, frightened, restless. It takes patience and the ability to choose the right words. It’s easy for an adult to say, “Open your mouth!” With children, this does not always work.

There are children of 6-7 years old who have to be treated like very young children: for example, instead of “let’s give an injection”, we say that “we will pour sleepy water on the tooth” or put a “snowflake”, etc. That is, we try to find alternative ways to explain to the baby what will happen to him, without scaring him. In a sense, such a half-truth.

There are children, do not believe it, frightened by their own parents. One wrong word can bring the baby “out of balance.” Therefore, we often have to conduct “educational” conversations with parents before proceeding with treatment or even examination.

Difficult moments arise with children frightened by a bad visit to the doctor in the past.