FAQs

Primary teeth, or baby teeth, are important for (1) proper chewing and eating, (2) holding space for the permanent teeth and guiding them into the correct positions, and (3) allowing for normal development of the jaw bones and muscles. Untreated cavities can and often do lead to problems that affect the developing permanent teeth. While the front four teeth are lost between 4-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 9-13.

Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth can begin to erupt; the first to erupt are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

Permanent teeth begin appearing around age 6, stating with the first molars and lower central incisors. This process continues until approximately age 21.

Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).

Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child’s dentist. DO NOT place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or cold milk. If the patient is old enough, the tooth may also be carries in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

Knocked Out Baby Tooth: Contact your pediatric dentist during business hours. This is not usually an emergency, and in most cases, no treatment is necessary. Primary teeth are not put back in the mouth.

Chipped or Fractured Permanent Tooth: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments (stored in cold milk) and bring them with you to the dentist.

Chipped or Fractured Baby Tooth: Contact your pediatric dentist.

Severe Blow to the Head: Take your child to the nearest hospital emergency room immediately.

Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.

• Radiographs (X-rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.
• Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
• The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year.
• Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount

Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use.

Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. Use a “smear” of fluoridated toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s tooth brushing. Remember that young children do not have the ability to brush their teeth effectively.

Parents are often concerned about the nocturnal grinding of teeth. Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between age 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have issues than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.

A few suggestions to help your child get through thumb sucking:

• Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
• Children who are sucking for comfort will feel less of a need when their parents provide comfort.
• Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
• Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
• If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.

Cavities are caused by germs that are passed from adult to child. Babies are born without the bacteria that cause cavities. They get it from saliva that is passed from their caregiver’s mouth to their own by sharing spoons, drinks, and kisses. Once a child acquires the cavity-causing bacteria, a poor diet and oral hygiene contribute to cause decay.

Tooth decay happens when bacteria in your mouth consume the sugars in your diet. When foods with sugar and starch are eaten, it gives bacteria on the teeth energy, allowing them to multiply and start making acids that can eat away the enamel on teeth. This “acid attack” usually lasts for an additional 30 minutes after the end of a meal or snack. If your child snacks frequently, the acid attack is prolonged and causes a cavity.

If your braces wire is poking, apply orthodontic wax to the sharp end or gently push it back with a clean pencil eraser. For relief, rinse with warm salt water and call your orthodontist as soon as possible to fix it properly.

If your bracket is broken, try to leave it in place and cover it with orthodontic wax if it’s irritating your mouth. Contact your orthodontist as soon as possible to schedule a repair and avoid delays in your treatment.