Dental Care

Q. When should my child first see a dentist?

A: “First visit by first birthday” sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. If you see any suspicious spots on your child’s teeth, particularly if the teeth came in early or the child has been taking a bottle to bed, don’t wait.  Bring the child any time you suspect a problem. Early examination and preventive care will protect your child’s smile now and in the future. 

Q. Why so early? What dental problems could a baby have?

A: The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (formerly known as baby bottle tooth decay or nursing caries). Once a child’s diet includes anything besides breast-milk, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

Q. How can I prevent tooth decay from nursing or using a bottle?

A: At-will breast-feeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced. Children should not fall asleep with a bottle containing anything other than water. Drinking juice from a bottle should be avoided. Fruit juice and milk should only be offered in a cup with meals or at snack time.

Q. When should bottle-feeding be stopped?

A: Children should be weaned from the bottle at 12-14 months of age.

Q. Should I worry about thumb and finger sucking?

A: Thumb sucking is perfectly normal for infants; many stop by age 2. Prolonged thumb sucking can create crooked teeth or bite problems. If the habit continues beyond age 3, a professional evaluation is recommended. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

Q. When should I start cleaning my baby’s teeth?

A: The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of 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 fluoridated toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.

Q. Any advice on teething?

A: From six months to age 3, your child may have tender gums when teeth erupt. As soon as the teeth penetrate through the gum tissue, the discomfort begins to go away. Many children like a clean teething ring, cool spoon or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger. Give the baby Tylenol Drops when needed, but be sure to stay within the guidelines on the bottle.  A surface anesthetic preparation like Ora-Gel for Teething may be useful at bedtime or when the child seems particularly upset, but it washes away in a short time.  Be sure to use it only according to the directions and not below the age of two years old.  There is no perfect solution, so just give extra love and this problem will resolve itself.  If the child has a fever or actually seems sick, be sure to check with your pediatrician.  An illness may be present along with the teething.

Q: Is there something I should do before my infant gets teeth?

A: It is very important to establishing a separate pattern of eating and sleeping while your infant is small.  Feed the child, then wipe off the gums with a gauze square or clean washcloth.  This separates eating from sleeping and gets the child accustomed to mouth cleaning routines.  Keeping the bottle out of the crib allows the child to learn to sleep through the night at a younger age, and avoids a later struggle over taking away the bedtime bottle.

Q: When will my child get teeth?

A: The primary teeth usually erupt at about six months, but there is a huge variation between children.  Some infants have teeth which erupt soon after they are born, and some are toothless until they are 18 months old.  The order in which the teeth erupt is almost always the same.  The lower front teeth usually come in first. 

Q: How does the pediatric dentist work with a toddler?

A: We keep the child secure by leaving him/her in the parent’s lap.  After a period of getting acquainted, we move into a knee-to-knee position with the parent who slowly leans the child’s head back into the dentist’s lap.