Double Tooth Photos

Pediatric Dentistry

Nov 7, 2011

Since starting Oral Answers, many people frequently email me photos that would be useful to share with everyone here on Oral Answers to illustrate a particular dental condition. Since many parents end up coming to Oral Answers via the page on double teeth, I thought it would be appropriate to start a collection of double tooth photos.

This double tooth photo collection will start out with the three photos below. If your child has a double tooth (either gemination or fusion), a photo of your child would benefit other parents who come to this site searching for photos and information.

To get your photo below, simply use this contact form or simply send them to OralAnswers [at] gmail [dot] com, replacing the bracketed words with the normal email symbols.

Double Tooth Photos

This first photo is the one I featured on the original post that discusses double teeth. It is Rachel’s son, who has gemination:

The following two photos are from Tiffany. At first glance, her son appears to have a gemination tooth on the opposite side as Rachel’s son in the photo above:

Here’s a close-up of the tooth pictured above:

Here’s an updated photo of Tiffany’s son now that he’s two years old:

Submit Your Photos

I would love it if you would submit your photos of a double tooth to help parents gain a better knowledge of what double teeth can look like. Please use this contact form or simply send them to OralAnswers [at] gmail [dot] com, replacing the bracketed words with the normal email symbols.

If you have any questions or comments, feel free to leave a comment in the comments section below. Thanks for reading!

Teething Baby Pictures

Oct 24, 2011

One of the most frequently read articles on Oral Answers over the past year is an article that I wrote back in January called What A Baby’s Gums Look Like While Teething.

That article only showed pictures of the two lower teeth coming in. I figured that it would also be helpful to show what the upper two teeth look like while coming in.

Also, since all babies are different, I figured it might be helpful to see pictures of a different teething baby.

Melissa, an avid photographer, did an excellent job of documenting her son’s teething experience.

Her son Logan is now four years old and has all of his baby teeth. Melissa generously allowed me to use her photos in this article to show what his teeth looked like as they came through his gums and how he made it through the teething stage.

How A Baby’s Teeth Look As They Cut Through The Gums

Here’s a picture of Logan’s two upper front teeth as they came poking through the gums:

Here’s a slightly different angle of the same picture:

Here’s a photo of Logan 8 days after the two above pictures were taken:

Melissa says that Logan’s teething lasted about one week per set of teeth that came in (teeth usually come into the mouth in pairs.)

How to Help Your Baby Survive Teething

There are many things that you can do to help your baby survive the teething process — I don’t mean survive literally, as modern science has shown that babies don’t die from teething!

Melissa states the following about how she helped Logan make it through his difficult teething experience:

“Since he did have one set come in right after another, it was hard to tell when he wasn’t teething minus the spike of a fever right before his teeth would come in. We constantly kept a bib on him to help soak up the drool. He had eczema and the drool made it worse, so I used a clear diaper rash ointment down his chin, neck and chest to protect that area and treat and prevent the rash from getting worse. Logan liked small, plastic, water filled teething rings that you put in the refrigerator. He also liked cold, wet wash cloths to chew on. Apples helped for some of his teeth, but he didn’t like them every time. We tried Orajel, but he didn’t really like it that much. It did seem to help when he would let us get it in there.

Mostly, he liked chewing on our fingers. It could hurt us, but at a certain point you will do anything to give your little one some relief. Baby Tylenol for the fevers and night time pain helped once in a while, but if you have a baby who is constantly teething, like Logan, you can’t exactly keep them hopped up on Tylenol. Hyland’s has a teething pill that is natural that really helped Logan and I highly recommend. I also nursed Logan until he was 12 months old, and I think that helped. He never bit me, but it seemed to sooth him somehow.”

Here’s a link to the Hyland’s Teething Tablets that Melissa mentioned. They seem to have pretty good reviews on Amazon – I wish I’d known about them with our first child!

Here’s a few photos that show Logan easing his teething pain with plastic teething rings, a toy he ripped off his bouncer, and an apple:

Just as a comparison, here’s two photos that show Logan teething as a baby, then again as a toddler. It seems like he didn’t mind it as much once he got a little big older.

You and Your Baby Will Make It Through Teething

I remember when our oldest son was teething for the first time, my wife and I had no idea what to do. He was extremely irritable. At the time, I was going to school full time and my wife was working full time. We were both exhausted and I vividly remember one night we were both up with our son and my wife ran out to go get some Orajel (which we’ve since learned more about).

Those days are far behind us and we now have a couple of kids with full sets of teeth. In retrospect, teething was just one small part of their infancy. Although it was uncomfortable for them at the time, it really is just a distant memory now.

Near the end of her email to me, Melissa said:

“Time has a way of making you forget some of the little parts of their childhood.”

Teething will be over before you know it, and you and your baby will both make it through just fine!

If you have any questions, comments, or concerns about teething, feel free to leave a comment below. Thanks for reading!

Six Names for Baby Teeth and Their Meanings

Pediatric Dentistry

Aug 29, 2011

Dentists often use many different words that all refer to the same thing. Dentists say calculus when they mean tartar and radiographs when they really mean to say x-rays. One interesting group of synonyms like this are used to describe a child’s first set of teeth. Here are six different names that are all used to describe our first set of teeth.

Six Names for Baby Teeth and Their Meanings

1. Baby Teeth

The first set of teeth are most often known as baby teeth. This is because they start to come in around the age of six months, when you’re a baby.

2. Primary Teeth

Primary means first. Baby teeth are often called primary teeth since they are the first set of teeth that come into the mouth.

3. Milk Teeth

Long ago, people thought that babies’ teeth grew in as a result of the mother’s milk washing over the baby’s gums. This is how the first set of teeth became known as milk teeth. Because this was so widely believed, many babies would be put to death if they were born with teeth, a condition known as natal teeth.

To learn more, read When Your Baby is Born with Teeth: Natal Teeth.

4. Deciduous Teeth

Remember learning about coniferous and deciduous trees in elementary school? Deciduous trees lose their leaves. Baby teeth are often called deciduous teeth because they fall out, similar to how a deciduous tree’s leaves fall off.

5. Training Teeth

The first set of teeth are also called training teeth because they train the child to take care of the permanent teeth. Although they are training teeth, sometimes it is still necessary to get dental work done on baby teeth in order to keep the permanent tooth healthy.

6. Temporary Teeth

Temporary teeth is the counterpart to permanent teeth. Since the first set of teeth generally stay in the mouth for less than a decade, they are sometimes labeled temporary teeth due to the fact that they are eventually replaced by the permanent teeth.

Although baby teeth are “temporary” it is still important to take care of them. Here are 5 reasons baby teeth are important.

Baby Teeth By Any Other Name Are Still Baby Teeth

Don’t let your dentist confuse you — all of these terms refer to your child’s first set of teeth! Can you think of any other names for baby teeth? I’d love to hear what you have to say in the comments section below. Thanks for reading!

When Your Baby Is Born With Teeth: Natal Teeth

Pediatric Dentistry

Aug 3, 2011

Natal Teeth: Teeth in Newborns | ©Langstrup/Shutterstock.com

Many hundreds of years ago, babies that were born with teeth would be tragically put to death because they were thought to be demons.

Fortunately, that doesn’t occur today. In fact, parents may be happy to find that their child is born with some teeth because it means that their baby has to experience teething for two less teeth. Although the mother may not be too happy to have to breastfeed a baby that already hast teeth!

Teeth that are present in a newborn’s mouth are called natal teeth. Neonatal teeth, on the other hand, are teeth that come into your baby’s mouth in the first 30 days of life. Sometimes natal teeth can be supernumerary, or extra teeth, but most of the time they are just regular baby teeth that have come in six months early.

What Causes Natal Teeth?

While the exact cause is not known, it is believed that the tooth simply develops in an abnormal position that is much closer to the surface of the gums.

A recent paper, a review of natal teeth says, “The exact [cause of natal teeth] is not known. Infection, febrile states, trauma, malnutrition, superficial position of the tooth germ, hormonal stimulation and maternal exposure to environmental toxins have been implicated as causative factors.”

How Common are Natal Teeth?

I looked at a variety of sources while researching before writing this article. Some sources say that natal teeth occur in 1 in 6,000 births. Other sources stated that the number was around 1 in 2,700. All of those statistics simply came from reports that existed regarding births. However, when a group of researchers actually looked at 7,155 infants looking specifically for natal teeth, they found that 10 of them had natal teeth. That gives us a prevalence of 1 in 716 births.

The real number is probably somewhere in the range of those three statistics.

2% of infants with unilateral cleft lip and palate are born with natal teeth and 10% of infants with bilateral cleft lip and palate have natal teeth. Natal teeth are more common in females and children of certain American Indian tribes.

Certain cysts that form on the gums of babies, such as gingival cysts of the newborn and Bohn’s nodules may look similar to natal teeth, but it is important to know that unless the white thing your seeing is as hard as a tooth, it’s probably not a tooth.

Where Do Natal Teeth Occur?

85% of all natal teeth are lower central incisors, 11% are upper incisors, 3% are lower canines and molars, while 1% of natal teeth are upper canines and molars.

What Should You Do If Your Baby Is Born With Teeth?

Many parents are surprised to find that their baby already has teeth and wonder if they need to do anything.

Many times, parents don’t need to do anything. They can simply relish the fact that they don’t have to go through the teething process for the natal teeth!

It’s not all roses though,there are a few different problems that can occur as a result of natal teeth. I’ve listed them below with an explanation of what to do about them.

1 – Natal Teeth Can Cause Problems with Breastfeeding

Breastfeeding may be difficult and you may have to pump or mix formula and give it to your baby in a bottle.

McDonald & Avery’s Pediatric Dentistry textbook states, “A retained natal or neonatal tooth may cause difficulty for a mother who wishes to breast-feed her infant. If breast-feeding is too painful for the mother initially, the use of a breast pump and bottling of the milk are recommended. However, the infant may be conditioned not to “bite” during suckling in a relatively short time if the mother persists with breast-feeding. It seems that the infant senses the mother’s discomfort and learns to avoid causing it.”

2 – Natal Teeth Can Cause Ulcers on the Underside of the Tongue

Sometimes the natal tooth will be sharp and can cause an ulcer to form on the underside of the tongue. This problem is known as Riga-Fede Syndrome. In this case, the dentist can smooth off the sharp edge of the natal tooth or add a small amount of white filling material to smooth out the tooth. Once the sharp edge of the tooth is gone, the ulcer usually resolves.

3 – Natal Teeth May Pose a Choking Hazard

While many natal teeth are fixed firmly into the jawbone, sometimes natal teeth are very loose. In cases where natal teeth are very loose, some sources say that it is a good idea to have the natal teeth extracted. Other sources say that there are no documented cases of a child choking on a natal tooth and that extracting it can be an emotionally difficult procedure for the parents.

I think that the most important thing to find out here is whether or not the natal tooth or teeth are extra teeth. Dr. Pinkham’s pediatric dentistry textbook says that all extra (supernumerary) natal teeth should be extracted, while regular baby teeth that are natal teeth should be evaluated to see if they pose a choking hazard to the infant.

Conclusion

Natal teeth may occur more often than once per every thousand births. They may not cause any problems, but they can cause ulcers on the infant’s tongue and problems with breastfeeding. They can cause difficulty if they are loose as they may pose a choking hazard for the baby.

Do you have any questions about what to do when your baby is born with teeth? Did your child have natal teeth? Please share your comments, experiences, and questions in the comments section below. Thanks for reading!

Extra Tooth: Mesiodens and Other Supernumerary Teeth

Jun 13, 2011

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Supernumerary Teeth — Extra Teeth: Supernumerary Premolars | ©iStock.com/Watanyou

Has your child ever come up to you and told you that they have an extra tooth growing out of their upper jaw behind their permanent teeth? It’s probably more likely that you’ve been told that your child has an extra tooth, or supernumerary tooth (we try to make up complicated words!) as dentists like to call it.

If so, you’re not alone! It is estimated that supernumerary, or extra teeth occur in 2% of Caucasian children, with an even higher frequency in those of Asian descent.

Below you can see an x-ray of a child with a supernumerary tooth. The original x-ray is on the left, and I outlined the supernumerary tooth in green in the x-ray on the right.

This particular extra tooth is called a mesiodens. That means that it is right between the two upper middle front teeth. Only about 25% of these teeth actually erupt into the mouth. Most mesiodens teeth stay in the jawbone and never make it into the mouth.

What Causes Supernumerary Teeth?

Currently, it is believed that supernumerary teeth occur due to the continued growth of the tissue that forms teeth, known as the dental lamina.

Supernumerary teeth can be hereditary or they may be associated with one of two conditions: Gardner’s Syndrome and Cleidocranial Dysplasia. Supernumerary teeth can also occur in people that don’t have those two conditions and in those withouta family history of supernumerary teeth.

How Common Are Extra (Supernumerary) Teeth?

It is estimated that supernumerary teeth occur in 0.1-3.8% of Caucasians. They are even more common than that in people of Asian descent, although I couldn’t find any hard numbers.

Supernumerary Teeth are twice as common in boys as they are in girls. Most supernumerary teeth form before the age of 20, although they are more commonly found with the permanent teeth rather than the baby teeth.

What are Supernumerary Teeth Called?

Extra teeth have a lot of names! They are classified based upon where they are located and what they look like.

If an extra tooth is located in the middle of the two front teeth, it is called a mesiodens. If the extra tooth is located around the molar area, it is called a paramolar. If the extra tooth is located behind the wisdom teeth, it is known as a distodens.

If an extra tooth is shaped like another “normal” tooth, it is called a supplemental tooth. If it is not shaped like a normal tooth, then it is known as a rudimentary tooth. Rudimental teeth are then classified based on what they look like:

Conical Rudimentary Teeth look small or peg-shaped.
Tuberculate Rudimentary Teeth appear to be barrel-shaped and have more than one cusp.
Molariform Rudimentary Teeth look similar to premolar or molar teeth, but not enough to be called a supplemental tooth.

What Does a Supernumerary Tooth Look Like?

When I was out visiting my sister last summer, she told me that my nephew had to get an extra tooth removed. She told me I could even take a picture and put it up on Oral Answers.

You can see my nephew’s supernumerary tooth to the right. It was a mesiodens, since it was growing right between his front two teeth. As you can see, the tooth doesn’t really resemble any particular tooth, it just looks like a cylindrical piece of enamel.

Where Do Supernumerary Teeth Occur?

Almost all (around 95%) supernumerary teeth occur in the upper jaw. They mostly occur between the upper two front teeth. After that, you are most likely to find a supernumerary teeth behind the wisdom teeth.

Interstingly, supernumerary teeth don’t always occur in the jaws. Neville’s Oral Pathology textbook states, “Although most supernumerary teeth occur in the jaws, examples have been reported in the gingiva, maxillary tuberosity, soft palate, maxillary sinus, sphenomaxillary fissure, nasal cavity, and between the orbit and the brain. The eruption of accessory teeth is variable and dependent on the degree of space available.”

As you can see, supernumerary teeth can pretty much occur anywhere in your head, although they are most likely to occur in your jaws like the rest of your teeth.

Do You Need to Have Supernumerary Teeth Removed?

Most dentists recommend removing supernumerary teeth because they can cause problems. Regezi’s Oral Pathology textbook states:

The significance of supernumerary teeth is that they occupy space. When they are impacted, they may block the eruption of other teeth, or they may cause delayed eruption or maleruption of adjacent teeth. If supernumerary teeth erupt, they may cause malalignment of the dentition and may be cosmetically objectionable.

Because they can cause problems, it is generally a good idea to have supernumerary teeth removed.

Conclusion

If you have extra teeth, don’t be alarmed! It is pretty common to have supernumerary teeth. You can work with your dentist to figure out what your options are for removing the tooth and aligning your smile correctly.

Have you had a supernumerary tooth? Do you have any questions about supernumerary teeth? I’d love to hear what you have to say in the comments section below. Thanks for reading!

Can Baby Orajel Cause Methemoglobinemia In Your Teething Baby?

May 18, 2011

Baby Teething Gel and Methemoglobinemia — ©Jandrie Lombard/Shutterstock.com

Imagine waking up in the middle of the night to an upset teething baby. You stick some Orajel in the baby’s mouth and go back to bed for some sleep. The next morning, you realize that your baby isn’t breathing. Although rare, this can happen.

Last month, the FDA spoke out about a certain complication known as methemoglobinemia that can occur with Orajel and other popular baby teething gels on the market.

Methemoglobinemia occurs when hemoglobin (the protein in blood that carries oxygen) gets modified so that it can’t carry oxygen to the body as effectively. Because we all need oxygen to survive, methemoglobinemia is a potentially fatal disease.

Any teething gel that contains benzocaine can cause methemoglobinemia. This includes such brands as:

The complication that can occur with baby teething gels is due to the local anesthetic, benzocaine, which teething gels use to cause a numbing sensation in your teething baby’s gums.

In their warning, the FDA states: “Methemoglobinemia has been reported with all strengths of benzocaine gels and liquids, including concentrations as low as 7.5%. The cases occurred mainly in children aged two years or younger who were treated with benzocaine gel for teething.”

In case you’re wondering, the strength of benzocaine in Orajel Baby teething gel is 7.5%. Here’s the Drug Facts label for Baby Orajel if you’d like to take a look.

Symptoms of Methemoglobinemia

If you’ve used a lot of teething gel on your teething baby, it’s important to look for the following symptoms, which can be a sign of methemoglobinemia:

Pale, grayish-blue skin, lips, and finger/toe nail beds.
Shortness of breath
Tiredness and fatigue
Rapid heart rate
Confusion
Headache
Lightheadedness

If you believe that your baby has methemoglobinemia, it is important to seek medical care immediately.

How to Prevent Your Teething Baby From Getting Methemoglobinemia

The best way to prevent your teething baby from getting methemogloginemia would be to simply not use teething gels. The American Academy of Pediatric Dentistry says that you can simply massage your baby’s gums or give them a chilled teething ring.

Looking for more ways to calm your teething baby without using Orajel? Check out the article, Eight Natural Teething Remedies to Help Your Teething Baby.

Conclusion

If you want more information about Methemoglobinemia and teething gels, you can check out this news release from the American Dental Association.

It is important to remember that any drug that you give your child can have serious side effects. Make sure that you are an informed parent by learning about each drug you give your child – not just teething gels!

Do you have any questions, comments, or concerns about methemoglobinemia and teething gels? I’d love to hear what you have to say in the comments section below. Thanks for reading!

Eight Natural Teething Remedies to Help Your Teething Baby

May 13, 2011

Many parents aren’t comfortable giving their little teething babies teething gel, especially when they hear about the rare, but serious side effects that can occur. Back before teething gels were invented, many parents used natural methods to calm their teething babies. Fortunately, for those parents that don’t want to give their teething babies drugs, there are many natural teething remedies to choose from. The teething baby boy pictured to the left would be a great little spokesman for the natural teething baby association as he happily soothes his aching gums with a carrot. While I do list some natural teething remedies below, it’s pretty likely that I passed over some good ones. If you know of a good, natural teething remedy that I didn’t mention, please write about it in the comments section below.

Eight Natural Teething Remedies to Help Your Teething Baby

1 – Teething Biscuits. Many parents love using teething biscuits to calm their teething babies. Be sure to choose a teething biscuit that is healthy for your little one. When used in moderation, teething biscuits shouldn’t adversely affect your little one’s oral health.

Want to learn more about teething biscuits? Read Teething Biscuits: A Natural Way to Calm Your Teething Baby.

2 – Frozen Teething Rings. Cold items such as teething rings can alleviate the pain that a teething baby experiences.

3 -Frozen Carrots & Bananas. Frozen bananas are a sweet treat that can ease your baby’s sore gums. If your baby chews on a frozen carrot, only small bits of carrot come off at a time. Some parents don’t want to give their children frozen objects because they don’t want to inadvertently freeze their baby’s gums by giving them something so cold. If you want to play it safe, just go with a cold carrot, as pictured above.

Important – Any time you give your baby something to eat, you must stay with them at all times to help prevent choking.

4 – A small, cold metal spoon. You can either keep some spoons in the refrigerator, or put a small metal spoon in a glass of ice water. Your teething baby can then hold the spoon and bite down on it to help soothe their irritated gums.

5 – A cold, damp washcloth. Some parents have found that their baby enjoys chewing on a frozen damp washcloth or a cold, wet washcloth.

6 – Dried Fruit. Many parents advocate the use of dried apples to help ease teething troubles. Any dried fruit that allows the child to chew can help alleviate teething problems. Keep in mind that you should use dried fruit in moderation, as it can cause tooth decay.

Want to know which of the six kinds of fruit are bad for your child’s teeth? Read Is Fruit Good or Bad For Your Teeth? It Depends.

7 – Ice chips in a clean baby sock. Some parents have found that by putting small ice chips in a baby sock, and then tying off the sock, they can give their baby something cold without the risk of their baby’s gums getting too cold.

8 – Gently rub your baby’s gums with your finger. I’ve tried this with my children and it seemed to help them, although my daughter has bit me before! It didn’t hurt too much however due to the lack of teeth. Holding your baby and massaging their gums with your finger can also provide comfort to your teething baby during this hard time.

Beware of Possibly Dangerous Natural Teething Remedies

The internet is an interesting place. Almost anybody can say anything about any topic under the sun. It is important to know that although teething does cause some irritation in your child, it’s probably a good idea to not use any unproven homeopathic remedies. Dr. Steven Pray, a professor at the College of Pharmacy at Southwestern Oklahoma State University has said, “Parents or caregivers should be cautioned against use of unproven and potentially dangerous teething remedies such as homeopathic teething tablets containing belladonna, coffee, magnets, tea tree oil, anise seed, clove oil, and cantharides.” Use your common sense when dealing with your teething baby. Many parents simply look for a quick fix to their baby’s teething troubles, possibly putting their precious baby at risk.

What Do You Do to Help Your Teething Baby?

Do you have any other suggestions to help the parents that are reading this post be able to more effectively calm their teething baby? Do you have any questions, comments, or concerns? I’d love to hear what you have to say in the comments section below – Thanks for reading!

At What Age Can Kids Brush Their Own Teeth?

Pediatric Dentistry

Mar 25, 2011

Age When Kids Can Brush Their Own Teeth — ©Edyta Pawlowska/Shutterstock.com

Have you ever heard any of the following quotes regarding the age that kids should start brushing their teeth by themselves?

“My daughter could brush all by herself when she turned two years old!”
“Kids can brush alone when they can cut through a thick New York strip steak without any help.”
“They can brush alone when they are old enough to color in a coloring book and stay inside the lines.”
“They can be in charge of their own teeth when they are old enough to tie their shoes.”
“They’ll be able to brush by themselves when they can write in cursive.”
“They can brush their teeth alone when they’re old enough to hit a moving target 20 feet away with a paintball gun while standing on one leg.”

I might have made up that last one, but as you can see there’s a lot of confusion about the exact age at which a child can brush their own teeth and do a good enough job.

So when exactly are kids really old enough to brush their teeth all by themselves? The answer really depends on a couple of other questions which we’ll go over first.

Are Younger Children Worse at Brushing Their Teeth?

Can Kids Brush Their Own Teeth When They Can Write? — Some Say That Kids Can Brush When They Can Write In Cursive

What if you could videotape people of different ages brushing their teeth and figure out at what age kids finally “get it” enough to remove the slimy layer of plaque from their teeth?

Two researchers decided to do just that. They recorded a group of 5 year-olds, 11 year-olds, and 18-22 year-olds to see exactly how much plaque they removed when they brushed. Here’s what they found:

5 year-olds only brushed 25% of the surfaces of their teeth
11 year-olds only brushed 50% of the surfaces of their teeth
18-22 year-olds brushed 67% of the surfaces of their teeth

As you can see, as people get older, they appear to be able to clean their teeth better. Interestingly, only developmental age has been shown to be associated with how well people brush their teeth. The older they are developmentally, the better they brush. The textbook Dentistry for the Adolescent and Child by McDonald & Avery states, “Although both chronologic and developmental ages were found to be predictors of plaque removal ability, only developmental age demonstrated statistically significant predictive power.”

As children get older, they develop better dexterity and hand-eye coordination. If we strictly went by the information in the study above, we probably wouldn’t even trust 18 year olds to brush their teeth by themselves! Maybe, brushing has more to do with learning the right brushing technique rather than getting older.

For example, what if someone tried to teach the 5 year-old to brush? Wouldn’t they be able to brush by themselves if they knew what they needed to do?

Can Younger Children Be Taught to Brush Their Teeth Better?

Recently, a group of researchers tested some new technology geared at helping small children learn how to brush their teeth better. They created a technology known as Ubicomp that uses computers to help children learn how to brush their teeth utilizing the Playful Toothbrush. Here’s what they found:

“After using the Playful Toothbrush for five consecutive days, kindergarten children exhibited significant improvement in effectiveness of teeth cleaning, increased number of brushing strokes, longer brushing time and more thorough brushing coverage in teeth areas.”

You can read a PDF file of the complete study to learn more about the technology used and how it improved the kindergarteners’ brushing skills.

So At What Age Can Kids Brush Their Own Teeth?

Ultimately, there isn’t one answer that will cover every child. Each child is different. Of the three pediatric dentistry textbooks I read while researching for this article, I found that two of them glossed over this question, which demonstrated to me that it is a difficult question to answer. The textbook Dentistry for the Adolescent and Child by McDonald & Avery was the only one that alluded to an age when kids can brush their own teeth. The authors state:

“Although children in the preschool age range begin to demonstrate significant improvements in their ability to manipulate the toothbrush, it is still the responsibility of the parent to be the primary provider of oral hygiene procedures. All too often, parents of these children feel that the child has adequately achieved the skills necessary to clean the teeth. It is important to stress to the parents that they must continue to brush their child’s teeth.”

They believe that children 3-6 years old still lack the fundamental skills necessary to brush their own teeth. In the next section dealing with children ages 6 to 12, they state:

“The 6- to 12-year stage is marked by acceptance of increasing responsibilities by the children. The need to assume responsibility for homework and household chores tends to occur during this time. In addition, the child can begin to assume more responsibility for oral hygiene. Parental involvement is still needed. However, instead of performing the oral hygiene, parents can switch to active supervision. By the second half of this stage, most children can provide their basic oral hygiene (brushing and flossing). Parents may find they only need to brush or floss their child’s teeth in certain difficult-to-reach areas of the mouth or if there is a compliance problem. Parents do need to actively inspect their child’s teeth for cleanliness on a regular basis.”

The magic age at which kids can brush their own teeth seems to be sometime between the ages of 6 and 9.

Conclusion

Since every child is different, you will need to individually figure out when your child is ready to begin brushing without any help. A good way to do this is to use plaque disclosing tablets or solutions. These plaque disclosing agents turn the plaque on your child’s teeth a different color so that it is easy to visualize and remove. As long as your children are removing almost all o the color-stained plaque from their teeth, they are able to brush by themselves.

I currently have very young children who are eager to do things independently. Rather than letting toothbrushing become a battle every night before bed, I have the following deal with my kids: They get to brush first and then I tell them I’m going to “check to see if they got everything clean” as I help them finish up. My wife and I plan to continue doing this for a few more years. Once they are a little bit older we will likely start using plaque disclosing tablets more regularly. When we begin to notice that they are removing much of their plaque independently then we will transition to letting them brush by themselves.

Do you have any questions or comments about the age when a child can begin brushing their own teeth? Please join in the discussion by leaving a comment below. I’d love to hear about what you’ve done to help your child brush all alone, at what age you got your child to brush, and if they ended up getting any cavities after they took over their oral hygiene routine.

Thanks for reading!

Teething Biscuits – A Natural Way to Calm Your Teething Baby

Mar 18, 2011

Teething Biscuits Natural Teething Remedy — ©Dave Clark Digital Photo/Shutterstock.com

Many parents are looking for a way to help soothe their teething baby that doesn’t involve smearing a numbing gel such as Orajel on their gums. Teething biscuits are just one of many alternatives and have been around for quite some time.

Does Your Teething Baby Need Teething Biscuits?

The short answer to this question is no. Your baby does not need teething biscuits. Certain babies may not be ready for solid foods such as teething biscuits. As a parent, you know your baby better than anyone else and can probably make the best decision as to whether or not teething biscuits are right for your child. Here are a few advantages to teething biscuits:

1 – Teething biscuits can soothe your baby’s gums and satisfy the urge that your child has to bite during teething (one of the 10 symptoms of a teething baby)

2 – Teething biscuits help your child learn to feed him or herself.

3 – Teething biscuits can provide valuable nutrition to your child that may be difficult to obtain while the child is teething.

My wife and I gave teething biscuits to our daughter during her teething episodes. We found that some of them made a mess, but overall they helped ease our daughter’s teething troubles.

Where to Buy Teething Biscuits

You can find teething biscuits at pretty much any grocery store or at an online retailer such as Amazon. A few popular types to consider are:

Baby Mum Mum Rice Rusks
Earth’s Best Wheat Organic Teething Biscuits (Also available in Barley)
Healthy Times Vanilla Premium Organic Teething Biscuits

Make Your Own Teething Biscuits

If you’d rather not pay retail prices, it may be cheaper to make your own teething biscuits at home, not to mention that you’ll know exactly what you are feeding your baby.

WholesomeBabyFood.com has this page with some good teething biscuit recipes and it tells you what ingredients are safe to use for your baby.

Conclusion

Teething biscuits certainly aren’t the only natural way to help your teething baby. In my next teething article I’ll go into detail about the many other natural ways to help pacify your teething child.

I also want to add a caution that any solid objects near your child’s mouth do pose a choking risk so you should always supervise them if you decide to give them teething biscuits.

Have you ever given teething biscuits to your teething child? Do you have any questions, comments, or stories to share about teething? I’d love to hear what you have to say in the comments section below. Thanks for reading!

Dark Tooth: Why Your Child Has a Discolored Tooth

Feb 28, 2011

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Why Your Child Has a Dark Tooth — ©Tatyana Vyc/Shutterstock.com

If you have kids, you know that they can get themselves into a lot of interesting accidents. Many times when kids get a head injury they knock out a tooth. Other times, they simply hit the tooth really hard and injure it.

It has been estimated that 8-30% of kids under 7 suffer an accident that injures one of their baby front teeth.

Any time a tooth suffers an injury, there is a possibility that it may turn a different color. If you’re wondering what it means if your child’s tooth has turned pink, red, gray, black, brown, or yellow, then you’re the reason I wrote this article!

Tip – I will use words like pulp, dentin, and enamel in this article. If you don’t know what those mean, you might want to brush up on The Anatomy of a Tooth.

When Your Child’s Tooth Turns Dark (Gray, Brown, or Black) After a Tooth Injury

When blood leaks out of blood vessels after a tooth injury, blood by-products such as iron can make their way into the small tubes inside the dentin layer of the tooth. As the blood breaks down, it can make the tooth appear to be gray, dark gray, brown or even black. This color change doesn’t usually occur until 2-3 weeks after the tooth has been injured and can occur after a tooth has turned red (see below.)

The book Paediatric Dentistry by Welbury states that “although the reaction is reversible to a degree, the crown of the injured tooth retains some of the discoloration for an indefinite period. In cases of this type, there is some chance that the pulp will retain its vitality, although the likelihood of vitality is apparently low in primary teeth with dark gray discoloration.”

Basically, the author is stating that even if a tooth has a dark color, it may still be able to return to health. Some experts have said that the darker the discoloration, the more likely it is that the nerve of the tooth has died. For example, this study “found that 33 of 51 traumatized teeth with gray-black discoloration were necrotic.” However, other experts state that the shade of darkness doesn’t reflect the health of the pulp.

If your child’s tooth has turned dark, the best thing to do is to have your child’s dentist look at it. If there are other signs that the tooth is dead such as swelling or an infection that shows up on the x-ray, then your child’s dentist will probably choose to do something about it such as performing a root canal treatment or removing the tooth.

If there is no sign of infection in a dark tooth, the dentist may choose to not do anything and let the tooth eventually fall out on its own when the permanent tooth is ready to take on its role in the mouth. A study by Sonis showed that 72% of darkened teeth fell out normally without any bad effects on the permanent tooth.

Also, if there are no other signs of infection, this study showed that there is no need to do a root canal. The researchers concluded that “Root canal treatment of primary incisors that had change their color into a dark-gray hue following trauma with no other clinical or radiographic symptom is not necessary as it does not result in better outcomes in the primary teeth and their permanent successors.”

When Your Child’s Tooth Turns Red or Pink After a Tooth Injury

If a tooth is going to turn red after an injury it can turn red shortly after the injury, or it can wait anywhere from a few weeks to months before it begins to turn a pinkish red color.

Red and Pink Teeth Immediately After the Injury

If a tooth turns red shortly after being traumatized, it usually means that the blood vessels inside the pulp broke. When the blood vessels rupture, blood leaks inside the whole pulp area of the tooth resulting in a reddish pink color. This condition is known as pulpal hyperemia.

Sometimes pulpal hyperemia is difficult to detect. You may have to shine a light on your child’s tooth and look at the tongue side of the tooth with a mirror to detect this color change.

The pink/red color may take a long time to go away or it may never go away and the tooth may start to darken to a shade of gray.

Red and Pink Teeth Weeks after the Injury

As a result of trauma, sometimes cells inside the tooth start eating away at the hard layers of the tooth through a process called internal resorption. These cells are called odontoclasts and in certain cases they can eat away to the outside of the tooth within a few short weeks. The tooth looks pink because as the pulp layer of the tooth gets bigger, its red color more easily shines through the thin layer of remaining tooth structure.

A man named James Howard Mummery first noticed this “pink spot” that appears on teeth, which is why it is typically referred to as pink tooth of Mummery. Pink tooth of Mummery can start occurring anywhere from a few weeks to months after a tooth is injured.

These teeth are usually kept until the crown of the tooth is dissolved. Then the tooth root can either be removed or it can be left to get dissolved spontaneously as the permanent tooth comes into your child’s mouth.

When Your Child’s Tooth Turns Yellow After a Tooth Injury

The dentin layer of a tooth under the enamel is normally a yellow color. If a tooth reacts to an injury by laying down a lot more dentin, it is known as pulp canal obliteration (Also called calcific metamorphososis, progressive canal calcification or dystrophic calcification.)

The increase in the amount of dentin and the concurrent decrease in the amount of pulp gives the tooth a yellow, opaque color.

The book Pediatric Dentistry by Pinkham states that “although pulp canal obliteration is a pathologic process, it has no known deleterious effects and therefore does not necessitate any treatment except follow-up.”

It is important to regularly follow-up with your child’s dentist about any teeth that have turned yellow after an injury. The book Paediatric Dentistry by Welbury notes that “a small percentage [of yellow teeth] demonstrate pathologic change many years after the injury.”

Conclusion

Many times parents want to rush treatment when their child’s tooth changes color. It is important to understand that “in the primary dentition of a healthy child, color change alone does not indicate a need for pulp therapy or extraction of the tooth (Pinkham.)”

Basically, if your child’s baby tooth has changed color, often the best treatment is no treatment. As long as an infection doesn’t develop, simply waiting it out and seeing what happens could mean that your child doesn’t have to go through unnecessary dental treatment. And that’s a good thing, especially after they’ve already been through a traumatic tooth injury.

Do you have any stories, questions, or comments about tooth discoloration? Do you still have a question that I didn’t answer? Feel free to write your thoughts in the comments section below so that we can all learn from each other – Thanks for reading!

Submitted Photos

Krista from The Muminator blog shared the following photos of her daughter after she had an accident in 2012:

Here’s a photo not too long after her daughter was playing on the furniture and fell:

Here’s a photo a few weeks after that. The tooth continued to get darker:

And a final photo of the tooth returning almost back to its normal color:

You can read all about her daughter’s experience on this thorough blog post that she wrote about the entire experience.

The following photo is from Jennifer, who has left some very informative comments below regarding her daughter’s dark tooth. She states:

Its not white completely but is a lot better than what it was… The left side of the photo is around 3-4 weeks after the trauma.. and the right side of the picture was taken a few days ago, around 8 weeks after the trauma, It has also moved back into alignment a bit more as well, as it was knocked back with a blunt blow.

If you have a photo of your child who had an injury that caused a tooth to discolor, please send them to me using this form and I can post them here to help others who are going through this same experience.

How Long Does Teething Last?

Feb 11, 2011

If you’ve had a child, then you probably know how teething affects kids — and parents!

When it comes to teething, many parents want to know at what age teething starts and how long it will last. While I can’t give you an exact answer as to when your child will start teething and for how long, I can point out some general guidelines.

The Age When Babies Start Teething

The average baby’s first tooth pokes through their gums right around the age of six to ten months. Since all baby’s get their first tooth at a different age, it may help to give a general outline of when to expect all 20 of your baby’s teeth. I mostly used the data from the ADA’s Primary Tooth Eruption Chart (PDF) and have put the average age in months when each event occurs (shown in parentheses) below as well.

Around 4 to 10 months your baby will get their first teeth, the lower front two teeth, the lower central incisors. (~8 months)

Two months later the two upper front teeth (central incisors) will come into your baby’s mouth. (~10 months)

One month later, the upper lateral incisors will come in. (~11 months)

Two months later, the lower lateral incisors will come in. (~13 months)

Three months later, your baby’s first molars will come in on the top and on the bottom. (~16 months)

Three months after that, your baby will get the upper canine teeth. (~19 months)

One month later, your baby will get the lower canine teeth. (20 months)

Seven months later, your baby will get their lower second molars. (27 months)

Two months later, your baby will complete their baby teeth by getting their upper second molars. (29 months)

As you can see, your baby will constantly be getting new teeth over the course of about two years. It’s important to understand that while your child will keep getting new teeth during this time, they won’t be teething the entire time. Teething refers to the process by which a tooth erupts through the gums into the mouth. This process can include some pain and discomfort, usually during the period of time before you actually see the tooth emerge from the gum.

Now that you know when to expect all 20 of your baby’s teeth, let’s discuss teething in greater detail.

How Long Does Teething Last?

In the late 1990’s, a survey was sent out to many parents asking them about various aspects of their children’s teething habits. One question that I noticed in particular asked the parents how long their babies had teething symptoms for each tooth that came into their mouth. Aside from a few parents that said their children didn’t experience any teething symptoms (I wish I could say that!), here’s what the rest had to say about how long teething lasted for their kids:

As you can see, the results are all over the place.

If you do a quick search on the internet, you come up with many interesting stories, some of which claim that teething takes over 6 months! Take a quick look at the following comment that user chrellis_26 said on the BabyCenter website:

“My son started the teething process at about three and a half months, he was ten months old when he finally got one tooth. Lately, now at fifteen months, it can take days or weeks of irritable behavior before a tooth comes in.”

I think the reason that there are so many differing opinions on this issue is because many people attribute fevers and other unexplained irritable behavior to teething. For example, some people believe that teething can cause a high fever and diarrhea – both of which are teething myths (stay tuned for a teething myths article in the future!)

The real process of teething can cause some inflammation in the gum tissue as the tooth pokes through. Personally, I believe that teething would normally last from about 1-7 days per tooth. Several months of teething pain seems a bit far-fetched. The only authoritative quote I could find on this subject comes from the book Paediatric Dentistry, edited by Richard Welbury. It states:

“Inflammation of the gingival tissues before complete emergence of the crown may cause a temporary painful condition that subsides within a few days.”

Sometimes babies can get multiple teeth at the same time, so it may seem like teething is taking forever, especially when you’re waking up at all hours of the night to comfort your little bundle of teething joy.

Conclusion

To sum it up, teething will be occurring over and over from a week or so before your baby gets their first tooth and until a week or so before your child gets their last baby tooth — right around the age of 2 ½.

Do you have any questions about teething or any experiences to share? I’d love to hear about them in the comments section below. Thanks for reading!

The Differences Between Baby Teeth and Permanent Teeth

Pediatric Dentistry

Feb 7, 2011

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Baby Teeth and Adult Teeth Differences — ©Timothy W. Stone/Shutterstock.com

Have you ever noticed that baby teeth look like they’re whiter than adult teeth? Or maybe you knocked out a baby tooth when you were a child, but when you had a similar accident when you were older, your permanent tooth got chipped rather than getting knocked out.

The two scenarios above can be explained by the differences between adult and permanent teeth.

There are many differences between baby teeth and permanent teeth, but before I get into all of the differences, take a look at the photo above of the little girl swimming.

Now, take a closer look at her teeth in the photo below:

In the picture to the left, there are six permanent teeth that are visible. Can you spot them?

They are the two top front teeth, the two bottom front teeth, and the two molars on the bottom in the very back of her mouth.

These permanent teeth stand out in more ways than one. I’ll cover all these differences between baby teeth and permanent teeth below.

As you read, feel free to refer back to this picture to get a visual representation of some of the more noticeable differences that I talk about below.

The Differences Between Permanent Teeth and Baby Teeth

1 – The enamel and dentin are thinner in baby teeth, and the pulp is bigger relative to the rest of the tooth. This means that if your child gets a cavity, it will travel much faster to the nerve of the tooth. This is one more reason why it’s important to take your child to the dentist before they turn one year old and get routine checkups thereafter.

Not sure what enamel, dentin, and pulp are? Read my previous article about the anatomy of a tooth.

2 – Permanent teeth are more yellow than baby teeth. Take a quick look at the picture above and you’ll see that the six permanent teeth that are visible don’t look nearly as white as the other baby teeth.

3 – Baby teeth have shorter roots – because of this they aren’t anchored as well into the bone and may fall out more easily if your child falls on a hard step or hits their mouth on the coffee table. The shorter roots also give the permanent teeth more room to develop underneath the baby teeth and make it easier to dissolve the roots of the baby teeth when the permanent teeth are ready to come into the mouth.

Find out what to do when a baby tooth gets knocked out.

4 – Baby teeth fall out – If you take good care of your adult teeth you can keep them for your entire life. Just because baby teeth fall out, it doesn’t mean that they aren’t important. If you’ve been staying up late at night pondering this question, click the following link to find out why baby teeth are important.

5 – Permanent teeth have mamelons. Mamelons are the small bumps that give the permanent incisors a serrated look when they first come into the mouth. If you look closely at the girl in the picture above, you can see the little bumps on the edges of her four permanent front teeth. Mamelons quickly wear away as long as the teeth fit together properly.

Learn more about what mamelons are and what to do if you still have them as an adult.

Conclusion

As you can see, there are definitely some differences between adult and permanent teeth. These differences can not only affect the appearance of the teeth, but can also affect what happens to a tooth when you suffer an injury to the mouth.

Do you have any questions about baby teeth or permanent teeth? I’d love to hear what you have to say in the comments section below! Thanks for reading.

What to Expect at Your Child’s First Dental Visit

Pediatric Dentistry

Jan 31, 2011

What to Expect at Your Child's First Dental Visit — ©Khakimullin Aleksandr/Shutterstock.com

A couple of weeks ago I wrote about the age when your child should go to the dentist for the first time. Many people think that taking your child to the dentist before they are one year old is too early. They wonder what a dentist could possibly do with such a young child.

One of the main reasons that we like to see children at such a young age is so that we can catch small problems before they turn into large catastrophes. The American Academy of Pediatric Dentistry has said, “Unrecognized dental disease can result in exacerbated problems which lead to more extensive and expensive care, whereas early detection and management of oral conditions can improve a child’s oral health, general health and well-being, and school readiness.”

I think some of the reasons that parents don’t bring their children into the dentist by age 1 is because they don’t know why they should and they have a fear of the unknown. Hopefully this article will provide information to alleviate both of those concerns. If you’re wondering what a dentist will do at your child’s first dental appointment, you’ve come to the right place!

What to Expect at Your Child’s First Dental Visit

The first dental visit can be composed of a few different parts, depending on how your dentist conducts appointments with children on their first dental visit. A few things that your child’s dentist is sure to do is to look inside of your child’s mouth, introduce the child to the dental environment, and give oral health information to the parents.

Your Child’s First Dental Visit: Looking Inside the Mouth

Your child’s dentist will be able to take a quick look inside of your child’s mouth. The dentist probably won’t use the dental chair. An often-used method of examining very young children is to have the child lay down in the parent’s lap with the child’s head resting in the dentist’s lap.

During this brief examination, the dentist will look for a variety of things, including making sure that:

All of your child’s teeth are coming in properly and at the right time.
The tongue and tissues inside of the mouth are developing properly.
There are no early problems with the temporomandibular joint (TMJ)
Your child’s teeth are healthy and cavity-free (Now may be a good time to make sure that you’re not causing cavities on your child’s teeth!)
There are no developmental anomalies with any dental structures (such as extra teeth or fusion and gemination)

Your Child’s First Dental Visit: Introducing Your Child to the Dental Office

Pediatric dentists are specially-trained in the area of helping children become acquainted with the dental office. They know how to help your child get comfortable with the unfamiliar sights and sounds of the dental office.

Also, the dentist will note any behavior issues that your child may have in the dental office so that the dentist can be helpful and accommodating at future dental visits.

Your Child’s First Dental Visit: Getting Oral Health Information

Your child’s dentist will be able to give you valuable information regarding the oral health of your child. This can include discussing your child’s diet and pinpointing any foods or feeding habits that can be detrimental to your child’s dental health. Your child’s dentist may let you know how “at risk” your child is to develop cavities based on you kid’s oral hygiene and diet.

Also, if you haven’t been getting enough Oral Answers in your life, then your child’s dentist can help you understand why baby teeth are important.

Lastly, your child’s dentist is here to help you! If you have any questions at all about caring for your precious little one’s baby teeth, your child’s dentist will be able to answer them for you.

Questions About Your Child’s First Dental Visit?

If you have anything to say about this article or have any questions about your child’s first dental visit, please feel free to drop me a line by filling out the comment form below. Thanks for reading!

At What Age Should Your Child Go to the Dentist for the First Time?

Pediatric Dentistry

Jan 17, 2011

When Should Child Go to Dentist for First Time? — ©Khakimullin Aleksandr/Shutterstock.com

It has been said that although your baby may not be ready for a dental visit at one year of age, your baby’s teeth are ready.

However, even if you take your child to the dentist on their first birthday, you may be taking them later than is recommended by the American Academy of Pediatric Dentistry and the American Dental Association.

At What Age Should You Take Your Child to the Dentist for the First Time?

At my dental school, we follow the guideline from the American Dental Association that a child should have his or her first dental visit within six months of getting their first tooth, or before they turn 1. Whichever comes first. So if your little girl gets her first tooth at 4 months, it is recommended that she visit the dentist no later than six months later, which would be at 10 months.

I have included the official statements below from both the American Dental Association and the American Academy of Pediatric Dentistry on when a child should visit the dentist for the first time.

The American Dental Association on When a Child Should First Visit the Dentist

Here’s what the American Dental Association has to say on the topic of when a child should first visit the dentist:

The Association urges parents and guardians, as a child’s first tooth erupts, to consult with their dentist regarding:

1 – Scheduling the child’s first dental visit. It is advantageous for the first visit to occur within six months of eruption of the first tooth and no later than 12 months of age, and

2 – Receiving oral health education based on the child’s developmental needs (also known as anticipatory guidance).

The American Dental Association recommends that a child visit the dentist within six months of getting their first tooth, but definitely before their first birthday.

The American Academy of Pediatric Dentistry on When a Child Should First Visit the Dentist

The American Academy of Pediatric dentistry recommends that a child should first see the dentist by their first birthday. Here’s what they say on their website:

“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. Early examination and preventive care will protect your child’s smile now and in the future.

The American Academy of Pediatric Dentistry’s policy is similar to the American Dental Association’s statement. The AAPD ‘s policy says to go by the first birthday or when the first tooth comes in. Pretty much any time between 6 and 12 months is a good time for your child to visit the dentist for the first time.

What Will the Dentist Do at the First Dental Visit?

The dentist will simply examine your child and give you advice on how to better take care of your child’s oral health at the first dental visit. Of course, the exam does depend on how comfortable and cooperative your child is.

One of the best methods of examining children is to have the parent and dentist sitting down facing one another. The parent then holds the child’s body in his or her lap and the dentist holds the child’s head in his or her lap. This is known as “knee-to-knee dentistry” and has proven to be a good method to put children at ease while allowing the dentist to check for early cavities and oral developmental problems.

What Should You Do If Your Dentist Won’t See Your Child This Early?

As you can imagine, some dentists are comfortable with toddlers and some dentists aren’t. When I eventually graduate and become a dentist, I plan to treat patients of all ages and will refer extremely complicated patients to pediatric dentists, who are trained in the behavioral management of young children.

I found a really interesting letter written by Milton Houpt, the chair of the Department of Pediatric Dentistry at the New Jersey Dental School. It was a letter to the editor in the dental journal Pediatric Dentistry.

In it he talked about how his granddaughter recently turned one and needed to find a pediatric dentist. Rather than seeing her himself, he decided to find a younger pediatric dentist so that his granddaughter could develop a good relationship with her dentist. Upon calling the office, he was rather disappointed. Here’s how he relates what happened:

What I thought would be a routine call became, to my dismay, a great disappointment. This is what I was told: “We don’t see children until they are at least two and a half or three years of age. The parents in my practice are upscale. They would not let me examine their children if they were crying. And if I wouldn’t examine the child, how could I charge a fee? I couldn’t charge just for giving advice. And I am not going to see infants free of charge.

As this case demonstrates, not all dentists are willing to see children before their first birthday. They may not be comfortable seeing and charging for a dental visit for young children (as in the above case) or they simply may be stuck in the way they’ve always done things, which is to wait until the child is between the ages of 3 and 6 to first see them.

I believe the case above is an exception to the rule. From what I have read on the internet in various forums, it does seem that there are some dentists who are not willing to see a child until they turn 2 or 3 years old. If this is the case, it might be a good idea to find a pediatric dentist in your area that specializes in oral health care for children.

Conclusion – Should a Baby Really Go to the Dentist Before They Turn One?

All of the major organizations in the United States that have a vested interest in the oral health of children (the ADA, AAPD, and the AAP) recommend that a child go to the dentist before age one. This wasn’t always the case — up until around 10 years ago, I believe that the American Academy of Pediatrics still recommended age 3, but they have since changed their policy to more closely mirror that of the two dental associations.

If you’ve made it this far, you’re probably wondering if YOU should really take your baby to the dentist. From what I have observed, most 12 month-old kids that come to my dental school are the ones whose parents are taking good care of their teeth.

Even if you take great care of your child’s teeth, it is still a good idea to take them to the dentist because it helps them get acclimated to being in a dental office and can help you discover any previously unknown oral risks (such as having pits on some teeth that could make them more susceptible to getting cavities) that your child faces. Also, you will probably learn something new about how to take care of your child’s teeth and can find out if you’re causing your child to develop tooth decay.

Not sure why you should take care of your baby’s teeth since they fall out? Find out why baby teeth are important!

Most parents take their child to the pediatrician a total of seven times during their first year of life (at 5 days, 2 weeks, 2 months, 4 months, 6 months, 9 months, and 12 months of age.) These visits are routine checkups where a professional makes sure your child is developing properly and answers your questions. A visit to the dentist before they turn 1 will be similar to these routine medical checkups, only the focus will be on your child’s teeth and gums. And just think, you only need to take your child to the dentist one time before they turn 1 to ensure they are growing a happy, healthy smile!

Do you have any questions about your child’s first dental visit or how to find the right dentist for your child’s first dental visit?

Leave any questions or comments below in the comments section and I’ll get right back to you. Thanks for reading!

What a Baby’s Gums Look Like While Teething

Jan 10, 2011

184

Teething: How a Baby's Gums Look While Teething — ©Sergey Novikov/Shutterstock.com

A few years ago, my wife and I kept thinking that our son was getting his first tooth. He eventually got it, but there were many times when it looked like his first tooth would be coming in and it didn’t. It’s important to know that the first tooth usually comes in around six months of age.

Since a baby’s first tooth is often anxiously awaited by parents and often takes longer than expected to poke through, I decided to post a couple of photos of a young baby that were taken before and after his first tooth came in — just five days apart. This will show you what you might see if a tooth is close to making its debut!

The photo on the left was taken five days before the photo on the right. In the photo on the left, you can see that there is a little bump on the gums where the lower tooth will come in. In the photo on the right, you can see that the tooth finally poked through into the baby’s mouth.

What a Baby’s Gums Look Like When They Are Teething

Here’s a close-up of the image on the left. You can clearly see that the gums are raised up slightly where the new tooth will be coming in.

What a Baby’s First Tooth Looks Like

Here’s a close-up of the image on the right, that shows the baby’s tooth finally poking up through the gums:

Take a look at Teething Baby Pictures to see more pictures of baby teeth coming in.

Conclusion

It’s important to keep in mind that the appearance of the gums isn’t the only indication that your baby’s first tooth is about to poke through. Here are some other signs and symptoms of a teething baby.

If you have any questions or comments regarding your teething child, feel free to leave them in the comments section below. Thanks for reading!

Why Baby Teeth Are Important

Pediatric Dentistry

Dec 20, 2010

Importance of Baby Teeth — ©Alekso94/Shutterstock.com

Have you ever wondered why we have baby teeth? It’s kind of interesting that we are born with permanent limbs and other body parts, but the first teeth we have are only temporary.

You, like many parents, may have even wondered the following:

Why should I take care of my child’s baby teeth? They’re just going to fall out someday and can’t I just make sure that we take better care of the permanent teeth?

A common misconception among parents is that the baby teeth are “practice teeth” and therefore aren’t important. To be honest, if your child has a lot of cavities and ends up losing their baby teeth early, this will probably affect their permanent teeth.

Let me explain some of the reasons why baby teeth are important.

Why Baby Teeth Are Important

1 – The baby teeth are placeholders for the permanent teeth. The body naturally loses baby teeth in a certain order to allow enough room for the permanent teeth to come in. If the teeth fall out earlier, you disrupt this order and there may not be enough room for the permanent teeth. Luckily, a dentist can make an appliance called a space maintainer or spacer that will make sure there’s enough space for the permanent tooth to come in.

To learn more about space maintainers, read What a Space Maintainer is and Why Your Child Might Need One. If you want to see how a space maintainer might look inside of your child’s mouth, you can see a picture in my article What a Space Maintainer Will Look Like In Your Child’s Mouth.

2 -Cavities in baby teeth can cause infections that can harm your child and damage the developing permanent teeth. If the baby teeth are damaged, the damage isn’t isolated to the baby teeth. When a cavity reaches the pulp (the nerve) inside the tooth, it enters the bloodstream and can cause an infection. Usually the infection stays around the root of the tooth, but it can spread to other places in the body. The infection can cause a swelling in the cheek area or rarely it can spread to the brain, as in the tragic story of Deamonte Driver.

If a baby tooth gets a cavity that infects the pulp inside the tooth, it can cause an infection at the end of the tooth that is close to the developing permanent teeth. There is some evidence that has shown that inflammation in the root area of baby teeth can damage the permanent teeth.

3 – Baby teeth allow the child to develop good oral hygiene habits. It is much easier to teach a child the right brushing and flossing habits when they are young than it is to retrain an older child who has had bad habits for years. While I don’t like to consider the baby teeth to be “practice teeth”, I do think parents should use the time before their children’s permanent teeth come in to teach them how to take care of their teeth. If this is done, there will be fewer problems with the child’s permanent teeth because the child will know how to take care of them.

4 -Unhealthy baby teeth can cause a child to have low self-esteem. The most common place for cavities in children is in between the front teeth. If a little boy or girl has to walk around with brown spots on their front teeth, it can make them self-conscious and decrease their sense of self-worth.

5 – They help children eat nutritious food. That may not seem like a very big deal, but the American Academy of Pediatric Dentistry has noted that kids with lots of cavities may be severely underweight due to pain when they try to eat. Painful eating can cause them to lose the desire to chew foods and may cause them to choose foods that aren’t very nutritious. The American Academy of Pediatric Dentistry has also noted that nutritional deficiencies during childhood can impact cognitive development.

Although having healthy teeth to chew food may not seem too important, it can help ensure adequate development of your child.

Conclusion

I can’t stress enough the importance of taking care of your child’s baby teeth. Keep in mind that cavities are caused by bacteria, and tooth decay is a serious disease — the most common disease in children!

Luckily we do get two sets of teeth, but it is important to take care of both sets!

If you know anyone who doesn’t understand the importance of baby teeth, please consider sharing this article with them. If you have any questions, comments, or anything that I might have left out above about the importance of baby teeth, please leave a comment below. Thanks for reading!

When Should Your Baby’s First Tooth Come In?

Oct 13, 2010

When Will My Baby's First Tooth Come In? — ©Aliaksei Smalenski/Shutterstock.com

Many parents wait with anticipation to finally see their baby’s first tooth poking through the gums. A baby getting his or her very first tooth can be an exciting and sometimes tiring experience for both baby and parents.

When does the average baby get their first tooth?

When Does a Baby’s First Tooth Erupt?

The average baby’s first tooth comes into their mouth right around the age of 6 months. The first tooth is usually a lower front tooth.

What If My Baby Doesn’t Have Any Teeth at 6 Months?

Some parents may wonder if something is developmentally wrong with their child if they haven’t gotten their first tooth by the time they’ve reached six months of age.

Keep in mind that six months is just an average. Some babies are born with teeth already in their mouth. These are known as natal teeth.

Many babies don’t get their first tooth until they are almost one year old. My son didn’t get his first tooth until he was about 10 months old. Today, he’s a bright, intelligent little boy!

Conclusion – Just Relax!

In conclusion, if you’re baby’s first tooth hasn’t come in by the age of six months, rest assured that your baby is most likely normal. The average age that a baby’s tooth comes in is six months. Many baby’s get their first tooth after this, and some get them before. If you do have concerns, you can always call your family dentist to see if an appointment should be made.

Do you have any questions or comments about baby teeth or teething? Please leave them in the comments section below. Thanks for reading!

Adult Permanent Teeth Coming In Behind Baby Teeth: Shark Teeth

Pediatric Dentistry

Oct 11, 2010

452

Adult Teeth Coming in Behind Baby Teeth — ©Wckiww/Shutterstock.com

Many parents become alarmed when they look in their child’s mouth and see the permanent teeth growing behind the baby teeth. What went wrong? Aren’t the permanent teeth supposed to grow under the baby teeth and push them out?

Rest assured, permanent teeth coming in behind baby teeth is not an emergency!

Ordinarily, as the permanent teeth push up, the roots of the baby teeth dissolve and the baby tooth eventually falls out, allowing the permanent teeth to come in. Sometimes, the baby teeth don’t want to leave the mouth, and the permanent teeth come in right behind them. This condition is technically known as lingually erupting mandibular incisors and more commonly known as shark teeth or simply permanent teeth coming in behind baby teeth.

In this article, I’ll talk about why shark teeth happen, how common shark teeth are, whether or not they’re serious, and what your dentist or pediatric dentist can do to treat shark teeth. I’ll even sprinkle in a couple of pictures so you can check to see if this is what is happening with your child.

Here’s a close-view of the lower jaw of a child with his permanent lower incisors coming in behind his baby incisors. The child’s parent commented that hours after this picture was taken, one of the baby teeth fell out. So sometimes the body can even correct the problem on its own!

Why Permanent Teeth Grow In Behind The Baby Teeth

The book Pediatric Dentistry by Jimmy Pinkham states that “the cause of ectopic and lingually erupting incisors is not well established.”

There are a few guesses as to why shark teeth occur. Some dentists believe that this occurs because the roots of the baby teeth don’t get dissolved like they normally should and the permanent teeth have nowhere else to go, so they just come into the mouth where there is the least amount of resistance.

Other dentists say that the permanent teeth start growing in behind the baby teeth because there is too much crowding in the lower jaw.

Another theory says that because the permanent teeth develop behind the baby teeth, this is simply a slight deviation from normal and they just didn’t make it as far forward as they should have.

I think that all of these are good explanations as to why this phenomenon occurs. I personally think that all three are possible explanations and any of them might be true for a specific individual.

How Common/Serious Is It to Have Permanent Teeth Grow In Behind The Baby Teeth?

This study by Gellin states that permanent teeth growing in behind baby teeth is a fairly common condition, occurring in about 10% of all children.

Luckily, many times shark teeth will resolve on their own with the baby teeth eventually falling out. Sometimes, they don’t resolve on their own. So far, in less than a year of actually working in the clinics at dental school , I’ve seen two patients who are close to 20 years old that still had baby teeth in front of some of their permanent teeth.

One young woman has decided she will probably get braces because the baby tooth that hung around in her mouth caused a bit of crowding and now her teeth aren’t aligned very well. Sadly, she never had this corrected when her permanent tooth first came in. Most of the time, your dentist will be able to correct shark teeth before it becomes a problem.

Here’s a picture of a little boy named Evan. If you look closely, you’ll see that he has two permanent teeth coming in on the bottom with two baby teeth still hanging around. His mom stated that the day after this picture was taken, Evan lost one of the teeth.

The two photos in this article show that many times, shark teeth can resolve on their own. However, if they don’t, there are certain things a dentist can do to resolve the problem.

How a Dentist Can Help Manage Permanent Teeth Coming In Behind Baby Teeth

If your child’s shark teeth don’t resolve on their own within a couple of weeks, it would be a good idea to have your dentist take a look at what’s going on. Your child’s dentist will be able to remove the baby teeth from your child’s mouth if needed, and this usually resolves the problem.

If the dentist has removed the baby teeth and there is still not enough room for the permanent teeth to move forward and assume their permanent position in the mouth, then your dentist may perform a procedure known as disking where the dentist slims down some of the remaining baby teeth by removing a bit of enamel from them. This procedure should allow enough room for the permanent teeth to move into their final position.

In another article on this same topic, a pediatric dentist, Dr. Dean Brandon states “Often teeth come in pairs, so if one tooth is not coming in correctly its partner on the other side won’t either.”

It’s important to make sure that all of the teeth have enough room to come into the mouth and line up just right so that your child can have a straight smile that allows for efficient chewing.

Conclusion

Keep in mind that shark teeth really aren’t abnormal. It happens to approximately 1 in 10 children. Most of the time, shark teeth will resolve without intervention (i.e. the baby tooth will fall out and the permanent tooth will assume its proper position). If they don’t, your dentist can assess the situation and remove the lingering baby tooth if it is necessary.

If you have any questions or comments, feel free to leave them in the comments section below and I’ll respond. Thanks for reading!

Double Teeth – Gemination and Fusion

Pediatric Dentistry

Sep 6, 2010

163

Double Tooth Gemination and Fusion — ©Rachel Inbar

Many parents wait with great excitement and anticipation for the eruption of their baby’s first tooth. Sadly, baby teeth don’t always look quite right. This can cause extreme worry among parents. Pictured to the left is one such scenario of a baby’s two upper teeth. The tooth on the left is a “double tooth” while the one on the right is normal.

Double teeth are two teeth that are joined together by dentin or even by the pulp. If you’re not sure what dentin and pulp are, take a look at the layers of a tooth.

There are two scientific terms for teeth that appear to be two teeth stuck together as one tooth: gemination and fusion.

Teeth Stuck Together: What is Gemination?

Gemination is when one developing tooth has split off into two distinct teeth that remain attached to each other and develop together. Gemination comes from the latin word geminus which means twin. You can think of gemination as two “twins” that are permanently attached.

When you count the geminated tooth as one tooth, there are a normal number of teeth in the mouth. Rachel’s son (shown in the pictures) was shown to have gemination because he has all of his other teeth when you count the “double-tooth” as one tooth.

Teeth Stuck Together: What is Fusion?

Fusion is when two different developing teeth have joined together to create one tooth. You can think of it as two teeth fusing together. Gemination and fusion look very similar. Sometimes the only way to tell them apart is to count the number of teeth.

When you count the fused teeth as one tooth, the person will be missing one tooth.

How Common Are Double Teeth?

Tooth Gemination — The same boy pictured above, a year or so later. This boy has gemination. He has all four upper incisors including the double tooth. If he only had three upper incisors including the double tooth, it would be fusion.

Gemination and fusion have been reported to occur in the baby teeth in anywhere from 0.5% to 2.5% of Caucasian children. It is more common in Asian children, where it has been reported to occur sometimes in excess of 5% of Asian kids.

Gemination and fusion occur most commonly in the upper front teeth. However, it can also occur on the lower teeth as well. As a general rule, if a double tooth is located in the upper teeth, it is probably gemination and if the double tooth is found in the lower teeth, then it is probably fusion.

Above and to the right, you can see the same boy’s twinned tooth now that he has gotten a little older.

Can Gemination and Fusion Happen with Permanent Teeth, Too?

Gemination and fusion do occur in permanent teeth, although it is not nearly as common as in baby teeth. It reportedly occurs in one out of every 250 people.

Can Gemination and Fusion Cause Any Problems?

Gemination and fusion in the baby teeth can cause crowding, atypical spacing between the teeth, and can cause problems with or delay the eruption of the permanent teeth underneath.

Because of this, when a double tooth is found, you should have your dentist monitor the permanent teeth underneath it to ensure that they come in normal. Sometimes, your dentist will have to remove the double tooth in order to allow the permanent tooth to erupt normally.

Rarely, there are no permanent teeth located under fused double teeth. Your dentist will be able to provide more information about the permanent teeth through a simple x-ray.

One thing to watch out for is the propensity for fused and geminated teeth to have deep grooves between the “two” teeth. This groove can be very susceptible to developing cavities as it is hard to get a toothbrush all the way down in the crevice to clean it properly. You may want your dentist to put a sealant in this groove to help prevent a cavity.

How Are Gemination and Fusion Treated?

Sometimes, your dentist will be able to shave down and smooth the double tooth so that it doesn’t appear very obvious to the casual observer. I say sometimes because the anatomy of twinned teeth can be complex. If the pulp (click here to learn about the different layers of the tooth) is too close to the surface, then the dentist won’t be able to shave down very much of the surface.

Very rarely, the dentist may be able to surgically divide the teeth. This often works best with fusion because both teeth usually have their own separate pulp chambers and root systems. In any case, when surgically dividing the teeth, both teeth will need to have root canal treatment performed on them, which can end up being quite costly.

When Rachel gave me permission to use the photos of her son, she told me the following:

In case you’re curious – no one really notices it at all, even though it was obvious to me that we’d be constantly bombarded with questions about it. Maybe when he’s a little older (he’s almost 2-1/2 now).

Since kids will most likely lose all of their front teeth by the time they’re 9, you may elect to do nothing about the double tooth unless it’s a huge cosmetic concern. Shannon W, one of the commenters on Rachel’s original post said to just “enjoy it’s cuteness”…and that may very well be sound advice!

Conclusion & Further Reading

For the record, I got my facts (the statistics) about gemination and fusion from this book: Oral and Maxillofacial Pathology by Neville. If you want to read more on double teeth, that book is an excellent source.

Do you have any questions or comments about double teeth? Do you or your child have double teeth? If so, what did you do, if anything, to treat it?

Please share your experiences in the comments section below, so we can all learn from them. Thanks for reading!

Updated Photos

Here’s a photo that Rachel recently shared with me showing her son with the double tooth still doing well a few years later!

And a closeup of the double tooth:

Extra Pictures of Tooth Twinning

Here’s an image of Deb’s son showing:

You can read about his experience in this comment and this follow-up comment below.

If you would like to submit photos of twinned teeth, you can use this comment form or send me an email OralAnswers[at]gmail[dot]com. Thanks!

I want to thank Rachel Inbar for allowing me to use two pictures of her son with a “double tooth” for this article. Rachel runs a fertility blog and allows couples to share their fertility stories online.

What to Do When Your Child’s Baby Tooth Gets Knocked Out

Apr 14, 2010

284

Baby Tooth Knocked Out Child — ©Paul Binet/Shutterstock.com

What should you do when your child comes to you crying with a bloody mouth and a tooth in their hand? A normal reaction to this scenario is panic. However, if you know what steps to take, you could prevent permanent damage to your child’s teeth.

The American Dental Association estimates that by the time kids graduate from high school, one in three boys and one in four girls will have suffered some sort of traumatic injury to their teeth. Also, baby teeth are a lot easier to knock out than permanent teeth because their crowns (the top part of the tooth that is visible in the mouth) are a lot longer than their roots (the bottom part of the tooth that’s hidden under the gums.)

Most caring parents wonder what they should do when their child knocks out a tooth. It is critical that parents are informed so they do not inadvertently damage the permanent tooth that is developing underneath the baby tooth in their child’s mouth.

A couple of days ago, I wrote about the steps you should take when a permanent tooth gets knocked out. With permanent teeth, you want to put them back in the socket as soon as possible. However, when you are dealing with a baby tooth you may not want to put it back in because you could end up damaging the permanent tooth that is still developing below your child’s gum-line.

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