Toddlers and babies at the pediatric dentist

Most baby teeth break through at the age of 0–2 years. The first tooth usually comes through at the age of about 6 months. Most often it is a lower anterior tooth. The time period during which the baby teeth emerge is more variable than that of the permanent teeth. The front 8 teeth (4 up and 4 down) have usually come through by the age of 9–12 months.

The simple answer is that the teeth should be brushed as soon as the first tooth appears. Brushing your baby's teeth with a toothbrush of the right size and a fluoride toothpaste (1000 ppm) has proven to be the best protection against tooth decay. Children aged 0–3 years should use a rice-sized amount of fluoride toothpaste. Training toothpaste DOES NOT protect against tooth decay.

Before the teeth break through, parents can use a clean, small gauze cloth or a clean, dry washcloth. This wipes the teeth and gums to remove liquid and food residue. This can happen before bedtime. As soon as the child gets their first tooth, a small, soft toothbrush can be used to clean all tooth surfaces, paying special attention to the grooves on the chewing surfaces of the molars, as well as the gums and tongue, using the amount of fluoride toothpaste indicated above. When the child is old enough, parents should teach and encourage them to spit out toothpaste. Thorough rinsing is not required. Studies show that brushing and spitting out toothpaste is the best protection against tooth decay. Parents should always supervise the toothbrushing routine in small children.

If you use a rice-sized amount of fluoride toothpaste twice a day, it is safe for the baby to swallow the toothpaste. The very small amount was calculated so that it is safe even for a 6-month-old child. However, it's easy to wipe away the excess toothpaste with a clean towel while brushing your baby's teeth.

To reduce the number of infants and children suffering from preventable tooth decay, it is recommended to consult a dentist upon the eruption of the first tooth or by the first birthday. And why? Because an early visit gives the dentist the opportunity to examine the mouth and determine the normal development of the mouth. Above all, however, the teeth can be examined for their cleanliness. Therefore, the dentist has the opportunity to give advice on prevention and to create the best treatment plan for your child. In addition, parents have the opportunity to talk about feeding practices, teething and oral habits. If the child is found to be at risk of caries, the dentist may apply additional preventive measures such as fluoride varnish. It is best to prevent problems rather than fix them if they have already occurred.

Many babies develop tooth decay shortly after their teeth have grown into their mouths, as we described in question 13. When children are at risk of tooth decay, a fluoride varnish at the dentist can strengthen the teeth. If you take your child to a dental examination at the age of 1 year and every six months thereafter, your dentist can determine whether your child is at risk of caries or is already showing the first signs of tooth decay. In this case, applying fluoride varnish is a simple, safe and very effective method of protecting your child's teeth. If children already have the first signs of caries, applying fluoride varnish every 3 months can prevent the caries from getting worse and even reverse the process. Talk to your dentist about your child's individual need for fluoride applications.

For babies who are not breastfed, it is generally believed that the age of about one year is a good time to wean them from the bottle. Pediatric dentists like to see children stop using a bottle as early as possible. This is because they see an alarming number of children aged 0 to 2 years with early childhood caries. This type of tooth decay, which starts on the front teeth, can be caused by prolonged use of a milk bottle or a bottle with sweetened liquids, or when it is given to the baby to take to bed with them. The same can happen if the baby drinks sweet liquids from a beaker cup.

Bottle weaning can be done in two ways. The first is suddenly stopping the use of the bottle. This is the "cold turkey" method. The second method is a gradual reduction in the use of the bottle. The reduction usually begins throughout the day, when the baby is able to drink from a cup. The last and most difficult method is to stop using the bottle before bedtime.

Parents should keep in mind that it's not the bottle or beaker cup that will cause the problem. It is the sweet drinks contained in it that can cause tooth decay. If your baby needs to suck from a bottle or sippy cup after their teeth erupt, it's best to use only WATER. This approach also helps to promote the healthy habit of drinking water.

Breastfeeding is the most natural and healthy form of nutrition for mother and child. It is recommended by pediatricians and the medical community as an ideal form of infant nutrition. Before the baby gets teeth, it is best to stick to the schedule recommended by your pediatrician. As soon as the baby gets their first tooth, you should brush twice a day with a rice-sized amount of fluoride toothpaste and try to minimize night-time feedings. Breast milk contains sugar, which can cause tooth decay if left in the mouth for a long time. Infants aged 0–2 years who have teeth and are breastfed at night can develop tooth decay, which is just as severe as the tooth decay caused by breastfeeding with the bottle.

Sucking is a basic instinct of infants and children aged 0–2 years. Over the years, there have been numerous debates about the benefits of pacifiers. The benefits attributed to them seem to outweigh the potential drawbacks for children under the age of 2. If it helps your baby to calm down, then use the pacifier. Be sure to use pacifiers with a large flange that sits on the outside of the mouth and an oval teat. This type of pacifier is recommended for safety reasons and for better tooth development.

For years, many people thought that teething causes fever and general discomfort. Teething has been blamed for many things! Research on teething problems has shown that some children are irritable, drool more and sometimes get a rash on their face. However, for most children, teething only affects the teeth! This is a normal part of their development. If your child has a high temperature that worries you, it is unlikely to be caused by teething, and you should consult your doctor.

Over the years, many solutions have been proposed. There are also non-medical remedies that can help. For some babies, bite rings have proven to be helpful. The bite pressure seems to relieve the discomfort, especially when the bite ring is cooled. Another simple alternative is to use a clean, wet towel, which is placed in the freezer and provides the baby with a soft, cold surface to chew on. Painkillers and special drugs for local anesthesia, which are available for this purpose, should only be used as a last resort.

About 1 in 10 children suffer from caries before they are two years old. In some communities, this number can be much higher. The most common cause is when a baby is placed in bed at night with a bottle of milk or sweetened liquid. The contents of the bottle will stick to the teeth all night. And that's how tooth decay begins! The same effect can occur with a sweetened pacifier. In rare cases, infants who are breastfed all night for an extended period of time are also at risk. Caries in these toddlers has a typical pattern. It usually occurs near the gum line of the upper front teeth. Due to the age of these children, treatment becomes a major problem, sometimes even requiring general anesthesia. Parents need to be vigilant and keep their teeth healthy by brushing twice a day with a rice-sized amount of fluoride toothpaste as soon as the first tooth breaks through. If a disease or other disorder interferes with the growth of the teeth, the quality of the enamel is sometimes poor. These teeth can develop caries earlier and more easily. A dental examination at the age of about one year helps to detect these problems, and allows your dentist to carry out additional preventive measures such as the professional application of fluoride varnish.

Some children, even children aged 0–2 years, grind their teeth at night. This habit is called bruxism. In the first years of life, this is not uncommon, especially during the time when children have new teeth coming in. We know that this is very troubling to parents, but it rarely requires treatment. The habit of grinding is usually minor and only in rare cases leads to significant wear of the teeth. Regular visits to the dentist make it possible to assess the wear and tear and to take preventive measures to limit the damage to the teeth.

For years, the importance of milk teeth was underestimated. After their importance was recognized, the permanent teeth showed improvement. There are the obvious reasons why baby teeth are important – chewing, speaking and appearance. But milk teeth do even more. They keep the space in the jaw free for the permanent teeth. If milk teeth are removed before they naturally fall out, the space for the second teeth may be lost. Children who have had tooth decay in the baby teeth have a much higher risk of developing tooth decay in the permanent teeth. The introduction of good habits that prevent tooth decay in the baby teeth paves the way for a life with a healthy mouth.

Many children have unfortunate accidents and can damage their mouth and teeth. A wide range of injuries can occur. Sometimes the damage to the baby teeth is insignificant, sometimes it is serious and the teeth can be displaced or knocked out. More serious injuries can lead to damage to the permanent teeth, which are still forming in the jaw. The extent and type of damage depends on the child's age, as this reflects the developmental stage of the underlying second tooth. The extent of the damage is not visible until the permanent tooth enters the mouth. A consultation with the dentist immediately after the injury is always recommended to assess the damage (usually with X-rays) and take the necessary measures to limit the problems.