What should I know about my child's teeth?

What is the usual schedule of baby teeth?

It used to be that babies got their first tooth around six months old. Many babies have teeth before that these days, but it's also not abnormal to be toothless at twelve months old. Rarely, babies can even be born with a front tooth! Babies born with teeth other than a front tooth need to be evaluated by a doctor. There are twenty baby teeth total. Usually eight of those are lost between ages 6 to 8 and the rest by around age 12.

 How do I care for my child's teeth?

As soon as your baby has teeth, it's time to start cleaning them. This should include daily brushing, and flossing at least once a week. Ideally, the first dentist visit should be about six months after the first tooth. Unless you can locate a pediatric dentist (or "pediodontist"), that may not be possible, since most adult dentists will not see children until they are 2 or 3 years old.

One important way to protect your baby's teeth is to take care of your own teeth. All adults have bacteria in their mouths; that's why we brush our teeth. Babies are not born with bacteria in their mouths, but the bacteria in parents' mouths eventually take up residence in the baby's mouth due to kissing, shared cups and utensils, etc. If you don't brush and floss your own teeth, your mouth will have both more bacteria and worse bacteria, and that will ultimately affect your baby's teeth, as well as your own.

When food or drink other than water enters the mouth, it causes saliva to be released. Saliva is an acid, and exposure to increased amounts of saliva all day (or night) long can harm the teeth. Therefore, toddlers should not carry around a sippy cup filled with juice, since drinking small amounts from it frequently will result in acid damage to the teeth. Besides, juice has added sugar which is not good for the child's diet, and it also increases the bacteria in the mouth. 4-8 ounces of juice a day is plenty for children younger than school age.

 What about cavities?

Severely decayed teeth may require capping. Silver caps have historically been used, but ceramic caps are now available also, even for children. The advantage of ceramic caps is that they look very similar to regular teeth instead of looking metallic. If your child's teeth require caps, ask if ceramic caps can be used.

Broken teeth should be examined by a dentist as soon as possible. If a permanent tooth is knocked completely out, the best thing is to replace it immediately. Don't wait to come to the doctor or dentist's office. The sooner the tooth is replaced, the better the chance that it will survive. Scrubbing a tooth "clean" before replacing it is a bad idea, since that removes cells that help the tooth to stick in. If a tooth can't be replaced or is filthy, stick it in milk and get to your dentist (or at night, the hospital) as soon as possible. If a baby tooth is knocked out, before trying to stick it back in, consider whether it may be time for that tooth to come out. If you're not sure, call your dentist.