Baby teeth: 10 facts you need to know

There is nothing more gratifying for a parent of an infant than the sight of the first tooth erupting. Its a joyous day as your baby proudly shows their first eruption. Though these should be treated equivalent to precious pearls but unfortunately this is the least taken care part of body. Because since ages, we have this concept in our minds that these are baby teeth and these are going to fall, so why to take so much pains for baby/primary teeth as we call them.

The health of a child’s baby teeth is particularly vital to their overall health and the health of their future permanent teeth too. Children depend on strong baby teeth for chewing and nutrition as well as for speech and ultimately for their permanent teeth to grow in appropriately. Even though all baby teeth will eventually fall out, but loss or decay of these teeth can deform the mouth, leading to problems in permanent tooth eruption. So when your baby begins to develop their first teeth, it is exceptionally significant that you instantaneously start to take steps to inhibit oral health issues from occurring.

Here I will address the most common queries (including lots of myths and misconceptions) which I have been asked in my practice regularly. But before that i just want to give a brief overview of the stages of tooth eruption.

The first set of teeth erupts around 6 months of age, usually in the lower gum. After around 2 months the middle teeth in the top gum erupts. 2 teeth on either side of these rupt when the baby is around 9 to 10 months old. Then around 4 teeth erupt every 4 months, until all 20 are present by the age of 3 years. This is just an average estimate of eruption. Your baby might have a different time line both in timing and order of eruption. Usually concern arises when the baby does not erupt a single tooth by 15 months ( in that case baby should be evaluated to rule out certain disorders).

So now lets move to our top 10 FAQs

At what age does the first tooth erupt?

As explained above, normally on an average this process starts at around 6 months of age, but can vary from early as 4 months to as late as 15 months. Any delay beyond 15 months should be evaluated. (Their 20 primary teeth are already present, they just have to erupt out). Your baby should have a full set of primary teeth by age 3; permanent teeth won’t begin to replace them until the child is 4 to 6 years old.

When should brushing of baby’s teeth be started?

You should begin brushing your child’s tooth as soon as it appears. But even before that, get into the habit of wiping your baby’s gums with a clean damp cloth before bed after their last feed. This gets your baby used to having your fingers in their mouths and establishes a good bedtime routine. You may opt for using a soft cloth or gauze instead of a toothbrush even when the first tooth appears. Be cautious, as your child’s gums may be sensitive. The brush should be very soft, with no more than three rows of bristles. Do not use the same brush beyond 3 months.

When should the baby have his/her 1st dental visit?

In India especially, dentist is one person where people don’t go for routine checkups. This is all the more true for pediatric dentists, wherein the concept of oral hygiene for kids is very new. There are different recommendations for the same. If you as a parent are able to practice good dental hygiene and your pediatrician is able to check any teeth related problems, 1st visit can be deferred till 3 years of age. But again pediatric dentists are at a better place to detect any early tooth troubles so I normally advise parents coming to my clinic to start their infant’s dental visits as soon as 1st tooth erupts and no later than 1st birthday. Most people (I am yet to see one 🙂 ) don’t prefer to go, so to those I normally advise oral hygiene at least (which is again followed by only 30-40% of parents).

Do baby teeth really matter? After all they are going to fall out.

Baby teeth are important to speech development and proper tongue position when making certain sounds. Also baby teeth keep a proper amount of space in a child’s mouth for the succeeding adult tooth to erupt. Missing a baby tooth and not preserving that space before the adult tooth is ready to erupt may result in other baby teeth drifting into that open space, making it impossible for the adult tooth to erupt properly. The ultimate result may be an overly crowded dentition. Also if baby teeth aren’t cared for properly, they can decay, leading to a gum infection called gingivitis that can affect the health of the permanent teeth. Moreover, children who learn to take care of their baby teeth tend to have good dental habits as adults.

If the baby has started chewing on his/her hand and is drooling at lot, does this mean teething is starting?

Drooling and chewing normally starts at around 4 months of age. It is merely a development phase where in the baby has a tendency to explore objects by putting things in their mouth and most easily accessible object to them is their hand. Also at around 4 months of age, saliva production increases in comparison to the amount they can swallow and hence the drooling. But in case the baby is also cranky along with this, has a tendency to chew on the breast or bottle more than sucking, or there is a loss of appetite to certain degree, this can mean tooth eruption is about to begin.

Most babies have fever and loose motions or ear pulling between 6 months to 1 year of age. The elders in the family usually attribute it to teething. Is this true?

We sometimes blame these symptoms on teething when they may actually be the result of an infection. A baby’s body temperature may slightly rise when teething; however a true fever (temperature over 100.4 degrees Fahrenheit or 38 degrees Celsius) is not associated with teething and is actually a sign of an illness or infection that may require treatment. This infection usually results because the baby is putting everything into his/her mouth.

Is there any role of teething gels, homeopathic tablets or gels, amber teething necklaces, gels with benzocaines etc?

No, in contrast to the popular opinion, there is no role for any of these. These gels and tablets might have potential side effects. Also the teething necklaces might pose a strangulation risk or a choking hazard to your baby. There is no research to support these things.

What can be done to soothe baby’s teething pain?

Usually teething doesn’t cause children too much discomfort, but some babies might cause trouble. Parents can help ease teething pain by massaging their baby’s gums with clean fingers, offering solid, not liquid-filled, teething rings, or a clean frozen or wet washcloth, cold chew toys. If your baby is clearly uncomfortable, you can talk with your pediatrician about giving a weight-appropriate dose of acetaminophen or if over 6 months, ibuprofen.  

Is it bad to put a baby with bottle to bed?

It is highly discouraged to put your child to bed with a bottle at any age, even if no teeth are present yet. Going to bed with a bottle of milk, formula or juice will greatly increase your child’s chance of developing “Early Childhood Tooth Decay/ Baby bottle tooth decay”.  Prolonged exposure of baby teeth to formula or milk (which usually happens when baby goes to bed with bottle) can cause cavities just like a sugar snack/drink. Water is best to substitute in a bottle if your baby needs it to soothe or try a pacifier (but it should not be a honey or sugar coated one).

When should toothpaste be started?

Toothpaste is generally started when a couple of teeth have erupted, usually after 1st birthday. Use a rice grain size smear of a fluoride toothpaste to brush the baby teeth with a soft age appropriate toothbrush. Dont worry about swallowing. You can wipe it off with a soft cloth if you are too concerned about it. Once the child is 3 years of age and the child can learn to spit it out, the amount can be increased to pea size.

There is so much more to talk about teeth. Will cover it in some other post. Till then…

Stay safe/Stay healthy

(pics courtsey- istockphotos, pngwing, vectorstock)

Dr Garima| themoppetsclinic 🙂