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Dr. Marc Lazare
212-861-2599
Question: When will my infant’s primary teeth (aka deciduous or baby teeth) grow in, and how do you care for them?
Answer: A baby’s first tooth will usually erupt into the mouth by around six months of age. Some infants will be early, and some may be a few months later. If your baby still has not displayed their first tooth by the time they are 1 year old, then you can bring your child to the dentist for an exam. From day one you should be cleaning your baby’s gums, and tongue with a washcloth, rubber finger brush, or cloth finger tender (even though no teeth are present). Clean the gums at least twice each day -- after breakfast and after the last feeding of the day. Even better -- clean your baby's gums and tongue after every feeding to keep your baby’s breath fresh and to get them accustomed to this routine. Once the first tooth erupts, you should be cleaning these teeth, trading in your cloth wipe for an appropriate sized, soft toothbrush. In order to see the teeth more clearly when brushing, you may choose to have your child lay their head on your lap, or lay them down on a bed. Remember, only use toothpaste that does NOT contain fluoride at this time.
Question: What can I do to prevent my baby from developing cavities?
Answer: Parents and caregivers should realize that a baby's teeth are susceptible to developing cavities from the moment they appear in the mouth. As a result, oral care should begin soon after the baby is born, and their gums should be cleaned with a clean, damp cloth or wet gauze pad after each feeding. As early as 4 months or as late as 12 months of age, the upper and lower front teeth first begin to appear. You may begin brushing your child's teeth the moment these teeth emerge. Never let your baby or toddler fall asleep with a bottle, unless it contains only pure water and then only after the bottle is rinsed out well before being filled. A bottle containing milk, formula, fruit juices, etc., is likely to cause decay. A pacifier coated with a sugary substance is also likely to cause cavities. This condition is referred to as Baby Bottle Tooth Decay, or Nursing-Bottle Syndrome. The teeth most likely to be affected are the upper front teeth, but other teeth can become damaged as well.
Question: Why are baby teeth important?
Answer: Baby teeth hold the space for the permanent teeth to begin coming in at about 6 years of age. Your baby’s teeth, gums and tongue are not only very important for eating, but aid in the growth pattern of your child’s jaws and adult teeth. Note that baby teeth are also a key component in the ability to learning and perfect speech. Of course, a full complement of baby teeth will contribute to having a good self-image as your child grows older.
Question: What can I do if I have difficulty cleaning my baby’s mouth?
Answer: If your baby does not want to open their mouth, place your finger near their mouth, and they will slowly open as they think that you are trying to feed them. Even if your baby tries to bite down on your finger, be patient, keep trying, and they will soon open up again. Reach inside along the cheek till you get between the upper and lower gums, and your baby will then open more to allow you to wipe the gums in the very back. In the case that one or more ulcers are found in your baby’s mouth, just clean around the ulcer until they are healed (usually within one week). Get your child accustomed to cleaning his mouth regularly and going to bed with a clean mouth.
Question: Is it alright to let my baby sleep with a pacifier, sippy cup or bottle?
Answer: If your child uses a pacifier, do not dip it in honey or anything that has sugar, as this can cause cavities. Do not put your child to bed with a bottle or sippy cup that contains milk, formula, fruit juices or soda, since these contain sugary substances that can cause cavities too. Plain water is the only acceptable fluid to give your child when they are going to nap or sleep.
Question: How do I control my child’s drooling and teething pain?
Answer: Babies are very easily agitated by the teething process. Parents should try to distract their children with activities, and allow your child to chew on a clean, chilled, liquid-filled teething ring to relieve the discomfort and irritation. Drooling during this time is normal and expected. Just wipe your child’s mouth often to keep them clean and dry. Swollen gums are normal at this time, however if the gum turns blue or red, then bring your child to the dentist to evaluate. Additionally, teething should not cause fever. Since your baby is picking up anything and everything that has germs on it, and putting it in their mouth to chew on, it is possible that their fever is due to this spreading of illness, in which case parents should bring their child to their pediatrician.
Question: When should I first take my child to the dentist?
Answer: Parents should take their children to the dentist for their first check-up by the age of 2, unless your doctor recommends and earlier exam. Subsequently, they should go for regular check-ups every 6 to 12 months, so your child’s dentist can monitor their oral hygiene, diet and growth patterns. It is best if your child's first experience occurs at a time before invasive dental work becomes necessary. A ride on the dental chair, magic tricks with "Mr. Thirsty" and visiting the toy chest should make your child's visit pleasurable and non-threatening. The first visit should also include the counting of teeth while your child looks at what is happening in a hand held mirror. Remember, early dental check-up makes it easier to build a good rapport with your child to establish a foundation of trust and comfort for future visits.
Question: Does it really matter if my child has a cavity in their baby tooth; they will lose it soon anyway?
Answer: Yes, it does matter. Baby molars enter the mouth around the age of 2 years of age. If a cavity develops early on, that cavity is only going to keep growing down deeper towards the nerve. Since these baby molars aren’t lost until the age of 10-12 years of age, there is plenty of time for unnecessary, preventable damage to occur. As the cavity grows, the child may wind up needing a baby root canal or an extraction if an infection develops or if there not enough good tooth structure to utilize for a restoration. These baby teeth are fundamental to a child’s health and development, and they also maintain the space for the adult teeth to grow into.
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