|My son is over one
year old and has no teeth. Should I worry?
|Even though most children that age have a
number of teeth, some children may have delayed tooth eruption. There is usually no cause
for concern about this.
permanent lower front tooth is coming in behind his baby tooth. What should I do?
|If the baby teeth are moderately to very
loose, there is no immediate treatment. Patience is recommended. This is a normal process.
The tongue will push the permanent lower front tooth forward. If the teeth are not very
loose, your child should be taken for a x-ray and the situation evaluated. The milk tooth
may have to be extracted if your dentist feels it may not fall off on his own.
|My son sucks his
thumb or finger. What effect can it have on the bite, and when should I work on stopping
|Most children stop sucking their fingers
between the ages of three to five. If your child continues this habit past the time of the
eruption of the first permanent tooth, then it can have a permanent effect on the adult
bite. The habit should be stopped before these teeth come in. From a preventive point of
view, infants should be given pacifiers, as they will do much less harm than finger
habits, and most children will discontinue their use earlier. Read Thumb Sucking
|I have heard that a
nursing bottle can cause cavities on toddlers, at what age should I take my child off the
|Your child should stop using a bottle when he
is old enough to hold a cup. This usually occurs around one year of age. After this age a
child should NEVER be placed to sleep with a bottle because this may cause dental decay,
increase the incidence of ear infections, and prolong the use of the bottle. If your child
is habituated to sleeping with a bottle, the best way to stop this habit is by placing
only water in the bottle, or progressively diluting it until it is all water. Then be firm
with the child, give juice or milk in a cup, which will not cause as severe a decay.
|What are the signs
of teething, and what can I do to make my child more
|The signs of teething are drooling,
irritability, restlessness, and loss of appetite. Fever, illness, and diarrhea are not
symptoms. If your child presents with the latter signs, they need to be evaluated by your
doctor. The best solution to comfort the child is to have the child chew on a cold or
frozen rubber teething ring. Topical anesthetics/ gels are NOT recommended.
|Why are baby teeth
important? Don't they fall out?
|Baby teeth serve the important function of
eating, speech, and esthetics (self-image). These teeth not only help form the developing
jaws, but they hold space for the permanent teeth to make normal bite possible. The last
baby tooth falls out at about twelve years of age. A decayed baby tooth can become so
badly decayed that it can do damage to the permanent tooth. At times severe infections of
the face, head, and neck can be caused by infected baby teeth, necessitating care of baby
teeth knowing they will eventually fall off.
|When should I
expect my son to brush and floss on his own?
|We recommend that parents brush their
children's teeth for the first five to seven years of life, since young children lack the
manual dexterity of proper tooth brushing. The toothbrush should be a child's size, with
soft nylon rounded bristles. Toothpaste should not be used until the child is able to spit
(three to four years of age) to avoid swallowing it. A pea-sized drop should be dispensed
by the parent for young children. Flossing should be performed by the parent prior to
brushing. Most children lack the proper manual dexterity to floss on their own until the
age of ten and will need a parent's help and supervision.
Oral Health Care Information
Diet and Nutrition
Infants and toddlers often have a high carbohydrate diet.
There are also lots of natural sugars in milk and fruit juices.
Chips and dry cereals are carbohydrates that form a pasty
film that sticks firmly on teeth. These carbohydrates are then converted to sugars by the
normal oral bacteria that promote tooth decay and gum problems. Be careful!
Thumbs, fingers, and pacifiers can definitely cause or
intensify orthodontic problems.
- However, it is normal for infants and children to have a
strong sucking desire.
- Some disfigurement of the primary teeth will self-correct.
- Most children stop oral habits on their own.
- Oral habits should be stopped before the permanent teeth erupt (approx. 6 yrs. old).
- Grinding of teeth is normal and should not be an area of concern unless there is
significant wear of the teeth.
- Symptoms include - sensitive and uncomfortable gum areas,
drooling, irritability, possible low grade fever and diarrhea.
- Treatment can include - massaging sore gums with a finger or teething rings, placing ice
or frozen rings on gum areas. The best remedy is your child's pediatric dose of Tylenol or
fever reducing medication for pain.
Plaque is the enemy.
Brush 2 times per day (after breakfast and especially before bed.)
Brush in a circular pattern, cleaning one area at a time.
Toothpaste is not necessary. A wet brush will work fine to remove plaque and food.
A washcloth or gauze will work well for the early primary dentition.
Flossing is recommended for teeth that have tight contacts and trap food.
Stains can occur from foods, vitamins, iron drops, and other medicines.
We can easily clean these off if they occur.
Toothpaste has quite a bit of fluoride in it. If the child
is allowed to swallow it, this can cause white or brown spots to occur on the developing
permanent teeth. Use toothpaste sparingly with young children.
Too much fluoride can cause a discoloration of the
permanent teeth called fluorosis.
Sources of fluoride include - fluoridated water, bottled juices (from concentrate),
prescription vitamins, and toothpaste.
Know the fluoride level in your water.
If your water is not fluoridated, we can provide you with a prescription for fluoride
Do not allow your child to eat or swallow toothpaste as fluorosis can easily occur.
Traumatic Injuries: We hope you never have to experience a dental injury but...
30% of children have dental injuries before the age of 5,
with boys being twice as likely to experience an injury than girls.
If injuries occur, severe enough to cause bleeding or fractured teeth, the child should
receive an evaluation.
Change of color of teeth or red swollen gums are not normal
and can indicate a dental infection although the child is in no apparent discomfort.
Primary teeth react differently to injuries than permanent teeth. Often only an x-ray can
detect pathological changes in the traumatized primary teeth.
|Everyone says don't give
sweets to kids. What to give?
Minal has cooked up some suggestions
for LOW-SUGAR SNACKS
- Peanuts and raisins, mixed put mixture in a paper cup for
kids to carry around when playing outside.
- Carrot sticks used as dippers for health dip made from
- Fresh fruits - whole or cut & served attractively
- Quarters of hard boiled eggs
- Cubes / slices of cheese
- Flavored yogurts - in moderation, sugar added
- Panir sprinkled with salt & pepper.
- Carrot coins - cut carrot into "coin" shaped
slices - kids love to eat money
- Fruit juices - a wide range of tetra packed juices
- Milk shake - milk, 8oz. - banana or other fruit, 1 egg, 1
tsp. honey + 2 ice cubes - whirl in blender 1 min.
- Popcorn - pop before they come home from school - have ready
- Unsweetened cereals / corn flakes (check label for sugar
content) with milk & raisins or fresh fruit.
|Cleft Lip and Cleft
|Cleft lip and cleft palate are common birth
defects. An infant with a cleft lip typically has a gap or indentation in the upper lip;
an infant with a cleft palate has a gap in the roof of the mouth. Approximately one to two
newborns of every 1,000 will have a cleft lip, a cleft palate or both, although frequency
Many hereditary and environmental factors
contribute to the development of cleft lip and cleft palate. Clefts result from improper
growth and merging of the lip and palate tissues during the first trimester of pregnancy.
Infants who have a cleft lip or palate may have abnormalities (particularly to their head,
neck or internal organs) that, together with their cleft, are part of a syndrome.
With proper treatment, most infants with cleft lip or
palate can lead a normal life. Without proper treatment, an infant with cleft lip and
palate may develop related and often irreversible problems, including failure to grow,
recurrent ear infections that can cause hearing loss, speech difficulties and
developmental and psychological problems.
Symptoms At Birth: Gap in or indentation of the lip (cleft
lip), gap in the roof of the mouth (cleft palate) or both Flattened or unusually shaped
nose, which may accompany cleft lip
Infancy to Adolescence The following symptoms sometimes
occur, particularly in children with a cleft palate: Difficulty feeding, possibly
including nasal (food coming out of the nose), choking and coughing during feeding fatigue
and irritability (particularly when feeding problems exist)
Poor weight gain and development (particularly when feeding
problems exist) Accumulation of fluid in the middle ear with chronic infection (see Otitis
Media) Missing, malformed or extra teeth Hearing loss (especially if ear infections are
Difficulty breathing through the nose Impaired facial
growth Speech problems Self-esteem and psychological problems Maturation problems and