Pediatric Dental Health Guide



Eruption
Your child’s first teeth will begin surfacing between 3 and 16 months, but the average is around 6 months. The timing of the eruption of the first tooth is largely influenced by genetics, so if there is a family history of getting the first tooth late, than chances are your child will probably, also get his first tooth late.
The 2 bottom front teeth will be the first to come through, and your child will continue to get new teeth until he/she has all twenty of his primary teeth, about when he is 3 years old. Children begin shedding their first teeth when they are around 6-7 years old, and will finish up around 11-13 years old.
Permanent teeth begin erupting at around 6-7 years of age and continue until the child gets his 3rd molars, if they do erupt, (or Wisdom Teeth) when he is about 17-22 years old.

Teething
In most children, teething only causes increased drooling and a desire to chew on hard things, but in some cases it does cause mild pain and irritability and the gums may become swollen and tender. To help this you can vigorously massage the area for a few minutes or let him chew on a smooth, hard teething ring. Teething should not cause fever, diarrhea, sleeping problems or diaper rashes. While most children do not need teething gels or treatment with Tylenol for pain, you can use these products as necessary.

Home Care
Once your child’s teeth begin erupting, you can begin cleaning them by wiping them with a moist washcloth. As your child gets more teeth, you can begin to use a soft child’s toothbrush. You should use a pea-sized amount of fluoridated toothpaste or a non-fluoridated toothpaste until your child is able to spit on their own.

First Dental Visit
According to the recommendations of the American Academy of Pediatric Dentistry, the first visit to the dentist should be within 6 months of the first tooth coming in, or around the child’s first birthday.
The American Academy of Pediatrics used to recommend that the first visit to the dentist be at 3 years of age. Now, because so many children have cavities by the time they start kindergarten, the AAP states that high risk children should see a dentist 6 months after the first tooth erupts.
In addition to looking for and preventing problems, an early visit to the dentist can help educate you about your child’s oral health and proper hygiene. If your child is not high risk, your Pediatrician should begin oral health evaluations by 6 months of age.
If your child does not have any risk factors for developing cavities, such as sleeping with a cup or bottle or walking around all day with a cup of juice, and if his teeth are developing normally, then you can probably wait until your child is older and just ask your Pediatrician to check his teeth at each well visit.
Another risk factor for getting a lot of cavities can include having a mother with a lot of cavities. Also, kids with special health care needs, later order of offspring, and children from families of low socioeconomic status, are considered to be at risk for cavities and should likely see a dentist early.
If your child has any dental problems, such as staining of his teeth, crowding or abnormal tooth development, or if he has any risk factors for developing cavities, then he should see a dentist earlier. You may also want to see a dentist if your child has any persistent habits, such as sucking his thumb or using a pacifier as a toddler or grinding his teeth at night (bruxism).

Fluoride Supplements
All children need supplemental fluoride after they are 6 months old to help prevent cavities. For most children, they can get this fluoride from the water they drink, if they are in an area where the city water supply has an adequate amount of fluoride in it and they are drinking tap water.
Sources of water that generally don’t have enough fluoride include well water and filtered or bottled water, although some brands of bottled water or nursery water do have fluoride added to it. Also, commercially prepared pre-mixed formulas do not contain an adequate amount of fluoride, so consider using a powder or concentrated formula and mixing it with tap water, supplement your infant with extra tap water, or talk to your Pediatrician about giving fluoride supplements.
If you only use a water filter pitcher or a counter top filter, it likely doesn’t remove the fluoride from the water. Other types of water filters might though. If you have any doubt, check with the filter’s manufacturer.
In general, it is better to have your child drink water that is supplemented with fluoride instead of giving extra fluoride drops or supplements. Too much fluoride can cause Fluorosis, which is permanent white to brown discoloration of the enamel of the teeth. It is easier to get Fluorosis if you are giving your child fluoride drops and he is still getting fluoride from his diet.
Talk with your Pediatrician or Pediatric Dentist if you think your child may need fluoride supplements.

Staining
In addition to staining due to Fluorosis, medications and trauma to the teeth can also cause staining, as well as bacteria and food stains.

Sealants
Sealants are usually applied to the back teeth to help protect the grooves and pits of these teeth that can be hard to clean and are prone to developing cavities. A sealant is a plastic material that is applied to the teeth, hardens, and provides a barrier against plaque and other harmful substances. Sealants should be applied to the 1st and 2nd permanent molars and appropriate premolars as soon as possible after they erupt (usually around 6 years of age).