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Tooth Eruption and Problems

Is late eruption in babies cause for concern?

Eruption of the first teeth generally starts at 6 months,
however certain factors may cause delays.  Delays up to the age of one are
acceptable.  If no teeth have erupted at the age of 1, the baby should be
taken to a dentist for examination. 

What symptoms are visible in the gums during eruption?

Distemper, lack of appetite, itchy gums, and an increase in
saliva may occur a day or two prior to eruption.  The gums where the tooth
is about to erupt may be swollen.  All of these complaints will cease once
the teeth have erupted, and there is no medication to cure all complaints. 
Creams sold in pharmacies may be used before feeding in order to comfort the
child.

Will the general condition of the child change during eruption?

Previously, all problems a child had when they reached eruption
age would be tied to tooth eruption.  While eruption may have certain
effects on the child, conditions such as convulsions, diarrhea, and bronchitis
are no longer connected with eruption.  In order to be able to tie
irregularities in a child’s general condition to eruption, all other reasons
need to be analysed.  It is therefore important to consult a pedodontist
if such a problem is confronted.

When will the eruption be completed?

The eruption of baby teeth will be completed between the age of
24 -30 months.  Completely erupted milk teeth in children consist of 20
teeth in total; 10 on the upper jaw and 10 on the lower jaw.

When do permanent teeth erupt?

At age six, permanent teeth start erupting from behind the milk
teeth.  These are in the form of 2 each on the upper and lower jaw on both
left and right, four in total.  Because they are commonly mistaken for
milk teeth, they are often extracted instead of being treated when
decayed.  However, extraction of these teeth which are very important in
the tooth system, leads to crookedness whose treatment is very difficult. 

At the ages of 7-11 the milk teeth start to wobble and the
permanent teeth emerge from the bottom, replacing them.

At the age of 12, the second set of permanent grinders
emerge.  These too do not replace the milk teeth.

What happens when a child is born with teeth?

Occasionally babies are born with teeth or their teeth may erupt
immediately after birth.  Extraction of these wobbly teeth may be
necessary as the baby may swallow or choke on them.  They may also cause
irritation to the mother’s nipples during breastfeeding.  In such cases,
dentist intervention may be necessary. 

Brushing

When should brushing of baby teeth start?

As soon as the first teeth appear in the mouth, they should
start to be cleaned.  By using a clean cloth or gauze, the teeth should be
cleaned by wiping after breakfast and before going to sleep.  Use of a
toothbrush should begin after the first rear teeth start to appear.

What is the best method of brushing?

It is very difficult to suggest and enforce a brushing method to
preschool children.  The important thing is to make brushing a habit with
them.  When brushing, children generally brush the surfaces of visible or
easily accessible teeth.  However, germs accumulate more easily between
the teeth and on the chewing surfaces.  Therefore parent supervision is
essential before brushing.  In school age children, the toothbrush should
be placed on the spot where the teeth and gums meet, at a 45º angle, and then
the chewing surfaces of the teeth should be brushed by back and forth movements.

Which toothbrush should be preferred for children?

Fitting to the size of the child’s mouth, soft and nylon
bristled toothbrushes should be used.  Hard brushes are not advisable as
they may erode the teeth.  Just as a worn out broom cannot adequately
clean the floors, an old toothbrush cannot clean teeth.  As soon as a
toothbrush’s bristles start to wear out (on average every 3 months), they must
certainly be changed.

Which toothpaste should be used with children, and how much?

Toothpaste is not recommended for babies in their infancy and
children up to the age of three. Use of toothpaste should start after the age
of three.  However, contrary to what is shown in advertisements, the
amount applied onto a toothbrush should be the size of a pea, not half a
finger’s length.  When the toothpaste stage begins, any one of the
fluoride toothpastes on the market preferred.  It is imperative to
remember that an effective brushing process is more important than the choice
of toothpaste.

How many times a day should a child brush his/her teeth?

A three minute brushing session, once before breakfast and once
before going to bed, is sufficient.  Just as in many good childhood
habits, the habit of brushing teeth is also acquired during childhood.

Should milk teeth be treated?

Milk teeth, just like permanent teeth, should be treated. 
Having them extracted on the basis that “they’re going to be replaced, anyway!”
is a notion that can lead to a number of problems.  The importance of milk
teeth can be emphasised as follows:

Milk teeth play an important role in growth.  Children with
toothaches cannot eat properly.  Similarly, children who have teeth
extracted cannot eat and therefore cannot grow and develop.

Aside from general body development, milk teeth are also
necessary for the development of the jaws.  Children who have teeth
extracted due to cavities or gum problems may see their jaw drop and look
older.

Teeth are necessary for talking.  Especially during the
phase where children learn how to talk, the lack of front milk teeth may lead
to the letters F, V, S, Z and T to be mispronounced, which may turn into
lifetime habit. 

Every child likes to smile.  Healthy teeth are needed for a
nice smile.

Looking attractive is a natural need in people of all
ages.  Children with decayed or missing teeth may think they look ugly,
which may in turn cause psychological discomfort. 

One other function of the milk teeth is to save the place of the
permanent teeth emerging from below.  Imagine 10 children seated next to
each other on a couch.  When one of the stands up and leaves, the others
reshuffle and fill his/her space to be more comfortable.  If then another
child comes and tries to sit amongst them, they will have to squeeze
together.  Similarly if a milk tooth is extracted before it is supposed
to, the neighboring teeth shift towards the gap.  This leaves no room for
the tooth emerging from the bottom.  This tooth squeezes the others,
causing crooked teeth. 

Therefore just as with permanent teeth, milk teeth also need to
be treated!

A Child’s First Visit to the Dentist

When should a child first be taken to the dentist?

The most ideal time for this is the six months after the first
teeth emerge.  Problems with a child’s teeth may start at a very early
age.  Obtaining information about the child’s feeding, tooth care, and
sucking habits may prevent problems from happening before they start. 

How should a child and a parent prepare for the first examination?

Obtaining information regarding the procedure before taking a
child to the dentist is the best option.  Contacting a dentist before very
large cavities form and violent pains start will ensure that the treatment goes
much more smoothly for both the child and the dentist.  However, a child
brought to the dentist’s office with the preconceived notion that an injection
will not be administered, will lose all faith in both the parents and the
doctor should anaesthetics need to be applied.  Therefore correctly
informing a child regarding treatment is important in terms of fighting their
fears and re-establishing their trust.

Why do children have a fear of dentists, and what measures can be taken?

If the parents explain to the child that there is nothing to
fear in dental treatment, they can easily be taken to the dentist’s
office.  However, some parents scare children into thinking that dentists
are an matter of fear with statements like “If you don’t behave, I will take
you to the dentist and he will pull your tooth out!”.

Therefore;

Going to the dentist’s office should not carry an element of
punishment.  On the contrary, an atmosphere in which the child enjoys
going to the dentist’s office should be created.

Another point to be careful about is that a correlation should
not be drawn between going to the dentist and the pain the child is going to be
subject to.  However, misleading the child with “Your tooth won’t hurt at
all” will only make future treatment more difficult. 

Good dialogue between
the dentist and the child will assist the child in fighting his/her fears. 
For this to happen, it is important that the parent allow the child to answer
the dentist’s questions.