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It is not uncommon for a child to have permanent teeth coming in behind the baby teeth.  This happens because the permanent teeth did not resorb the roots of the baby teeth on their way up, instead the permanent teeth came in slightly behind.

 In some cases the baby teeth may need to be extracted in order to allow the adult teeth to come in. Keep in mind that removing teeth early doesn't make your child jaw bigger.   Although other times the baby teeth fall out on their own.  Once the baby teeth have fallen out, the tongue will act as nature braces and help gradually push the adult teeth into place.  However, in many cases this may mean that your child will need braces in the future due to crowded teeth.  



A Rapid Palatal Expander (RPE) is an early orthodontic treatment used to correct a cross-bite, and are the most common orthodontic appliance used to expand the palate of young children.  Dr. Glenn typically recommends an RPE for a child with a posterior cross-bite around 5-6 years old, depending on how the child will handle treatment.  Most patients feel pressure on their teeth throughout treatment, however experiences may vary.

The RPE is placed on the palate with 2 rings around each molar.  There is a key used to turn the expander twice a day for two weeks; each turn expanding the palate in small increments.   During treatment, some children start to see a gap between their front teeth; this is a positive sign.  A typical cross-bite will be corrected by the RPE within 3-6 months of use.

Primary Teeth Development Chart
Upper Teeth When tooth emerges When tooth falls out
Central incisor 8 to 12 months 6 to 7 years
Lateral incisor 9 to 13 months 7 to 8 years
Canine (cuspid) 16 to 22 months 10 to 12 years
First molar 13 to 19 months 9 to 11 years
Second molar 25 to 33 months 10 to 12 years
     
Lower Teeth    
Second molar 23 to 31 months 10 to 12 years
First molar 14 to 18 months 9 to 11 years
Canine (cuspid) 17 to 23 months 9 to 12 years
Lateral incisor 10 to 16 months 7 to 8 years
Central incisor 6 to 10 months 6 to 7 years

                                                                                                                            An overview of children's teeth

Other primary tooth eruption facts:

  • A general rule of thumb is that for every 6 months of life, approximately 4 teeth will erupt.
  • Girls generally precede boys in tooth eruption.
  • Lower teeth usually erupt before upper teeth.
  • Teeth in both jaws usually erupt in pairs -- one on the right and one on the left.
  • Primary teeth are smaller in size and whiter in color than the permanent teeth that will follow.
  • By the time a child is 2 to 3 years of age, all primary teeth should have erupted.


Fluoride is a compound that contains fluorine, a natural element.  Using small amounts of fluoride on a routine basis helps prevent tooth decay.  Fluoride makes your teeth less dissoluble in acid.  Fluoride encourages "remineralization," a strengthening of weakened areas of tooth enamel. 

Fluoride can occur naturally in water but is often added to community water supplies.  It is found in many different foods and in dental products such as toothpaste, mouth rinses, gels, and varnish.  Fluoride is most effective when combined with a healthy diet and good oral hygiene.   

Fun Facts!

1. Systemic fluoride has been shown to reduce caries between 50 to 70 percent. 

2.  Water fluoridation is still the No. 1 cost effective way to prevent tooth decay.  However, 30 percent of communities in the United States do not have fluoride in their public sources of water. 

3.  Children may need fluoride supplements or you may need to buy bottled water with fluoride, if they drink water that is not optimally fluoridated.  Dr. Glenn considers many different factors before recommending a fluoride supplement.  Your child's age, risk of developing dental decay and the different liquids your child drinks are important considerations.  Bottled, filter, and well waters vary in their fluoride amount, so a water analysis may be necessary to ensure your child is receiving the proper amount.

What Are Sealants?


 

Dental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay. Most tooth decay in children and teens occurs on these surfaces. Sealants protect the chewing surfaces from tooth decay by keeping germs and food particles out of these grooves.

Permanent molars are the most likely to benefit from sealants. The first molars usually come into the mouth when a child is about 6 years old. Second molars appear at about age 12. It is best if the sealant is applied soon after the teeth have erupted, before they have a chance to decay.

Applying sealants does not require drilling or removing tooth structure. The process is short and easy. After the tooth is cleaned, a special gel is placed on the chewing surface for 30 seconds.   The tooth is then washed off and dried. Then, the sealant is painted on the tooth. The dentist or dental assistant shines a light on the tooth to harden the sealant. 

Sealants can only be seen up close. Sealants can be white, and usually are not seen when a child talks or smiles.

As with anything new that is placed in the mouth, a child may feel the sealant with the tongue. Sealants, however, are very thin and only fill the pits and grooves of molar teeth.

A sealant can last for as long as 5 to 10 years.  Sealants should be checked at each regular dental appointment and can be reapplied if they are no longer in place.

Sealants do not protect between the teeth, only the biting surface on the pits and fissures area of the tooth.  This means your child still needs to flossing daily to avoid interproximal (in between) tooth cavities.  

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Trauma to Baby Teeth
Due to the active nature of children, trauma to the primary teeth (baby teeth) is very common. Most accidents to your child's baby teeth look bad, but may not require immediate attention. Swelling is to be expected and may look worse 12-24 hours after the injury. 

  • Tooth is knocked out  
    Clinical signs: The whole baby tooth is gone from its socket.
    Treatment: Control bleeding with firm pressure from a cloth. Locate the tooth and save for visual inspection by your child’s dentist.  Place the tooth in milk and contact us as soon as possible. Provide over-the-counter pain medicine and soft diet as needed. Contact us for evaluation.

  • Tooth is gray or brown in color
    Clinical signs: Tooth appears darker in color. Up to 70% of injured baby teeth can darken. A dark baby tooth does not always require treatment. These teeth are at a higher risk for dental abscess (infection).
    Treatment: Over-the-counter pain medicine if pain is associated with the discoloration.  Clinical examination and x-ray by us to evaluate for a dental abscess.

  • Tooth hit but not loose
    Clinical signs: These teeth will sometimes exhibit some bleeding along the gum line but no real mobility of the tooth. These teeth will often be sore for 1-3 days but have a very good prognosis. Discoloration may be noted at any time after the trauma. 
    Treatment: Soft diet and over the counter pain medicine (Tylenol) are indicated for initial treatment. Contact us for an evaluation.

  • Tooth hit and loose
    Clinical signs: These teeth will usually exhibit bleeding and bruising of the gum tissue but appear to be in proper position. They may “wiggle” back and forth or side to side. These teeth will often be sore for several days and have a guarded prognosis. Usually they will tighten back to normal in 1-2 weeks. Discoloration may be noted at any time after the trauma and is fairly common with this type of trauma. 
    Treatment: Minimize movement as soon as possible. Check to see if your child can close his teeth together normally. Firm pressure from a washcloth to control bleeding of the gum tissue, soft diet, and over the counter pain medications are indicated as needed. Contact us for an evaluation.


1. Why do kids grind their teeth? Does the answer change depending on the age of the child?

It is not uncommon for children to grind their teeth.  We see it in children younger than 7-8 years old.  A lot of children will stop grinding once their six-year permanent molars erupt. Their permanent teeth bite begins to establish itself once those molars erupt. 

Children's bites are very flexible and subject to changes as they grow. Occasionally, children will exhibit an abnormal bite causing them to grind because of the placement of their teeth.

2. Could it be stress-related? Do children grind their teeth for some of the same reasons adults might grind their teeth?  

Grinding is more commonly related to stress when children are middle school and high school age due to final exams and other major testing.

3. What should parents do if their child is grinding his or her teeth?

If the child is still very young with baby teeth still present, nothing needs to be done as we do not want to affect their growth. If the child is older, intervention may be necessary. The plan is to protect the permanent teeth while not negatively affecting their normal growth.

4. What should they look out for? When should parents worry? 

Dr. Glenn will notice and track wear patterns and recommend treatment when appropriate.

5. Any other tips for parents who are concerned about their children's teeth-grinding issue?

Our major concern is that permanent teeth are not affected and normal growth is allowed to occur. 

First Dental Visit 

The Amierican Academy of Pediatric Dentistry recommendeds the first dental check up at 1 year old or 6 months prior to the first tooth erruption.  At the first visit we will keep the it short and easy for your child.  Typically the child sits in the parent lap and holds hands while Dr. Glenn examines the teeth.  During the exam Dr. Glenn will check all of your child teeth for decay, examine your child's bite, and look for any problem with the gums, jaw and oral tissue.

During your first visit we will discuss:

1.  Good oral hygiene for your child's teeth and gums and cavity prevention

2.   Fluoride needs

3.  Oral habits (thumb sucking, nuk habit, lip sucking)

4.  Proper nutrition

 Regular check ups help you child stay cavity-free and it is important for your child's dental growth and development to be monitored.  We recommend children under 3 years old to have a dental check-up once per year; children 3 years and older should have a dental check-up twice a year.

Dental Fluorosis 

  
One of the many types of common tooth discoloration is Dental Fluorosis.  Dental Fluorosis is a developmental distrurbance of dental enamel caused by excessive exposure to high concentrations of fluoride during tooth development.  These changes are most prone to occur in children between 20 and 30 months of age.  The critical period of exposure is between 1 and 4 years old.  Dental Fluorosis occurs when a child ingest too much fluoride.  Be certain that your child can fully spit out their toothpaste before introducing fluoride toothpaste .  When a child swallows fluoride toothpaste at a young age it can affect their permanent teeth that are forming.  The affects of fluorosis are strictly cosmetic.   The teeth are actually stronger because of the extra fluoride, however fluorosis can cause severe stain throughout the teeth.  

How to treat Dental Fluorosis?

Dental fluorosis can be cosmetically treated by a dentist.  Tooth bleaching, microabrasion, or a conservative composite restoration are commonly used treatments.  Typically bleaching and micro-abrasion are used for superficial staining, where constructive restorations are used for more unaesthetic situations.  Be aware that this treatment can cause severe tooth sensitivity, so it is recommended that you wait until teenage years to do treatment. 

  

Sipping on things like soda, juice, and sports drinks will cause decalcification and decay.  Tooth decalcification is a process in which the teeth lose calcium.  This is caused by poor oral hyiene, not brushing two times daily or flossing.  Decalcification can also be caused by sipping on sweet liquids that contain sugar and acid.

The sugar and acid contained in these drinks are very harmful to our teeth.  It will cause cavities and tooth decalcification.   If you are going to drink these beverages, the most important thing to remember is consumption time.  The longer the sugar and acid is on your teeth, the more likely damage will be done.  So just remember don't sip all day and get decay.  Keep your smile healthy and happy this summer. 
  

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