Teething
By Dr. Brown
Mouthing of objects by little ones may not always be a sign of teething. Your baby may begin to chew on things like hands, fists, or fingers by a few days of age. Some children are very orally oriented and seem to gnaw on anything while others hardly ever put anything in their mouth. There are twenty primary teeth and more permanent ones. Baby teeth usually begin to erupt by 6-9 months but we have seen children born with teeth and some at 15 months with none yet! So there is a lot of variability when they come through the gums.
Eruption:
The first ones to erupt or come through the gums at around six months of age They are the bottom middle incisors, next are the top middle ones. Usually next are the upper outer incisors followed by the bottom outer incisors by 9-12 months of age.
Around one year of age come the first-year molars. These are not next to the lateral incisors however. They leave room for the eyeteeth and so there is a gap that fools parents. Eyeteeth erupt around 18 months.
Around 2 come the second-year molars. Then you get a break until the six-year molars come in. You will have to guess when that happens on your own. 12 year molars are next and then the 18 year molars, also know as the wisdom teeth.
Drooling:
Many children will drool beginning around 2-4 months of age but most will also drool even more when the teeth show through the gums. Low-grade fevers like 99 or even 100 may occur for many children. Many will also have looser stools for a day or so per new tooth.
Pain:
Most parents ask to give their child pain relief medicines for teething. This is usually not needed and if needed there is often something else going on to explain the discomfort. Oftentimes, just using a teething ring or cool wash cloth is needed. If the discomfort seems worse, please follow the directions on our Doctors Dosing Chart to give the correct dosage and the right frequency of an oral medicine.
Shedding:
Children usually begin to lose their teeth around age 6. The first to fall were also the first to show up, that would be the middle bottom incisors. They fall out regularly beginning around 6 years of age being replaced by permanent teeth. In fact, they shed because the tooth below pushes it out of the way for the adult tooth.
Dentists:
Most pediatric dentists suggest a first visit to the dentist after your child has 4-6 teeth. This often means by 1 years of age. Call us to help you find a dentist that will be right for your family.
Brushing:
Dentists suggest beginning to brush your child’s teeth when they erupt. Once a day with a soft brush and a smear of toothpaste is fine. Remember that the toothpaste may contain high levels of fluoride. While this may be good for the teeth to prevent cavities, if enough is swallowed it can cause permanent staining of the teeth but these may not be noticed until the permanent ones erupt, years after the consumption of too much toothpaste. So, follow the directions on the toothpaste tube (this is a first for most of us new parents). The suggested amount is a small pea size amount. Preferably use fluoride-free toothpaste until your child can spit the remaining toothpaste out.
As the parent, you will be the one brushing the teeth for years and the child may assist when they become competent. Often two brushes help, one for the parent to do the job and one for the child to play with and toss behind the couch.
Dont's:
Do not ever have the child run around with the toothbrush in the mouth. If they fall, it can cause much damage to the teeth and mouth. If you learn from another’s mistakes, one of our patient’s years ago fell on his to stab the back of his mouth. Three days later he was admitted to the hospital with an abscess to the back of the mouth that went to his chest. IV antibiotics and a week in the hospital fixed him up. We do not need more stories please!
Water for your child:
A source of water that has fluoride in it is important to cavity prevention. We have noticed an enormous increase in families in the office with bottled water. Most do not have fluoride. Dentists have noted a large increase in cavities since this is more common in the last decade. Childhood cavities were nearly gone before the bottles water craze appeared. I bet you were unaware that there are more quality controls and better standards of what is acceptable in our Chicago tap water than what is in almost all bottled waters! Tap water is also 1900 times cheaper and you do not have to buy it, bring it home, store it, nor do you have to get rid of the plastic bottles afterwards.
Mouthing of objects by little ones may not always be a sign of teething. Your baby may begin to chew on things like hands, fists, or fingers by a few days of age. Some children are very orally oriented and seem to gnaw on anything while others hardly ever put anything in their mouth. There are twenty primary teeth and more permanent ones. Baby teeth usually begin to erupt by 6-9 months but we have seen children born with teeth and some at 15 months with none yet! So there is a lot of variability when they come through the gums.
Eruption:
The first ones to erupt or come through the gums at around six months of age They are the bottom middle incisors, next are the top middle ones. Usually next are the upper outer incisors followed by the bottom outer incisors by 9-12 months of age.
Around one year of age come the first-year molars. These are not next to the lateral incisors however. They leave room for the eyeteeth and so there is a gap that fools parents. Eyeteeth erupt around 18 months.
Around 2 come the second-year molars. Then you get a break until the six-year molars come in. You will have to guess when that happens on your own. 12 year molars are next and then the 18 year molars, also know as the wisdom teeth.
Drooling:
Many children will drool beginning around 2-4 months of age but most will also drool even more when the teeth show through the gums. Low-grade fevers like 99 or even 100 may occur for many children. Many will also have looser stools for a day or so per new tooth.
Pain:
Most parents ask to give their child pain relief medicines for teething. This is usually not needed and if needed there is often something else going on to explain the discomfort. Oftentimes, just using a teething ring or cool wash cloth is needed. If the discomfort seems worse, please follow the directions on our Doctors Dosing Chart to give the correct dosage and the right frequency of an oral medicine.
Shedding:
Children usually begin to lose their teeth around age 6. The first to fall were also the first to show up, that would be the middle bottom incisors. They fall out regularly beginning around 6 years of age being replaced by permanent teeth. In fact, they shed because the tooth below pushes it out of the way for the adult tooth.
Dentists:
Most pediatric dentists suggest a first visit to the dentist after your child has 4-6 teeth. This often means by 1 years of age. Call us to help you find a dentist that will be right for your family.
Brushing:
Dentists suggest beginning to brush your child’s teeth when they erupt. Once a day with a soft brush and a smear of toothpaste is fine. Remember that the toothpaste may contain high levels of fluoride. While this may be good for the teeth to prevent cavities, if enough is swallowed it can cause permanent staining of the teeth but these may not be noticed until the permanent ones erupt, years after the consumption of too much toothpaste. So, follow the directions on the toothpaste tube (this is a first for most of us new parents). The suggested amount is a small pea size amount. Preferably use fluoride-free toothpaste until your child can spit the remaining toothpaste out.
As the parent, you will be the one brushing the teeth for years and the child may assist when they become competent. Often two brushes help, one for the parent to do the job and one for the child to play with and toss behind the couch.
Dont's:
Do not ever have the child run around with the toothbrush in the mouth. If they fall, it can cause much damage to the teeth and mouth. If you learn from another’s mistakes, one of our patient’s years ago fell on his to stab the back of his mouth. Three days later he was admitted to the hospital with an abscess to the back of the mouth that went to his chest. IV antibiotics and a week in the hospital fixed him up. We do not need more stories please!
Water for your child:
A source of water that has fluoride in it is important to cavity prevention. We have noticed an enormous increase in families in the office with bottled water. Most do not have fluoride. Dentists have noted a large increase in cavities since this is more common in the last decade. Childhood cavities were nearly gone before the bottles water craze appeared. I bet you were unaware that there are more quality controls and better standards of what is acceptable in our Chicago tap water than what is in almost all bottled waters! Tap water is also 1900 times cheaper and you do not have to buy it, bring it home, store it, nor do you have to get rid of the plastic bottles afterwards.