A baby’s oral health has to start with the mother’s oral health: if the mother has a healthy mouth, it is easier for the baby to have a healthy mouth. This is why it is essential to visit the dentist more frequently during pregnancy.
What are babies’ and children’s teeth like?
The dentition is the set of teeth in the mouth. When teeth grow in, break through the gums and become visible, it is known as tooth eruption. We experience two dental eruptions during our lifetime: the eruption of the baby teeth and the eruption of the permanent teeth.
Baby teeth grow in during the first two years of life. These baby teeth will eventually fall out and give way to the permanent teeth. Baby teeth are composed of a total of 20 teeth divided into incisors, canines and molars.
The first teeth to grow are the lower central incisors during the first six to eight months. After the ninth month, the upper central incisors grow in, and after one year, the upper and lower lateral incisors. The first molars grow at the end of 15 months, almost at the same time as the fangs, which grow at one and a half years of age. Finally, by the age of two, the second molars begin to grow.
During the growth of the baby teeth the baby may experience different symptoms, among them: desire to bite, abundant salivation, irritability, and in some cases fever.
To alleviate these symptoms and make the stage in which the baby teeth grow more pleasant, you can resort to cold: it is recommended to cool the pacifier and the bottle, thus relieving the sensation of pain.
The use of the pacifier is not recommended after three years of age because it can alter the correct formation of the child’s mouth.
There are babies who are born with teeth, which are known as natal teeth. These teeth may be formed or have some defect, so each case must be evaluated and determine whether or not to extract them. Normally, natal teeth are extracted so that the baby does not choke if they fall out. They are also extracted so that the breastfeeding process is easier and the baby does not cause injury to the mother’s nipple.
Growth cycles may vary among children, so some children take longer to grow teeth than others. But if we see that the baby teeth do not grow, it is necessary to contact a professional.
How should oral hygiene be in babies and children?
From the period of breastfeeding a good oral hygiene should be maintained and then it should be prolonged throughout childhood. Hygiene should begin before the appearance of the first teeth, during this stage the gums should be massaged with a wet gauze. When the first tooth grows, it should be washed with a little paste and a small special brush for these cases.
From the time children are small we should teach them good oral hygiene habits and encourage them to brush on their own so they get used to it. Of course, until they are three years old, the ability to spit is not fully developed and the child can choke, so it is important that an adult is present.
Oral hygiene should be done after every meal for three minutes. Brushing should be done on the teeth and tongue, with little toothpaste, followed by flossing and mouthwash. Small children do not have enough dexterity to brush their teeth, that is why it is recommended to make sure they do it properly.
The best toothpaste for young children between 6 months and five years of age is 1000 parts per million fluoride in small amounts. For children between six months and three years, the right amount is the equivalent of a grain of rice. For children between three and five years of age, the amount equivalent to one pea. From the age of five onwards, it is recommended to use a toothpaste with a minimum of 1450 parts per million of fluoride.
Fluoride is a very important element during the tooth formation stage because it hardens the enamel and minimizes the appearance of cavities.
Baby teeth are more likely to suffer caries than permanent teeth because the enamel layer is thinner and more porous. Even if the baby teeth fall out, we should not ignore the possible problems that can appear because they can be prolonged in the permanent teeth. The baby should not be in contact with sweet substances for a long time in order to avoid the appearance of caries. To avoid cavities in the milk teeth, the use of dental sealants is recommended.
The permanent teeth
Finally, when the deciduous teeth fall out, the permanent teeth appear, which replace and extend the deciduous teeth. The permanent teeth are classified in the same way as the deciduous teeth, but with one more category: the premolars, located between the canines and molars. In total, the permanent teeth are composed of 32 teeth, including the wisdom teeth.
Baby teeth fall out because the permanent teeth exert pressure, because they are coming in, on the baby teeth. When the permanent teeth are fully formed they begin to grow and the baby teeth fall out to make way for them.
Baby teeth can fall out prematurely, if this happens the surrounding teeth will tend to occupy the space of the tooth that has fallen out, generating malpositions of the teeth. To avoid these malpositions, a retainer is placed until the eruption of the missing tooth, to ensure that it has enough space for when it grows.
If the baby teeth do not fall out there are two reasons: the first is because there is something that hinders the process or because the permanent tooth is not fully formed. The second case is called dental agenesis and has a genetic origin. Another pathology that causes baby teeth not to fall out is ankylosis, that is, the baby tooth is attached to the bone.
The included or impacted teeth are the definitive teeth that do not grow. Normally, this usually happens with the canines. To solve this problem there are several techniques, but the most used is the attraction with orthodontics. For this, an access to the tooth is enabled through the gum and bone, then a button is placed on the tooth with which traction is made outward until it is placed in place.
The definitive teeth grow from 6 or 7 years of age. The first teeth to erupt are the first lower and upper molars at around 6 years of age and the lower central incisors. At 7 or 8 years of age the upper central and lower lateral incisors grow in. Between the ages of 9 and 13 the rest of the teeth erupt: fangs, second molars and premolars.
Wisdom teeth are the last teeth to grow in. They usually erupt between the ages of 17 and 24, but they do not erupt in everyone. They can grow without causing any discomfort, but in some cases they can generate a malposition due to lack of space in the jaw and will need to be extracted.
Childhood oral diseases
Some oral diseases can occur during infancy because the immune system of infants and children is not fully developed. Normally, these diseases are not serious, but they need to be treated in time. The most common are:
- Thrush (oral candidiasis in infants): it is common in newborn infants under six months of age. There are usually two causes: contamination during childbirth if the mother suffers from vaginal candidiasis or bad breastfeeding habits, for example, if she salivates a lot, it favors the growth of the fungus.
- Oral herpes: usually occurs asymptomatically, i.e. no outward symptoms, but there is also the possibility of developing herpetic gingivostomatitis. The main symptoms of this pathology are: high fever, headache, general malaise, sore throat and swollen gums with pain. After a few days blisters will start to appear on the face area.
- Infantile bruxism: it is a frequent problem in babies and children. Bruxism consists of involuntary clenching of the teeth. It is usually a physiological bruxism, related to the development of the mouth, and when the permanent teeth grow, it disappears.
- Dental trauma: during childhood development it is normal for cracks, breaks or avulsions to occur in the teeth. In the most extreme cases, if the tooth has been pulled out by the root, it must be preserved without touching the root and without washing it, after which it must be placed in a device that allows it to be preserved for 24 hours. In the case of not having this device, the tooth can be put in milk to preserve it for a few hours. When this happens, it is necessary to go immediately to the dentist for the reconstruction of the tooth.
- Mononucleosis or kissing disease: it is an infection caused by the Epstein-Barr virus of the herpesvirus family. It is transmitted orally through oral secretions and is usually spread during childhood or adolescence. It has an incubation period of 30 to 50 days and the main symptoms are: lesions in the oral cavity, pharyngitis, tiredness, high fever and swollen glands. Treatment is with anti-inflammatory drugs to reduce inflation, fever and pain.
- Mumps is a contagious disease caused by the Paramyxoviridae virus located in the parotid glands. The main symptoms are: pain when chewing and swallowing, swollen salivary glands, fever and loss of appetite. There is no fixed treatment for mumps, but the use of anti-inflammatory drugs to reduce symptoms and the injection of the MMR vaccine are recommended.