90 | Oh BABY! Baby’s First Tooth Your baby’s primary teeth (baby teeth) are quite important. Decay and/or loss of these teeth can jeopardize the proper development of the permanent teeth. It is recommended that you take your child to the dentist for his first dental examination, cleaning, and topical fluoride treatment at his first birthday. For most babies, that first tooth starts coming in between 4 and 8 months. Girls tend to get teeth faster than boys. Occasionally, some newborns are born with teeth. These are usually extra and should be examined by a children’s dentist. The dentist may remove these teeth in order to prevent problems with feeding and damage to the newborn’s tongue. Babies get teeth at different rates. Baby teeth generally come in pairs, and as long as your baby starts to get teeth before 18 months, you probably don’t need to worry. When teeth come in, most babies experience pain and can be cranky and fussy. Common signs of teething include sore, tender, and swollen gums; excessive drool; loss of appetite; difficulty sleeping; and a low-grade fever. Babies may be clingy and chew on their fingers and toys. They may break out in a rash or their face, neck, and chest due to the excessive drool. When Teeth Come In: Central incisors – 6 to 8 months. Lateral incisors – 7 to 9 months. Cuspids – 16 to 18 months. First molars – 12 to 14 months. Second molars – 20 to 24 months. After your baby’s teeth begin to come in, you’ll need to take care of them. Use a piece of wet gauze to wipe them off or a toothbrush if necessary – do this twice per day. Don’t use toothpaste until they are older. If your baby does not have teeth at 18 months, talk to your physician. There may be an underlying problem, such as hypopituitarism or hypothyroidism that is causing the delay and these need to be addressed. By the time they turn 4 years of age, your child should have a full mouth of baby teeth – 20 to be exact. As guides for permanent teeth, baby teeth are important and should be taken care of – brushing, flossing, and visiting the dentist. Breast-Feeding and Bottle Feeding Whether to breast-feed or bottle feed is an important concern of the new mother. Consultation with your pediatrician will result in the decision that is best for you and your baby. If the bottle is used, the type of nipple will have no significant effect on your baby’s bite. However, after the eruption of the first tooth (4 to 8 months), allowing the infant to nurse from the breast or the bottle for extended periods of time can have destructive effects on the teeth. Most children will complete their nutritional requirements at mealtime. Children who continue to bottle feed while napping, sleeping, or in-between meals past 6 months of age, run the risk of developing extensive tooth decay. Even breast milk can cause infant tooth decay. The most damaging bottle contents are fruit juices like apple or grape, citrus juices like orange or lemon, and sweetened beverages. Carbonated drinks and sugar or syrup-sweetened water are also dangerous. Sleeping with a bottle should never be allowed to start. If the child must sleep with a bottle, then it should contain water only. If your child has been sleeping with a bottle or does have a daytime bottle habit, you should arrange for a pediatric dental examination as soon as hospital. Pacifiers It is recommended that the baby be weaned from the bottle or breast at about one year of age. If the baby still has a continued need to suck, a pacifier may be used. The most important consideration in selecting a pacifier is safety. It should be one with a large handle which will not separate. Thumbsucking Thumbsucking at an early age is very common and while continued thumbsucking can lead to deformation of the upper front part of the mouth, it is not advisable for parents to attempt to terminate the habit. Bribes and threats will do little to correct the habit and often enhance the anxiety and guilt your child may have. Some children will discontinue thumbsucking by themselves, often when they start pre-school or kindergarten. For those who do not, most habits can be successfully corrected with the help of the pediatric dentist when, and only when, the child indicates a desire to stop. Teething The first tooth will usually erupt between the ages of 4 to 8 months. Teething can be a most disturbing time for new parents, but this is a normal process in the child’s development. Although often the subject of debate between physicians,