Why are children's teeth important?
Children have 2 sets of teeth - primary or 'Milk' teeth & permanent. Both are important for chewing, speech & for appearance. Additionally, milk teeth are important for proper development of muscles for chewing & keeping space available for permanent teeth to erupt into their right positions.
When do teeth appear in the mouth?
Generally by the age of 2 years all the 20 milk teeth erupt. They fall between the age of 7 and 12 years and are replaced by permanent teeth & the additional 12 teeth erupt behind the milk teeth - the first one of these erupts at the age of 6 years and is called the first permanent molar - this is a very important tooth in the arch. All permanent teeth erupt by the age of 14 years except 'wisdom teeth' which usually erupt between the age of 18 to 25 years. So between the age of 6 & 12 years a child has both milk & permanent teeth in the mouth, this is called the 'Mixed' Dentition. Parents of these children often mistakenly think that the tooth though decayed may be allowed to fall as "it will come again."
Does tooth eruption cause illness?
Many parents think that the fever, diarrhoea children get while teeth are erupting is because of teething. This is only a coincidence. At this age children are very active & tend to put everything into the mouth. This causes infection around the erupting teeth & upsets stomach.
Why do children sometimes get 'double teeth'?
Usually the permanent teeth are located just below their primary (milk) predecessors. With the pressure from the permanent tooth, the root of the milk tooth gets eaten away & the milk tooth falls to make way for the permanent tooth. But if the permanent tooth is placed too far away, it will erupt even without the predecessor falling as there is no obstruction and then we see double teeth - a new tooth behind or by the side of the old one. Such a situation should not be allowed to remain for long - say more than a couple of weeks. Timely removal of the milk tooth in such a case will allow the permanent tooth to take its right place.
What is the right age for correcting alignment of teeth?
It would differ from case to case but the commonest is 12-13 years. Many times early commencement of treatment gives better results but treatment is possible at an older age also, or sometime at young age.
When to start tooth brushing for children? What tonic to give children for better teeth?
As soon as the first tooth erupts. Initially parents must brush the child's teeth as the child is unable to do so. The child can gradually learn. There is no special or separate 'balanced diet' for teeth. A child otherwise healthy, does not require any tonic for teeth.
Is calcium or Fluoride helpful?
Calcium helps only when the teeth are being formed within the jaws & not after they have erupted. Fluorides help because they increase the resistance of the tooth to acid-dissolution which is what happens in the tooth decay. Fluorides can be given in drinking water, as tablets & can also be applied to teeth by the dentist or through the toothpaste.
Why do children's teeth decay?
The causes of tooth decay in children are the same as in adults but the progress is faster. An important factor in children is too long bottle feeding. Many of the children in whom bottle feeding with milk continues beyond the age of 8 months, develop what is called 'nursing bottle caries' which is extensive decay to teeth involving many teeth. Milk teeth being small in size, decay reaches the nerve (pulp) of the tooth very soon and causes pain. This is also why tooth destruction takes place very fast & some parents feel that when the teeth appeared itself, they were decayed. Remember, teeth can decay only after an eruption.
How is tooth decay in children treated?
Treatment of decay is the same whether it is for milk teeth or permanent - fillings, root canal treatment & crowns. For milk teeth ready made crowns are also available. If the child is unable to co-operate for treatment, it is better to get the child treated under general anaesthesia rather than lose the advantages of treatment.
Why not remove milk teeth?
Although it is true that all milk teeth are replaced by permanent teeth, this must happen at the 'right age'. There is an appropriate time for each milk tooth to fall & the permanent successor to take its place. If the milk tooth is lost, for any reason, much earlier than the scheduled time of eruption of the permanent successor, then it is very likely that the space created by loss of the milk tooth would reduce or even close because of drifting of the adjacent teeth & when the time for the permanent tooth to erupt comes, it has no place, so either it gets locked within the jaw or erupts in an abnormal position. So, as a broad guideline, by following conservative treatment procedures, all attempts should be made to avoid removal of primary (milk) incisors below the age of 4 years and other milk teeth below the age of 9 years. Should such early removal of teeth becomes necessary, an appliance called the "Space Maintainer" should be given to the child to wear.
How can tooth decay be prevented?
There is no foolproof method of preventing tooth decay. But it can be kept under control and its ill effects minimized by regular cleaning of teeth, reducing frequency of sugar consumption, proper diet, regular check-up by the dentist, treatment whenever necessary & application of fluorides.
If milk teeth are decayed, will permanent teeth also decay?
No. Permanent teeth will not decay because the milk teeth were decayed. But it does mean that the child is susceptible to tooth decay & requires proper attention & care to have & maintain a healthy dentition.
Is thumb-sucking bad for teeth?
Thumbsucking, mouth breathing, tongue-thrusting and such habits do not affect the positions of teeth if they are discontinued by the age of 5 years. Such habits can be due to a variety of reasons - including psychological. Attempts must be made to pin-point the cause & treat it to discontinue the habit. If such attempts fail or do not have any particular cause, certain habit breaking appliances can be constructed, to be worn by the child to get rid of the habit.
When should the child be taken to a dentist?
The first visit should not wait till a tooth starts paining. It should be at the age of 2 years and then for 6 monthly check-ups.
What to do when a child sustains an injury to the teeth?
The child should be examined by a dentist after the injury as soon as possible within hours. Whether the tooth breaks or not, it may require treatment immediately or after observation for some months. Such teeth have to be examined by the dentist at periodic intervals for up to 2 years after the injury. If the tooth falls out due to the injury, wash it and try to place it back. If this is not possible, immerse it in milk & if milk is not available, in water & take it to the dentist immediately - reporting within 1 hour of the injury is very useful.
What to do if the teeth do not erupt at the right time?
In some children like other milestones, eruption of the teeth may be delayed. It is wise to consult a dentist if this happens. He may advise an X-ray to confirm that the tooth is present & locate it in the jaw. After seeing the position in the jaw he may advise some treatment like a small cut in the gum or just wait & watch. Very rarely the tooth may be congenitally absent.
