Through the Ages

Age 0 -2 years

Why are primary teeth so important – aren’t they going to fall out anyway?

Primary teeth, sometimes called “baby teeth,” are important to your child’s health and development and should be cared for just as you would for permanent teeth. Primary teeth serve critical functions as a child learns to eat and speak. They are important for the normal growth and development of the face. In addition, they maintain space on the dental arch and guide the eruption of the permanent teeth. While some primary teeth are typically replaced around age 6, the back teeth (molars) can remain in until age 12 or 13. Without proper care, these teeth can decay and possibly cause toothaches, gum disease, and serious health problems. For these reasons, primary teeth are significant and require good daily hygiene and regular professional attention, just like permanent teeth.

When will my baby start getting teeth?

The primary teeth are forming under the gums even before a child is born! While it is possible to have “natal teeth,” where the baby is born with teeth already in the mouth, the primary teeth normally start to come in between 4 – 6 months of age, with the lower, center, front teeth (central incisors) coming in first. Permanent teeth start to develop under the gums around age 3 and begin to erupt around age 6. Eventually your child will have up to 32 permanent teeth, including the 4 wisdom teeth.

Teething

The vast majority of kids fly right through teeth eruptions with no problems, but teething can be difficult for some. When the back teeth are coming in, this can cause not only discomfort, but also fevers, blood blisters, and ear aches, which can simulate inner ear problems. To help your baby with teething, we recommend frozen bagels for them to chew on, so that the baby can gently work the gums to allow the teeth to erupt. You can also use Children’s Tylenol® or Motrin® to help your child be more comfortable. Please do NOT apply aspirin directly to gums as this can cause severe burns of the tissue. If you have any questions about teething, please call our offices @ 757.474.1200.

About bottles and nursing at bedtime

It is important to know that nursing a baby to sleep or putting a baby to sleep with a bottle of milk or juice can be very bad for her teeth. When a baby sleeps, her saliva production is lessened, so the natural cleaning mechanism for the teeth is not at work. Without this saliva, your baby’s teeth becomes covered in the sugars from the milk or juice. These sugars feed the bad bacteria that are in the mouth, creating an acid environment that encourages tooth decay. For this reason, we recommend cleaning your baby’s teeth with water and a soft bristled brush or washcloth before putting her down to sleep and after night feedings. If you must give something in a bottle to help her go to sleep, use plain water or flavored water without sugar. Link to Nursing Bottle Decay

How should I clean my infant or toddler’s teeth?

Clean your infant’s or toddler’s teeth with water and a washcloth or child’s toothbrush with soft bristles. It is recommended not to use toothpaste until he is able to spit it out and not swallow it. This ability usually occurs around age three.

Do you do early orthodontic evaluations?

Pediatric dentists are specialists with children’s dental development. Your child’s complete dental condition, including potential orthopedic (concerning the positioning of facial bones) and orthodontic (concerning the positioning of the teeth) conditions will be evaluated at every continuing care visit. Our pediatric dentists, Drs. Levin, Hasty, and Rosenblum work with our orthodontist, Dr. Barney, routinely during this process.

Is it a problem if my child sucks his thumb or uses a pacifier?

Orthopedic change can result from a prolonged use of thumb sucking or pacifiers, however, this is typically not an issue until age 4 or 5. Sucking is a normal reflex for infants and, as you are probably aware, can soothe them. Children usually stop sucking their thumbs naturally as they get more active and begin to require both hands for their activities, like holding toys, climbing on furniture and coloring.

The potential for dental emergencies

We don’t call them toddlers for nothing! The typical coffee table is the perfect height of the upper front teeth for many children and for that, we see many injuries to these teeth in this age group. Look at the layout of your furniture and think ahead about what could be a bad situation for your child. We strongly recommend precautionary measures, like installing bumpers or removing items with sharp corners, to save a lot of pain and trouble. Establish Children's Dentistry and Orthodontics as your Dental Home for your child now, before dental trauma happens, and put the emergency contact number in your cell phone directory and next to your home phone. (Our office number is 757.474.1200). If your child experiences any facial trauma, please remain calm and consult with his dentist, because in many of these situations, your assurance is important!

Tooth Eruption Chart

Link to our existing tooth eruption charts.

Age 2 -5 Years

Why are primary teeth so important – aren’t they going to fall out anyway?

Primary teeth, sometimes called “baby teeth,” are important to your child’s health and development and should be cared for just as you would for permanent teeth. Primary teeth serve critical functions as a child learns to eat and speak. They are important for the normal growth and development of the face. In addition, they maintain space on the dental arch and guide the eruption of the permanent teeth. While some primary teeth are typically replaced around age 6, the back teeth (molars) can remain in until age 12 or 13. Without proper care, these teeth can decay and possibly cause toothaches, gum disease, and serious health problems. For these reasons, primary teeth are significant and require good daily hygiene and regular professional attention, just like permanent teeth.

Eruption of teeth

During this age, your child will get his final primary teeth as – the second molars generally erupt around age two years. He will then experience a lag time during which he will neither gain new teeth nor lose any teeth. Children typically begin to lose, or exfoliate, their first primary teeth around six years of age, but some children may begin this as early as four years. If you have any questions regarding your child’s tooth eruption or loss, please consult with his dentist.

Preventing cavities and controlling dental caries

Between the ages of 2 and 5, children tend to become more independent and we recommend that parents stay diligent at controlling their child’s nutrition, snacking habits, and oral hygiene. This is the age where children often increase their snacking and drinking of sugary liquids. It is no coincidence that we see a lot of tooth decay in children who drink a lot of fruit juice. Therefore, we highly recommend that juices be limited to twice a day consumption or the child be given plain water or flavored waters with no sugar.

Also at this age, children tend to want to do more things by themselves; however, we strongly recommend that a parent continue to help a child brush and floss his teeth until he is 7 or 8. A good rule of thumb is that if they cannot tie his shoes, he or she can’t do an adequate job of brushing and flossing.

Is it a problem if my child sucks his thumb or uses a pacifier?

Thumb-sucking and pacifier use in children younger than 4 is not considered a problem. Children usually stop this habit between the ages of 2 and 4.

Children who suck their thumbs frequently or with great intensity after the age of 4 or 5 ARE at risk for dental or speech problems. Such problems include the improper growth of the jaws, misalignment of the teeth and shape of the dental arches. A child may also develop speech problems, including mispronouncing Ts and Ds, lisping, and tongue thrusting. Questions regarding oral habits are common, so please do not hesitate to ask our doctors and team members!

If you are concerned about your child’s thumb sucking or pacifier habit, talk with the dentist about your child’s dental condition, and what you can do to help your child quit their habit. A good book about thumb sucking is:

David Decides About Thumbsucking: A Story for Children, A Guide for Parents,
by Susan P H.D. Heitler.
For mor einformation please link to our thumb sucking page.

Early orthodontic evaluation and treatment

The ages of 2 to 5 years often present opportunities to correct many orthopedic (concerns the positioning of the facial bones) discrepancies and to allow for normal function of the jaws. The goal of most intervention at this age is to create an environment that allows for normal eruption of the 6 year molars. Also, at this time, we can begin to assess crowding and develop strategies for managing the eruption of the permanent teeth.

The potential for dental emergencies

This is very active and adventurous time for most children. They are often climbing, jumping , and testing their limits. Please keep a watchful eye on them and help them to understand how to have fun while making good choices to avoid major injuries. We also recommend that you put our emergency number in your cell phone and next to your home phone. When you need it, you do not want to have to look for it! If your child experiences any facial trauma, please call the emergency number for Children's Dentistry & Orthodontics @ 757.474.1200.

Age 5 -12 Years

About Orthodontics

This is a time of transition from primary to permanent teeth and for reconfiguration of the jaw joint structures. We want to make sure that there are no cross bites or constriction of the dental arches that require an abnormal joint shift to bring the teeth together. We also want to assure normal eruption of the permanent molars, as they are important for the normal function of the joint.

At this time too, we want to assure proper alignment of the incisors, top and bottom, and correct alignment of the cuspids or “eye teeth.” (They can sometimes become impacted in the arch or look like fang teeth!) This is a time for rapid growth of the body and the face, and for that reason, it’s a good time to make any necessary changes in the development of the face. This is the age group of children who often receive head gears, for example, to correct overbites and underbites.

At Children's Dentistry & Orthodontics, we support the position of the American Association of Orthodontists that children be considered for a comprehensive orthodontic evaluation by age 7. The evaluation may include standard arch length measurements, registration of their bite and a panoramic radiograph study of their face. A cephalometric radiograph may be required at a later date. When appropriate, a consultation with our university-trained orthodontist, Dr. Barney, is scheduled to discuss any treatment recommendations.

Panoramic Radiograph

When your child’s first permanent molars erupt, we will suggest taking their first panoramic radiograph. This radiograph is critical for us to see the presence, or absence, of the permanent teeth as well as their shape and eruption pattern. We are also able to evaluate the development of the jaw joint (temperomandibular joint) and the presence of many pathological conditions that affect the jaws. This radiograph is critical to many decisions that we make concerning your child’s restorative and orthodontic care.

Preventing cavities

We recommend that parents continue to teach and reinforce good nutrition, including healthy snacking habits and good oral hygiene with their child. We strongly recommend that a parent continue to help a child to brush and floss his teeth until he is 7 or 8. A good rule of thumb is that if he cannot tie his shoes, he can’t do an adequate job of brushing and flossing his teeth. Continue to schedule and keep regular continuing care appointments, or dental check-ups, for your child every 6 months.

Mouth guards for sports

We are very supportive of the use of mouth guards in any contact sports, including football, soccer, and hockey. Mouth guards not only protect the teeth, but can reduce concussions, brain injuries, and injuries to the joints. A mouth guard must be comfortable and not cumbersome, so that the child will use it. If you have trouble finding one to fit, we can make a custom one for your child.

Chewing gum

We encourage the use of sugarless gum to help prevent tooth decay! Sugarless gum can actually clean the biting surfaces of the molars and stimulate saliva production. This brings minerals to the surface and helps the teeth heal. Keep in mind that gum with sugar is very bad for the teeth.

Sealing out decay

Sealants are used to protect the decay-prone areas of the back teeth, and are possibly the best preventive care measures that we can provide your child. Studies show that sealants can reduce caries in these permanent teeth by 70%. Sealants are easily applied and are quite durable, so ask the dentist if your child can benefit from sealants.

Age 12 -17 Years

Preventing Cavities

We see a great frequency of dental caries in teenagers due to the availability of soft drinks and sports drinks in school. Sports drinks are good to use following athletics to replenish fluids, but regular and indiscriminate use bathes the teeth in sugar and acid and leads to decay. We recommend a switch to flavored waters or plain water to give the teeth a break from the sugar-producing acid and provide a chance for them to re-mineralize and heal.

Sealing out decay

Sealants can be used to protect the decay-prone areas of the back teeth, and are possibly the best preventive care measures that we can provide. Studies show that sealants can reduce caries in these teeth by 70%. If a teenager has never had decay, we may not suggest sealing his teeth – particularly if he brushes and flosses well and has a healthy diet. However, if a teenager has had a history of cavities, it may be a reasonable recommendation. Sealing can be an effective preventive measure, but should be considered on a case-by-case basis. Not every tooth requires sealants and our doctors and team will advise appropriately.

Teeth grinding

Talk with the dentist if your teenager is grinding her teeth. At this age, teeth grinding can lead to jaw joint problems from the stress of overworking the jaw muscles. Often a custom made mouth guard allows the muscles to rest at night, reduces the pain, and protects the teeth and jaw joint.

Mouth guards for sports

We are very supportive of the use of mouth guards in any contact sports, including football, soccer, and hockey. Mouth guards not only protect the teeth, but can reduce concussions and injuries to the jaw joints. A mouth guard must be comfortable and not cumbersome so that your teenager will use it. If you have trouble finding one that fits properly, we can make a custom guard for your teenager.

Chewing gum

We encourage the use of sugarless gum to help prevent tooth decay! Sugarless gum can clean the biting surfaces of the molars and stimulate saliva production. This action brings minerals to the surface and helps the teeth heal. Keep in mind that gum with sugar is very bad for the teeth.

Tobacco use

Most parents and teenagers are aware that smoking cigarettes is bad for their health, can damage their mouth and lungs, and stain their teeth. It is also important to note that smokeless tobacco is especially dangerous because the nicotine is absorbed directly through the gums. Studies show the incidence of cancer of the mouth increases as a direct result of its use. It is important to understand that tobacco in any form is very detrimental to oral health, and we strongly advise against its use.

Tooth whitener

Many teenagers are concerned with personal appearance and having healthy white teeth can boost their self esteem. While excellent oral hygiene and regular checkups are the best way to a beautiful smile, some teenagers may want to try whitening their teeth for extra dazzle. Over-the-counter teeth whitening products can be safe and effective, but consult with the dentist prior to using them to be sure. For a faster, safer and more effective result, we can provide cosmetic teeth whitening with custom trays. With this process, a chemical reaction occurs within the tooth to produce fast and stable results. Talk with the dentist if your teenager is interested in this process.

Bad breath

Many teenagers are concerned with bad breath. Our advice for this problem is to adequately brush your teeth and gums, palate and tongue, and floss every day. We have found that Crest Pro-Health™ toothpaste has been shown to be very effective in reducing bacteria and can improve the breath. Colgate Total™ toothpaste is another good option. We do not recommend that children or teenagers use alcohol-based mouth rinses.

It is important to note that if your teenager has allergies, asthma, or sinus infections, he will often have secondary halitosis that can’t be brushed or rinsed away. In these cases we recommend seeing your child’s doctor to address the primary cause.

If you have further questions, we have four offices throughout Virginia Beach and Chesapeake for your convenience, please call us:

• Kempsville Office: 757-474-1200
• Thalia Office: 757-486-2525
• Great Neck Office: 757-496-8300
• Chesapeake Office: 757-548-3030