She Says… Teeth. Again.

Dear Teeth,

You are Owen’s kryptonite.

He’s an easygoing, laid back, chill little guy until you come along. You were a little late to join the party, and now that you’re here, I wish you would leave. When you are working your way through his poor little gums he gets clingy and whiny and the river of snot coming out of his nose is downright disgusting. So far you’ve come in pairs; as in, two coming in at the same time. First the bottom two, then the top two, and as of last night the next two on the top row are here. This is useful for me because we’ve actually had teething-free time between teething times, but really, cut the kid some slack. He’s doing the best he can to deal with you.

We drink Ibuprofen like water around here.* I wish we didn’t have to.

My child teethes on anything and everything he can get in his mouth. And believe me, that’s a lot of things.

Couldn’t you just come in all at once instead of dragging this whole process out?

K. Thanks. Bye.

With deepest respect,

*Now before my super serious readers get all up in my grill about that Ibuprofen statement, please note that it was a figure of speech. We never dose more than the prescribed amount, and I try to use medication as sparingly as possible. Though any parent who has ever looked into the eyes of their child in pain will tell you that when they need it, they need it. But please don’t write me emails about what a bad mother I am for drugging my child with meds. Please.

Anyway, grasshopper, with teeth come great responsibility.

Since Owen’s a wee bit too young to be put in charge of his oral hygiene, it’s MY responsibility to keep his pearly whites, well, white. (Sidenote: I once had the same philosophy about Schnitzel’s teeth, but after a few months of trying to brush his teeth every night we gave up on that. The vet still comments on his beautiful white teeth, so I think his steady diet of sticks from the backyard act as a pretty good toothbrush. But I’m guessing I’m going to need to be a bit more proactive with Owen). Lucky for me I have a pediatric dentist for a father-in-law. Or rather, my father-in-law happens to be a pediatric dentist. I asked him a few FAQ’s as a new mom and I thought his answers might be helpful to those of you who don’t have a pediatric dentist on call. Feel free to ask him any other questions that come up and I’ll find out the answers for you!

It’s Ask a Pediatric Dentist Day at This Place is Now a Home 🙂

1. When should babies first see a dentist? Those teeth are pretty tiny. I’m not really sure what they could possibly see.

We recommend a first visit at one year for an exam and parent education. Many problems can be avoided by early diagnosis and establishing good oral hygiene and diet habits right from the start. Waiting until two or three years, after all the primary teeth have erupted, is too late.  Most pediatric dental offices charge very little for an under 2 year visit. Another good reason to have a one year visit is to avoid any parental expectations of cooperation at the dentist; young children are often pressured to be a good dental patient. It’s also good to have a dental “home” established since so many kids have injuries while learning to walk.

2. Tooth brushing at this age seems kind of crazy, with just a few little lumps sticking up. I think they “brush” his teeth at daycare, but I’m not sure what that entails. Should I be wiping his gums/teeth before bed too?
The main thing is to clean them.   While a damp washcloth or tissue is probably adequate to clean a couple of teeth, if you use a damp toothbrush, you can avoid it becoming a big deal later if you try to introduce toothbrushing.  Same reasoning with floss.  Even though there is nothing to floss, taking a piece and playing at flossing can make it a lot easier when there are more teeth present, and it’s actually important to floss.  Even if there are spaces between most of the teeth, once the 1st and 2nd primary molars erupt, they usually will come into contact in short order, and you can’t clean in between them with a toothbrush.  By the age of 5, I see a lot of kids with 8 cavities visible on their first x-rays even though you can’t see anything wrong looking in their mouths.  The enamel on primary teeth is only half the thickness of permanent teeth; if you have the kind of bacteria that promotes decay and sufficient exposure to sugars, it’s a recipe for decay between the teeth.
You’ve been hearing me extol the virtues of flossing for years now.  Seriously, if I could get every one of the parents in my practice to floss their kids teeth until they were old enough to do it themselves, I would fill half the number of cavities I do now.  All those kids would grow up with the habit and then would floss their own teeth daily. That’s how you avoid the typical cavities still prevalent in teenagers that result in fillings that require periodic replacement, and eventually crowns, root canals, periodontal disease, etc.  I really believe that although science has yet to give us a magic mouthwash or vaccine that eliminates decay (which is still the most common chronic disease of children), daily flossing from an early age would eventually save enough money to pay for our all our other health care in as little as 20 years.
There a lot of good information on the American Academy of Pediatric Dentistry site.  Here’s a list of FAQs about babies:
3. This one is a personal question and probably not interesting to the rest of the blog world, but Owen’s pedi says he is anemic, so we have to give him iron supplements. I read on the letter the doc wrote that iron can turn teeth gray. Similarly, my brother had a pink tooth when he was little and my mom always said it was because he had to take amoxicillin for ear infections when he was little. I’d rather not have a child with gray or pink teeth… have you ever seen this happen? Is it permanent or will it just be a baby tooth issue?
Iron causes a surface stain that is easily removed with a little pumice and peroxide on a spinning rubber cup.  Same with Amoxicillin or other antibiotics that can alter the oral bacteria so the stain producers take over. Tetracycline will permanently discolor developing teeth, but are not prescribed for children unless it’s a life threatening situation.
A pink tooth or gray tooth from an injury is the result of the nerve dying.  I wouldn’t exaggerate if I said that half the 5 year old boys I see have gray teeth, yellow teeth pink teeth, black teeth, chipped teeth or prematurely lost teeth due to injuries.  Benjamin had two lovely dark teeth for several years before they fell out.
So there you have it! Straight from the dentist’s mouth. Have questions for the doc? Ask away…

14 responses to “She Says… Teeth. Again.

  1. Thanks for this post…very helpful!

  2. Great info! Is there any benefit to starting a routine before the first teeth come in?

  3. I love this. I regularly get asked, “How old is your baby? How does she have so many teeth already??” so I’m well versed in baby tooth brushing too. The key is to make it fun. We have a tooth brushing song (made up by yours truly) and I do it while she’s in the high chair. After we’re done, she gets to play with her Eeorye toothbrush, so it’s just a fun experience for her.

    Sidenote: you don’t need to brush your dog’s teeth daily. Every two weeks is more than enough, especially if they eat dry kibble and chew on hard toys. I brush my dog’s teeth monthly (when she gets her heartworm pill) and that’s enough to keep everything healthy.

    We used Motrin every night for a month too, so don’t feel bad. It eventually gets better. Faith just started to get her 1st year molars (lucky us being early on everything tooth related) and we’re back on the Motrin train.

  4. Haha, I was the same way with our dog’s teeth in the beginning too. I don’t think I’ve touched that toothbrush in almost a year now. Brushing dog’s teeth is really just gross, especially mine who like to eat crap, literally. Raw hides and chew toys work just as well 😉

  5. My little boy had 8 teeth by the time he was 7 months – crazy!!!! Anyway – I had been rubbing his teeth with a face clothe, but noticed that his teeth were still a little yellow. I promptly bought a tooth brush and tooth paste that was safe for infants even though they said to wait until a year…..BUT – I know one year olds that only have a few teeth. Did I make the right decision??!!

  6. we got our first tooth here recently and he loves brushing his tooth! in fact he grabs the toothbrush from me and wants to do it himself and cries when i take it away again. hilarious! great informative post!!!!!!

  7. Thanks for that piece of information wrapped in a nice interview! I would never have thought of starting to floss at an early age.

  8. I have a one year old with three very small teeth poking through and here are my questions:

    Should I buy him a regular small size toothbrush or should I be looking for something specific? And while we’ll stick with a manual toothbrush for awhile should we be thinking about an kid sized electric one for the future? Any advantages there?

    After doing some research we decided to give our child the fluoride supplement recommended by our pediatrician, especially since the water in our county is not fluoridated. Any additional insight on the fluoride/no fluoride debate?

    Thanks for giving your readers an opportunity to ask your father-in-law some questions! I’m finding out as a first time parent that the more questions you ask the more answers you have. Especially when you feel like (almost!) every decision is a big one.

  9. Great post! Thanks Pedi-Dentist Dad-in-law! I find it very challenging to actually “brush” Cameron’s teeth. I’ve always wiped his gums every night at bath time with a cloth and he’s had 7 teeth since he was 7.5 mths old (4 top, 3 bottom – all in a month & a half) and I upgraded to a toothbrush (bought paste but didn’t use it b/c I didn’t like the ingredients list but I do plan to buy a better more natural brand). It proved pretty challenging to get anywhere brushing and I try playing games with him so that he will let me brush them, but instead he just wanted to chew on the brush. Is it somewhat effective “brushing” if he chews on the bristles? I’m trying to imagine flossing his teeth and well, that should be quite the experience! lol I agree that it’s best to get him used to it and in the habit himself though. Do you use regular adult floss or is there special baby floss?

    I always find it funny that you actually need to disclaim your funny comments because they are always in good nature, but there are always peeps who have no sense of humor at all eh?

  10. Isn’t it funny how everyone has an opinion? Before flying with my son people were telling me to “just give him benadryl” so he’d “be quiet” and wouldn’t disturb anyone else. Now that I gave him infant motrin a few times during last week since he’s had a cold and a fever on and off, I get a lot of opinions on how much, how often and why I’m giving motrin to him at all.

    Good info on brushing teeth and dental visits.

  11. This is Benjamin’s dad the pediatric dentist. I’m going to answer the questions that have been posted so far.

    @Nellie -It’s never too soon to start introducing a toothbrush. The fact is, very few toddlers will be able to do an effective job of brushing, much less flossing, and the sooner you make it part of the routine, the less you’ll experience “do it myself” that seems to accompany anything you try to do for 2 year old. Again, I can’t stress enough what a gift you give your child if you really make flossing a daily event that doesn’t get skipped (and therefore gives the message that it’s not so important). If I had to choose between flossing once a day or brushing my teeth 5 times a day, in the long run, more problems would be prevented by the daily flossing. Obviously, flossing daily and brushing well at least a couple of times a day is best.

    @Karen – Electric toothbrushes are great if your child likes it. For adults, it can really do a more thorough job in a shorter time. But for young kids, it can be overstimulating and it’s not really necessary. Furthermore, if toothpaste flavors seem to be an issue, just skip it. It’s the mechanical cleaning that is most important.

    Some fluoride is necessary for optimal development of permanent teeth. Too much can cause discolorations and even scarring. My rule of thumb is to only prescribe Fl supplements if the community water supply does not have Fl added, even if the household is on a well. A lot of bottled juices may also contain Fl since many are constituted with public water supplies. You can also give supplements based on where your child is for the day. If they are in a daycare situation that’s Fl and not at home, skip it on the days they go to daycare.

    However, the biggest reason kids get too much Fl is eating Fl toothpaste. I think this is more of a problem for siblings of kids who are using Fl toothpaste. They want to do everything the older child does so you have to make sure your younger child isn’t in the bathroom eating toothpaste with the older child.

    @Angie – Eating the bristles is not as good as “brushing” but don’t stress about it. If the bristles are really getting frayed, perhaps you could have a toothbrush your child holds and you use a less chewed one to actually go over the teeth. There is no need to have special floss, but there are flavored flosses that some kids like and also flossers with little handles. I personally find those more difficult to manipulate then wrapping the floss around my middle fingers and using my index fingers and thumbs to control a short span (inch or less) of floss and jiggling it in the contact point between the teeth. But whatever works best in your situation is what I’d go with. If you did nothing but flossed between the last two teeth in each corner once a day, you would be cleaning the place where the majority of children develop decay in the primary teeth. Remember that they are called “baby teeth” because you get them as a baby, but the primary molars are not lost until typically between 10-13 years. I still see too many well cared for children who develop 8 cavities between those molars before the age of 5.

  12. Thanks Benjamin’s Dad!!

  13. Kate-
    I love your blog and read it everyday!!! My daughter is a month younger than Owen and love hearing all the updates. My little girl is like Owen-happy and smiley–until she’s getting her chompers. She is a clingy mess and she just whines and cries and is happy for like 5 minutes at a time. NOT FUN. But, I think the few days every few weeks/month is better than a full few weeks of hell.
    And I’ve tried all the other “teething” tricks-a frozen washcloth, teething toys, etc…nothing works for us, except Ibuprofen and Baby Orajel, which I have to put on her pacifier b/c she won’t even open her mouth.
    thanks for the teeth info also!!

  14. Those teething days can be a nightmare! Wait until his molars start coming in! I learned the hard way that us moms are responsible for our children’s teeth. I was only semi consistent with teeth brushing and my daughter ended up with 3 cavities. Now I not only have to brush her teeth but floss them as well. Who has to floss a 4-year-old’s teeth!? Thanks for the helpful dental info. Doesn’t it seem like oral hygiene is so much more complicated than it used to be? I also found some great tips and helpful information for caring for my little ones’ teeth in this Mom’s Guide. Of course, with a dentist for a father-in-law you might not need the extra help!

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