infants

Teething Q & A

September 21st, 2020

Teething can be a difficult time for children, and it is often an intimidating time for parents as well. Many questions plague inexperienced parents, so we asked Dr. Garrett to answer some of the questions we get most often.

When does teething occur?

The most important thing to remember with these questions is that every child is different. Some children develop teeth quickly, while others are a bit slower to develop. Having a child whose teeth grow more slowly is not a problem. Stay patient, and everything will turn out alright. That said, teething typically occurs between infancy and age three, but it is not uncommon for children, especially boys, to continue teething past age three.  

Which teeth appear first?

Again, every child is different, but most children’s front, lower incisors erupt around six months. Between six and twelve months, the average child will get eight front incisor teeth. The next teeth to come in are usually molars, which often occurs around twelve months. Canines follow the first set of molars and come in about eighteen months on average. Lastly, between eighteen months and two years, the average child will develop their second set of molars, but it is common for this to take longer. Some children do not see their second set of molars until after their third birthday, which is normal.

Should I use Orajel to soothe my child through teething?

Orajel and other topical anesthetics are not recommended for teething children, as they will be mostly ineffective in these cases. Topical anesthetics are meant to numb and soothe the very outer layer of skin. Teething causes deeper pain from below the surface of the skin.

What should I use to comfort my child through teething?

Tylenol is typically the best pain relief option for children that are teething. It is soft on stomachs, easy to get, and it is usually effective with children. The key with Tylenol is ensuring that you give your child the correct dose. Giving your child too much can be dangerous, and we recommend tracking dose amounts and the times you administer it. If you have given your child Tylenol and they are still in pain, you can alternate it with Motrin as well.

What should I do about a permanent tooth coming in behind a baby tooth?

This is an extremely normal event. Because of children’s crowded mouths, adult teeth often come in behind a baby tooth, as it is the path of least resistance. As long as the baby tooth is loose, it will likely fall out on its own. If the baby tooth is not loose, it may need to be extracted, which is routine and usually causes children minimal pain.

Teething can be a challenging time for first-time parents, but it does not have to be! Remember what we always say: It does not matter how you take care of your child’s teeth, as long as you take care of them from the beginning.

Non-Nutritive Oral Habits

September 4th, 2019

Non-Nutritive Oral Habits

Learn with Dr. Garrett about non-nutritive oral habits and what those tendencies can mean for your child’s future dental health!

So, what is considered a non-nutritive sucking habit?

A non-nutritive sucking habit means that a child is placing something whether it be a pacifier, blanket, fingers, toys, etc. in their mouth without a food nutrition benefit.

Why do kids suck their thumb and use a pacifier and is it normal for them to do this?

A  majority of the time there is a negative connotation associated with children sucking their thumb because of the orthodontic issues that can come about later. However, it actually is a very normal habit for kids and it can even happen as early as the womb. For some kids, it is a self soothing thing and it’s desirable as a way to cope.

This habit actually gives them a positive endorphin feedback, which is why it can become addictive and they can start to use it in a non- coping way and rely on it for too long. Therefore, as long as it is monitored, it is not harmful to your children’s dental health. 

What are the negative effects of a non-nutritive sucking habit?

The oral ramifications of these habits is that whenever you place a thumb or another non food item in the mouth it applies either a biting or sucking force that is irregular to their teeth. It throws off the dental balance and can compress or flare the skeletal alignment and depending on how frequent the kids do it and the duration they do it, it can be a profound amount of force.

If kids are employing non-nutritive habits for an extended period of time, it applies the same sort of consistent shifting force that normal orthodontics like braces would. The difference is that it is not controlled so you have no handle on where the teeth are going to go or what they are going to do.

When should you stop allowing your kids to have non-nutritive sucking habits and does the amount of the habit have anything to do with when they should stop?

Depending on the individual child, if they are still partaking in non-nutritive habits past the age of three, but it is a very infrequent thing and it’s a short duration, that is not particularly harmful. However, if you have a child who is doing it for a long period of time and you are starting to see issues with their teeth then you should do your best to deter them from their non-nutritive habit no matter their age.

What are some techniques parents can use to stop their kids non-nutritive sucking habits?

Parents can often feel pressure to get their children to stop and they tend to get frustrated, but it is hard sometimes to force the child to stop with punitive approaches because they usually just don’t work that good.

What tends to work the best is the buy in approach which assumes that by the age of three most kids have enough language that you are able to have a dialogue with them and explain why this is an important negative consequence. Positively reinforcing them, reward systems, and prizes, are ways that you can encourage your child to break the habit and even if the child doesn’t stop right away, you are laying a foundation of why it is important for the child to stop. Then later once the child starts to buy in and they understand why they need to stop, then you can start introducing punitive approaches before it gets so far that you have to introduce nail polish on the fingertips or other tactics to get them to stop.

Are there any special things you can do for kids that have sensory issues or any type of neurological dysfunction?

Sometimes kids with certain oral sensory or neurological issues will have oral habits that are much more deeply rooted and they’re hard even when the child is aware to get them to stop because the child may feel like they need to do it or they can’t help themselves. In this case, occupational therapy is sometimes beneficial to help the child work through the issue more specifically and intentionally than what a parent typically has the training or time to do, but this is a case by case solution. 

Any other advice?

Ideally, yes we want to stop the non-nutritive oral habits and yes, there are some consequences, but at the end of the day, none of that stuff is that big of a deal. Even kids with pretty profound dental change at three will get some self correction and limited orthodontic treatment can fix it, so don’t stress yourself out about it. With a little intentionality you can monitor the habit and try to stay on top of it!

PDAO'S Tips for Preventing Baby Bottle Tooth Decay

March 6th, 2018

SOMETIMES, BEDTIME CAN BE a real struggle, and a bottle might seem like an easy solution. Unfortunately, putting a baby to bed with a bottle of milk or juice does more harm than good, because the easier bedtime comes at the expense of the baby’s oral health. Keeping those baby teeth healthy is crucial so that the adult teeth will have a better chance of coming in straight.

What Is Bottle Rot?

Prolonged exposure to the sugars in milk or juice erodes the enamel on a baby or toddler’s teeth, particularly the central incisors. If you’ve ever heard of the phrase “baby bottle tooth decay” or the more sinister-sounding “bottle rot,” this is what it refers to, and it’s definitely something to avoid. It can also happen with sippy cups and even breastfeeding! If a baby’s gums and teeth aren’t properly cleaned after feeding, the sugary milk residue left in their mouth increases the risk of tooth decay.

Stopping Bottle Rot Before It Starts

Preventing bottle rot is simple: only use a bottle for the baby’s mealtimes, not to soothe them or help them fall asleep when they aren’t hungry. A pacifier will be much healthier for their teeth. After the baby reaches six months old, it’s safe to use a bottle of water, or a sippy cup of water for toddlers. Not only will it not cause bottle rot, but it won’t leave stains if it spills!

After every meal, make sure to clean out milk residue. Once baby teeth start appearing, it’s time to start brushing them. Use a soft toothbrush and a dab of toothpaste no larger than a grain of rice. Because babies can’t rinse and spit, make sure to use a non-fluoride toothpaste that is safe to swallow.

Treating Existing Bottle Rot

If your baby is already showing signs of tooth decay, come see us! We’ll be able to assess the extent of the decay, deal with any cavities, and come up with a plan to prevent future damage. One of the easiest steps you’ll be able to take at home is to limit their consumption of sugary drinks like juice and soda. You can also bring them to us for fluoride varnish treatments to give their teeth extra protection.

Watch this Video For More Information:

https://youtu.be/SlwiXRmlLyA

We Are Here To Help

We know that parenting is full of unexpected twists and turns, but we’re happy to help you navigate the ones involved in infant and child dental care. Like you, we want your child to have a healthy smile for life! If you haven’t already brought them in for a checkup, schedule one today! You can schedule online www.smilesarewild.com or call our office 479-582-0600.

Thank you for being our valued patients!

Top image by Flickr user Sander van der Wel used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.