Big Red Tooth – Dr Candice Schwartz

Where teeth and health meet

Teething

Teething

There are many myths associated with teething which date back to the dark ages. Babies are protected by their own natural immunity that was transferred to them through their mother’s placenta and this immunity lasts until approximately 6 months of age. A large majority of babies are also breast fed up until 6 months of age and gain immunity through the breast milk. So at 6 months there is a sudden drop in these forms of natural immunity and protective antibodies, which increases risk for infection. Coincidentally it is at around 6 months of age that the first teeth usually appear. For this reason it is doubtful that teething causes symptoms (like fussiness, diarrhea, runny nose and fever) but in actual fact these common symptoms are not related to teething at all and just coincidentally appear at the same time as emerging teeth. In addition the increased stress associated with teething could make your child more vulnerable to infection right before a new tooth appears.

I advise parents to keep a watch for vomiting and listless behavioral patterns, as these are almost always a sign that the problem is not teething. Keep a close eye on the behavior of your baby.  If your baby starts vomiting and has a fever for an extended period of time, exceeding 38 degrees Celsius you must contact your doctor. Teething should not require emergency care. If there is any concern that something other than teething may be causing symptoms, contact your health-care provider. The only signs that should be associated with teething are restlessness, increased salivation and fist/hand chewing.

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Teething remedies

I am a firm believer in Baltic Amber bead teething necklaces. Amber beads release Succinic acid, which is then absorbed into the body when kept in constant close contact with the skin. The long-term exposure to Succinic acid reduces inflammation that in turn eases the pain and discomfort stemming from the chronic oral inflammation of the mouth during teething and boosts immunity and the body’s ability to fight infection during this susceptible period. It works with the body to support the immune system, restore health, and reduce infection as well as pain. I recommend that this necklace be worn from 2 months of age, every day. At night, secure the necklace around the ankle of your baby with their sock so it does not present as a choking hazard.

I also recommend a visit to your homeopath. A homeopathic teething remedy and immune supporting remedy (like Oscillococcinum) taken from early on, in combination with teething beads has shown very effective results in alleviating teething pain and other illness accompanying the teething period.

Give your baby something fibrous to chew on like a cold carrot stick/apple slice. Natural rubber teething rings chilled in the fridge are also effective. Their gums are itchy so help them out by massaging the gums with a natural rubber finger brush combined with a Xylotol based toothpaste.

Do not give your child teething biscuits/rusks as these are high in sugar and promote plaque accumulation. Do not give your child any sugary drinks (fruit juice, sweetened tea etc) in their bottle. This may pacify your child short term, but the long-term damage and addiction to sugar is irreversible.

And finally is not helpful to apply commercial teething gels as these topical preparations have little to no effect- the child swallows most of the gel and continuous application is impractical and may lead to sensitivity to benzocaine.

 

Teething is a time when your child needs above all else, love and support.

 

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First dentist visit. What age should I bring my child to the dentist?

Many parents ask me when they should bring their child to the dentist for the first time. My response to this is always, whenever you see the first tooth grow out.

The reason I request to see children so early on is not to jump into their mouths and do a long examination. In order to prevent dental fears later on in life, a relationship with your dentist, based on trust and understanding is essential. It is easy to slowly nurture a bond with a child if I see them on a regular basis from an early age. You should be bringing your child to the dentist every 4-5 months, throughout their childhood. This good oral awareness will stay with them for the rest of their life.

Do not expect too much from the first dental visit. Encourage your child to be excited about this first experience at the dentist and always speak about the dentist in a positive light. You must ensure that you do not transfer your own fears onto your innocent child. I will never forget an experience I had early on in my career. A mom brought her young daughter to see me, she was 3 years old. The child walked into my surgery with confidence and a big smile on her face and jumped with enthusiasm into the dental chair. She was so excited to be at the dentist. As I was taking her back in the chair, her mother piped up “don’t be scared honey, the dentist is not going to hurt you”. All of a sudden the child’s entire attitude shifted. She was afraid and started crying and the entire appointment was downhill from there. The mother transferred her own negative expectations onto her child and ruined any chance of it being a positive experience.

Be very aware of the type of words and language you use. NEVER use negative nouns/adjectives like “pain, hurt, fear, scared, injection etc etc”. Be selective in your description of the dentist so the child is only expecting good, positive things.

Also be informed about which dentist you choose for your child. Phone the dentist rooms beforehand to find out if they are child friendly. Many dentists do not have the patience or interest in treating young children. Make sure you take your child to a pediatric dentist. It will make all the difference.

Another reason for bringing your child to the dentist from the time the first tooth enters the mouth, is actually for you, the parent. A pediatric dentist will take a lot of time and energy explaining preventive measure to you and teaching you about what to expect in the mouth and how to prevent cavities. Technology and ideas about prevention have changed a lot since you were a child. Educate yourself so you can give your child the greatest gift; the opportunity of having a healthy, cavity free mouth.

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Baby teeth eruption patterns

Many parents ask me when will their little one will start to lose their baby teeth. A large number of parents I see are under the misconception that the primary dentition (baby teeth) are not important because “they will fall out anyway”. This attitude must be adjusted. The primary teeth are vital for the child’s oral health and normal oral development for a number of reasons.

Firstly the primary teeth are used to chew and eat with. Children only lose the front 8 incisor teeth at the age of 6 years. These are then replaced by the adult upper and lower incisor teeth (front teeth). The back teeth (primary molar teeth) remain in the mouth till the age of 10 – 11 years. So if these teeth decay at an early age and it does pose a problem from a functional perspective.

Secondly the primary teeth act as space maintainers that “guide”the adult teeth into their correct positions. If a primary molar (specifically the second upper/lower primary molar) is lost prematurely, an orthodontic space maintainer is required to keep the open space in tact and prevent the permanent molar tooth from drifting forward into the space. If a space maintainer is not placed timeously, this could create an orthodontic problem later on in the child’s life. If a child loses a baby tooth early as a result of tooth decay or an accident, a permanent tooth may erupt early and potentially come in crooked due to limited space.

Lastly, the health of the primary dentition is a very good indicator for future oral health. If a child’s teeth are taken care of from an early age and they are educated about the importance of keeping their mouths clean and visiting their dentist regularly, they tend to have far fewer dental problems later in life. Children who suffer with many dental cavities from an early age, require extensive dental treatment and this general leaves them loathing the dentist. It is up to the parents to enforce good oral hygiene habits at home and bring them to visit the dentist every 6  months.

What can you expect from your child’s teeth?

By the age of 3 years, your child should have all their primary teeth (20 in total).

Between the ages of 5 – 7 years the upper and lower anterior incisor teeth will fall out and the permanent incisor teeth will grow out.

At approximately 6 years of age, the first permanent molar teeth will grow into the mouth. No teeth will fall out to accommodate the growth of these teeth. This is a good time to visit the dentist and have fissure sealants placed on the molar teeth.

Between the ages of 9 and 11 years, your child will lose their primary molar teeth and these will be replaced by the permanent premolar teeth.

The second permanent molar teeth will grow through the gums at approximately 8 – 9 years old. These should also have a fissure sealant placed on them to prevent dental decay.

By the age of 12- 13 years, all the permanent teeth should have erupted into the mouth and the primary teeth all fallen out.

 

 

The ages I have mentioned above are only averages. Timing can vary, though, and girls generally lose baby teeth earlier than do boys. The last baby teeth typically fall out by age 12 or 13. There can be a deviation of up to 2 years when it comes to tooth eruption times. If your child is “late” with their eruption pattern, please do not worry at all. If you are genuinely concerned about a tooth not wanting to grow out, you can see your dentist for a panoramic xray which will show exactly where the teeth are sitting and if they might be missing.

The picture below is a representation of a child skeleton of approximately 5 years old. You will notice the primary teeth present in the mouth. All the adult are present in the maxilla and mandible (jaw bones) of the child, ready and waiting to grow into the mouth.

The formative years are a wonderous time and so much is going on in a small child’s body. It is up to you as the parent, to respect these small miracles and help your child look after their teeth. With proper care, you can help your child’s permanent teeth last a lifetime. There are no second chances after the permanent teeth erupt! (:

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