February 7, 2019

child and mother playing together

Having a child requires a lot of time, energy, and attention. So, we get that you don’t have time to worry about more things! Which is exactly why our Exceptional Dentistry team is here to take away the worry when it comes to all things dental health related.

Since February is National Children’s Dental Health Month, we decided to give you a roadmap (so to speak) to ensure that you’re able to care for your little one’s smile and health.

When Do Kids Start Getting Their Teeth?

Baby teeth (aka primary teeth) usually start coming through the gums around six months. But some children don’t get teeth until after they are one year old.

The primary tooth eruption pattern is normally the two front teeth on the bottom followed by the four front teeth on top. The rest of their tiny chompers start filling in their smiles in pairs (one on the right and one on the left) until all 20 come through.

Typically, your child will have all their baby teeth by the time they are three years old. Baby teeth are smaller and whiter than how their adult teeth will be once they come in.

After your little one is around four, their facial and jaw bone grows with spaces between their baby teeth. This allows room for their adult teeth to come in. Their mouth will house both primary teeth and permanent teeth between the age of six and twelve.

Baby teeth save space for their incoming adult teeth and these teeth ultimately help your child look, chew and speak normally.

But here’s the thing: the functionality of the mouth has a much larger impact on your child’s entire body, overall health, and quality of life than you might realize.

Before we get into that, there’s one other thing about the transition from baby teeth to adult teeth that many of our parent-patients ask us about; what do you do when your child’s adult teeth come in behind the baby tooth?

Ectopic Eruption and What to Do About It

It can often be unnerving for parents when these “shark teeth” show up! (They’re called shark teeth because they look like a shark’s grin with their two rows of teeth). But you can relax, it’s not a dental emergency!

You see, normally the roots of baby teeth get dissolved by the big tooth underneath, then the baby tooth loosens and falls out, making room for the permanent tooth pushing its way up. Occasionally the baby teeth don’t dissolve and fall out, so the permanent tooth takes the path of least resistance and shows up behind it.

This often happens with the lower front teeth around the age of six and sometimes with the upper back molars around the age of eleven. Shark teeth can arise when baby teeth linger and the permanent teeth have nowhere else to go. Sometimes it’s from crowding in the lower jaw or when an erupting adult tooth didn’t reach forward enough under the baby tooth.

Most of the time shark teeth fall out on their own, but if the baby tooth isn’t loose, then it’s time to call us so Dr. Powell can remove the baby tooth and make room for the permanent tooth.

The Mouth and the Machine

We alluded earlier to the fact that the mouth is much more than just teeth. Which is why we like to help our patients understand that the mouth can be thought of like a unit of a much larger machine. This unit, which consists of many parts, can either aide or hinder in the proper development of the facial structure.

Much like a domino effect, one piece out-of-wack can take down the whole thing.

So, not only does the mouth consist of teeth, but there’s also lips, tongue, and cheeks. Each piece helps the other pieces, which in turn, contribute to the functionality of the whole machine (aka the body).

Of course, your child’s teeth ensure that they can speak properly and aid their digestive process, but the ultimate goal of that complete mouth unit is the correct formation of the facial structure so that they can breathe properly.

Breathing affects the body in many ways, and although important for adults as well as children, making sure that your child develops proper tongue placement, lip seal, and nasal breathing will have an effect on their entire life.

What Do Parents Need to Pay Attention To?

Being able to identify warning signs early on puts you ahead in your ability as a parent to make sure that you are helping your child develop good habits that are crucial to the growth and development of their facial structure.

Here are the red flags that should get your parent-spidey-senses on high alert:

  • Shiners under the eyes and/or Dennie-Morgan lines (aka fine lines under the eyes) 
  • Trouble latching in breastfeeding
  • Mouth breathing
  • Forward tongue position (tongue sits on lips)
  • Bedwetting
  • Snoring
  • Teeth grinding
  • Behavioral problems (like ADD or hyperactivity)
  • Learning disabilities

Airway Obstructions

Allergies cause the effect of enlarged tonsils and ultimately airway obstruction, which is why it’s important to see an allergist if you’ve noticed shiners or Dennie-Morgan lines under your child’s eyes. You might also start by removing dairy from your child’s diet.

Facial development is another factor for the airway.

The roof of the mouth is the floor of the nose. A deep palate constricts the nasal cavity as does a narrow maxilla which forces the tongue to block the throat.

Sleeping disorders are also a result of an obstructed airway. They may manifest for your child as bedwetting, teeth grinding, snoring, behavioral problems, and learning disabilities.

Facial Development

So, we already know that facial development affects airway, but it also affects tongue position which affects the ability to get the proper lip seal and teeth position.

Teeth can be moved quite easily in fact. The weight of a piece of paper could even move your teeth if you applied it frequently enough. So, we’re sure that you can imagine what your tongue can do (you know, the thing in your mouth that’s always pushing against your teeth).

This is exactly why you want to ensure that your child is developing the proper habits so that the facial structure will develop correctly.

The tongue, lips, and cheeks are really nature’s braces. And when they are functioning properly they will help get the teeth in the correct position.

If the thought of saving money on braces just flashed into your head then you’d be correct. When a child’s facial structure develops properly the chance of never needing braces drastically increases.

On another note, it’s true that the development of your child’s mouth will also affect the aesthetic development of their face. And while you’re likely not thinking about aesthetics, it’s possible that your child will once they reach adulthood.

Take Action by Helping Your Child Develop Good Habits and Get Proper Treatment

It’s never too early or too late to spring into action for your child. Which is why we’re going to break down what you can do at each age.

Infant to Toddler

This probably goes without saying, but if you notice any of the warning signs (like shiners, snoring, mouth breathing, etc.) that we already mentioned you definitely want to call us. In the meantime, here’s what you can do to ensure you’re helping your child develop properly:

  • Don’t let your child suck their thumb. Thumb-sucking narrows the palette and affects facial development.
  • Avoid pacifiers or only use them to calm when fussy. We get that crying and fussiness makes it super tempting to just use a pacifier. But pacifiers cause the same issues that thumb-sucking will. If you absolutely must use one, then we recommend that you only use it to soothe your child and then remove it once they are calm. We also recommend that you use the correct size (the packaging should have ages listed on the product or your pediatrician should be able to help you). It’s also a good idea that you get one that’s shaped for the palette (like Nuk pacifiers) so that the tongue can stay in a natural position. However, we don’t recommend the use of a pacifier after the age of one.
  • Visit a highly trained and educated dentist if your baby is having a hard time latching because they might be tongue-tied. This makes it so that the tongue cannot get into the proper position for swallowing.

Toddler (12-36 months)

If you notice that your child is mouth breathing, then do your best to instruct your child to breathe through their nose. If they aren’t able to do this, then again it might be an airway obstruction like enlarged tonsils. Enlarged tonsils can also result in a forward position of the tongue.

If you notice any of the other symptoms like hyperactivity, bedwetting or learning disabilities then those are good indications that they need help with tongue position, lip seal, and nasal breathing.

You can take action by:

  • Eliminating allergies or having your child’s tonsils removed. Get in contact with an allergist or an ENT. Alternatively, if you do have a dentist who is informed about this subject matter, they should be able to point you in the right direction.
  • Encourage your child to breathe through their nose. Sometimes it could just be a poor habit that is developing and with a little extra attention, you may be able to help your child develop the proper habit.

Ages 4-7 Years

Many of the same things that we discussed for younger children also apply to children age four to seven but at this age, they can also benefit from the following:

  • Visit the dentist for myofunctional therapy. At this age, it would be up to you to take myofunctional therapy and teach your child what to do. This therapy will train the tongue, lips, and facial muscles to be in the proper position while your little one’s facial structure is still in the developmental stages.
  • Frenuloplasty of the tongue. This treatment will help with the range of motion for the tongue so it can get into the proper position when swallowing and while at rest (all tongues should rest at the top of the mouth and not behind the teeth.) And while the name might sound like a big surgery, it’s actually a simple procedure that can be done without general anesthesia and typically has a three to four-day recovery time.
  • Don’t let them rest their faces on their hands. We already mentioned that repeated contact can move teeth and so it goes for resting their face in their hands. It’s a good idea to help them develop the habit early on of keeping their hands away from their face.

Ages 8-17

Again, you’ll find that many of the things recommended for the younger ages can still apply at this age. One big difference is that your child is now old enough to do myofunctional therapy without you as they should be able to follow instructions and grasp concepts.

The other thing is, if you’re just reading this post now and your child is a bit older, then poor facial development might’ve already taken place.

The good news is it’s not too late (even adults can take action, actually) and your child’s epiphyseal plates (aka growth plates) might not be closed yet.

  • Have them begin myofunctional therapy.
  • Mouth taping, breath right strips, and chin straps. These are a very affordable measure that can be taken to ensure that nasal breathing is happening while sleeping. Your child can even use paper tape or a mouth tape that you can buy.
  • Get an AGGA, RAGGA, or FAGGA. These are growth appliances with the goal of avoiding jaw surgery, as a growth appliance will stimulate the DNA that is already there and help develop the facial structure.

If your child is past the age of 17 and technically not a child anymore, don’t worry because there are still options. While adult treatments may take a little longer it’s still possible to develop proper nasal breathing, tongue position, teeth position, and lip seal even as an adult.

Your Child’s Dental Health: Hygiene Awareness

In addition to proper facial development and proper breathing, you’ll also want to help your child develop good oral health. You might be wondering when you should take them to see a dentist or when you should start to brush their teeth.

When Should You Take Your Child to the Dentist?

Unless your baby is showing any of the symptoms we mentioned before, there’s no need for an infant to see the dentist. Once your child starts getting more teeth (typically 13-24 months) you can bring them in to see the dentist but the sole reason would be to get them familiar with dental visits so they won’t be afraid as they get older.

By age three you can take them to the dentist for an actual visit. These early dental visits are important as over 50 percent of children will have some kind of tooth decay before they turn five!

Develop Good Oral Health at Home

If you’re checking this post out when your child is still a baby then once you see that first tooth you can use a soft washcloth or small toothbrush to clean their mouth. No need for toothpaste, just get it wet with water. It’s easiest if you sit on the floor with your child laying on their back in your lap so you can see what you’re doing.

Once your child is a little older, a great teaching tool is letting them see you brush and floss daily, and there are many things that you can do to make brushing and flossing fun for them. You’ll be brushing and flossing for them until they develop the coordination to do it themselves. Brush twice a day for two minutes. If your little one wants to help, you can take turns brushing or let them start and then you finish.

When your child’s teeth touch, it’s time to start flossing those areas that a toothbrush can’t clean. Their coordination is usually developed enough by the time they reach six or seven years old to start brushing on their own and flossing by the time they are nine or ten.

These habits you build with them now will help them prevent cavities and gum disease later.

We don’t want you to be worried about your child’s dental health and are here to support your efforts to help keep them healthy and strong. Please give us a call if you have any questions or concerns about your child’s dental health, and most importantly, schedule their visit as soon as possible.

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