Infant Oral Health:

  • Most children cut their lower front teeth by the age of six to eight months.
  • These are followed by the two upper front teeth. The rest of the teeth should appear within the next 18 to 24 months.
  • At two to three years, all 20 of your child’s baby teeth should have erupted.
  • The first adult teeth usually start to erupt by around age six.
  • These include molars behind the baby teeth and the bottom front teeth.
  • Most children will continue with this process until around the age of 14.
  • Since all children are unique, the timing of eruption may vary from child to child.
  • Variations in the time frame of eruption and tooth loss are common.
  • If you have any concerns, feel free to talk to our office.

Ask your pediatric dentist to evaluate the fluoride levels in your child’s drinking water. If the child is not receiving adequate amounts of fluoride, your dentist may recommend supplemental fluoride.Park Smiles NYC Pediatrics does not have fluoridated water. Other drinks or foods in your child’s diet may contain fluoride. Fluoride intake will be discussed during your child’s visit.

Early Childhood Caries is formerly known as baby bottle tooth decay or nursing caries. The condition occurs when the child is overexposed to sugary liquids. Severe early childhood caries usually occurs when the child is routinely put to bed with a bottle containing juice, soda or milk. It can also occur from allowing toddlers to “graze” with a sipper cup. Early childhood caries often destroys teeth and leads to the need for major dental treatment. The condition can potentially damage your child’s adult teeth if left untreated.

By following the guidelines listed below, you can prevent baby bottle tooth decay from occurring.

  • Help your child start learning to drink from a regular cup by their first birthday.
  • If your child “grazes,” only allow water in any bottles or sipper cups used.
  • Clean your baby’s gums with a fresh gauze pad after each feeding.
  • Begin brushing as soon as you see the first tooth.
  • Never give your child a pacifier coated in sugar or dipped in honey.
  • The bacteria that causes caries is transmissible, avoid sharing drinks or kissing your baby close to the mouth, especially if you have not seen your dentist for regular appointments.
  • Before your child cuts his or her first tooth, clean the gums after each feeding with a soft, damp washcloth
  • As soon as the first tooth erupts, you can begin using a toothbrush. Be sure to use a brush with soft bristles and a small head.
  • You can purchase toothbrushes specifically designed for infants at your local department store.
  • Regular tooth brushing will remove plaque and bacteria that can lead to decay. Use the toothbrush twice a day at least once before bed.

When the baby’s first tooth erupts, you can use a tiny smear of fluoridated toothpaste. When the child reaches the age of three, you can increase this amount to a pea-sized dollop. Be sure to supervise the brushing process to ensure that the child is using an appropriate amount of toothpaste. The consumption of excessive amounts of fluoride may cause staining of the teeth.

The American Academy of Pediatric Dentistry, the American Academy of Pediatrics, and the American Dental Association recommend that your child’s first pediatric dental visit should be scheduled once the first tooth erupts or by age one. At your child’s first dental visit, your pediatric dentist will perform a comprehensive exam to ensure your little one’s teeth are erupting properly. Your dentist will also review important oral health and diet practices that will minimize caries development. After your initial visit, your little one should continue to see the dentist every six months.

One of the most common questions I get is, “Why are baby teeth important? They are going to fall out anyway.” Primary teeth are vital for your child’s overall health and play an important role in facial growth and development. They also act as natural space maintainers and guide the eruption of the adult teeth. Decay in primary teeth can cause pain, swelling, infection and early loss of primary teeth.

Teeth development in general begins before birth for baby teeth and at around birth for permanent teeth. Typically, the lower front teeth will begin to erupt at approximately 6 months on average.

The permanent teeth typically erupt at age 6 with the lower front teeth and the adult molars and will end at around age 12.

Teething occurs when the baby teeth begin to grow in. While this is relatively problem-free for most children, others may experience some discomfort. We recommend frozen wash cloths, frozen teething rings and if needed some Tylenol or Motrin to provide comfort through this process. You may notice a drop in appetite, but it’s important to ensure that your little one is well hydrated.

It is always wise to contact your dentist or health professional if you have additional questions or concerns about teething.

For infants, you can use a washcloth and water to clean the teeth, but once the back molars begin to erupt, a soft bristled toothbrush can be introduced. The current ADA and AAPD guidelines recommend that fluoridated toothpaste can be used for this age group.

Putting a baby to sleep with a bottle of milk, juice and/or nursing a baby to sleep can be harmful to the teeth. The normal mechanisms that help keep teeth clean during the day like salivary flow is much lower at night. The teeth are bathed in the sugar that provides a perfect environment for decay. Children who frequently continue to bottle or breast feed while napping, sleeping or in between meals, run the risk of developing extensive tooth decay. Fruit / citrus juices, and sweetened beverages cause the most damage. You can brush the baby’s teeth after the last feed at night with a soft bristled toothbrush and use a washcloth to wipe the teeth if your infant has multiple feeds at night.

Sucking is a normal reflex for infants and is present even before birth. It helps infants self soothe. As they get older, the habit may be discontinued. In some toddlers, the habit persists. Every effort should be made to help your child break the habit by age 4 or 5. Prolonged thumb sucking or pacifier use can result in orthopedic changes such as a narrowed arch. As the adult front teeth begin to come in, if the habit persists, the teeth can be flared.

General Information:

Certain bacteria live in the mouth of each person. When these bacteria come in contact with sugary food, they produce acids which dissolve the enamel of the teeth. The resulting holes in the teeth are called cavities.

Children who are actively involved in sports should wear a mouth guard. If your child plays a high-intensity sport such as basketball, hockey or football, ask us about obtaining a custom mouth guard to protect the lips, teeth and gums from injury. Make sure your child always wears a helmet when riding a bicycle to avoid damage to the head and oral structures.

Although many children suck their thumbs or fingers as infants, most grow out of the habit by the age of three without causing permanent damage. Pacifiers should be discontinued by the age of two. A pacifier habit is easier to discontinue than a thumb-sucking habit. If your pediatric dentist notices damage occurring to the teeth or oral structures, make every effort to help your child stop sucking his or her thumb or fingers by the age of three or sooner. If your child continues sucking after adult teeth have come in, we may recommend a retainer appliance to help your child break the habit.

Baby teeth serve multiple functions. Several of these are listed below.

  • Baby teeth help the child chew his or her food well and to eat a balanced diet. Children whose baby teeth are suffering from multiple cavities may become underweight from an inability to eat a healthy diet. Cavities can cause toothaches that prevent a child from chewing certain foods.
  • Fillings are important to repair cavities in baby teeth and help protect the development of the adult teeth below. Cavities that are left unattended will eventually reach the core of the tooth and destroy the nerve. The nerve will become inflamed and will eventually die. The result is a dental abscess that often results in the loss of the tooth and can damage the developing adult tooth below. The most severe cases will require emergency hospitalization. To help prevent abscesses, cavities in baby teeth should be cared for promptly.
  • To help protect a child’s self-esteem, it’s important to give them the gift of a beautiful smile. Missing teeth or teeth with spots can have a negative impact on a child’s outlook in life.
  • Baby teeth serve as placeholders for permanent teeth. Children who lose teeth prematurely are at risk of having their adult teeth come in crooked or misplaced.
  • General health in all people is influenced by the heath of the teeth and gums. Thus, it is very important to maintain a healthy oral structure in your child’s mouth.

Going to the Dentist:

Your child should visit the dentist once every six months to prevent the formation of cavities and other dental problems. We may recommend more frequent visits if your child’s oral health requires more attention than average.

The single most important thing you can do as a parent to prepare your child for this first visit is to have a positive attitude. Children are remarkably adept at picking up attitudes from those around them and will tune in if you are nervous. If you make negative comments about dentists or dental visits in the child’s hearing, your child will anticipate a negative experience.

To help prepare your child for the visit, show your child a picture of the office and the dentist on the office’s website. Tell your child how important it is to have healthy teeth and that the dentist will help you in this goal. Consider a library visit to check out some children’s books on teeth, dentists and good dental care. If you wish, you can call us for suggestions. Remember that our pediatric dentist is specially trained in relieving the fears and anxieties of patients and that our staff is equally experienced at putting children at ease.

Sealants fill in the deep crevices on the chewing surfaces of each tooth. They block food particles from coming in contact with the teeth and causing cavities. Sealants are simple to apply and are an effective method of cavity prevention. We recommend sealants as a safe and effective way to prevent cavities in your child’s mouth.

The frequency of dental x-rays will depend on the health of your child’s mouth. Once the baby teeth in the back are able to touch one another, we recommend a series of x-rays to detect any cavities. We also recommend another set yearly dependent on if your child is at a high risk of developing dental problems, we may recommend more frequent x-rays.

Dental x-rays pose very little risk for children. Pediatric dentists are extremely careful about the amount of radiation to which their patients are exposed. Lead aprons and digital machines are used in our office to ensure the safety of the children and to minimize the amount of radiation to which your child is exposed.

Pediatric dentists are skilled in helping children feel at ease in the dentist’s chair. However, some children suffer from anxiety and may panic. In these cases, we will recommend nitrous oxide to help calm the child. If the child is especially fearful, we may recommend sedation or general anesthesia to ensure a safe and effective delivery of the necessary treatment.

Urgent Visits:

The most important thing to do when a child knocks out a permanent tooth is to remain calm. Locate the tooth and hold it by the crown. Rinse the tooth with salt water or milk to remove debris, but do not use water. Be careful to avoid contact with the root. If the root is intact, you can try to reinsert it into the socket. If you are unable to do so, place the tooth in a glass of milk and take your child to the dentist immediately. If your child knocks out a baby tooth, don’t try to reinsert it; you may damage the developing adult tooth below it. You should still take your child to see the dentist for an evaluation as soon as possible if he or she knocks out a baby tooth.

If your child is suffering from a toothache, rinse the affected area with warm water and use floss to remove any food from the surrounding gum areas. If necessary, give your child Children’s Tylenol or Motrin according to package instructions to control the pain. Never place aspirin directly on teeth or gums. If the child’s face is swollen, call our office immediately, 212-988-6727 . A swollen face indicates a serious infection requiring immediate attention. For after-hours emergencies, we can be reached at 212-988-6727.