Taking good care of baby teeth, it's a big deal

By Hong Kee-sang

Some parents and grandparents seem to believe that taking good care of and, indeed, seeking treatment for decayed baby teeth is pointless — they’ll fall out soon, won’t they? The point, though, is when they’ll fall out and whether they’ll fall out in a healthy manner. Baby teeth are crucial for maintaining space for the correct development of permanent teeth and guiding them to their correct place when they eventually erupt. For example, severe decay and inflammation in a baby tooth can lead to damage of an adult tooth or result in a permanent tooth growing off-mark. Decay between baby teeth or premature loss of baby teeth due to decay or trauma can also lead to loss of space, resulting in crowding and crookedness when all the adult teeth are in. Trauma to baby teeth can often lead to damage or incorrect eruption of the permanent teeth. Really, it’s not just enough that the baby teeth aren’t causing pain and that a child can eat normally — healthy, sound baby teeth are an essential foundation for healthy, sound adult teeth.

In which order do baby teeth come in? They start coming in with the lower central incisors erupting when babies are six or seven months old. The upper centrals follow soon after. The other teeth then erupt in order from front to back. However, it’s common to see the baby canines erupting after the first primary molars have come through. By age one, most babies have eight teeth — four upper incisors and four lower incisors. The first baby molars usually erupt when babies are 12 to 14 months old, and the primary canines when 16 to 18 months old. As the last baby teeth, the second primary molars, come through when infants are 20 to 24 months old, children usually have their full set of baby teeth by age three. Some teeth may come in a bit later or before the one that’s supposed to erupt ahead of it, but a difference of several months is not considered a problem. Also, there is a big individual variation — some babies don’t start getting teeth till they are a year old, while in others the teeth start erupting when the babies are only two or three months old. Just as babies of the same month age may vary in their height and weight, there is a fairly wide variation — don’t panic because your baby’s teeth come in a little sooner or later than the average.

Right around the age of six or seven, children will start losing their baby front teeth and getting permanent incisors. Also, the permanent molars will come in at about that time — behind the rearmost baby molars without any baby teeth falling out. There is a lull for a couple of years before the baby canines and primary molars are placed with permanent canines and bicuspids. Again, a year’s variation is considered normal between children.

Are there age-specific ways to take care of children’s oral hygiene? In babies without teeth, freshly cleaned gauze towels are all you need. Two or three times a day, after feeding, wet the gauze towel with boiled or bottled water and gently wipe the babygums and the vestibules, or where the gum and cheek meet. Wrap the towel around your finger and wipe the baby’s tongue as well.

When teeth start to erupt, silicone toothbrushes that you put on your finger like a thimble come in handy. A wipe-down with gauze towels is still needed.

When baby molars start to come through, you need a proper children’s toothbrush. As little children aren’t fully capable of spitting out toothpaste, use the tiniest amount, equal to a grain of rice, and wipe out the excess after you finish with a gauze towel.

By age three, most kids have 10 teeth in the upper jaw and 10 more in the lower jaw. If the front teeth don’t have gaps between them, you’ll need to floss regularly. Tooth brushing alone won’t sufficiently remove food debris from between teeth or clean the surfaces between the teeth. Baby teeth are notoriously prone to developing decay between the teeth.

When the child turns six, first permanent molar will erupt behind the rearmost baby molar, without any corresponding baby tooth falling out. Because it’s so far back in the mouth, it’s difficult to brush these teeth well as they erupt. As these first permanent molars are so important and have to last a lifetime, don’t rely on the child’s effort to keep the teeth clean while they’re coming in — check the quality of the tooth brushing and help out as needed.

The writer is a dentist at Seoul Children’s Dental Center in Cheongdam-dong, southern Seoul, and has General Registration as Dentist in Australia. For further questions, send an email to the writer at keesanghong@hotmail.com, or call the hospital at (02) 515-0926, or visit the hospital’s website, https://www.seoulchildrendentalcenter.com.