Baby’s first teeth

1. Before bub gets teeth, do you need to clean their gums?

Before bubs have teeth, there is no real need to clean their gums. The most important thing at this stage is to limit sharing cutlery like spoons, or sharing the dummy (yes I have seen parents do this). Babies and our kids need to establish their own oral bacteria. Oral bacteria is important as it is the beginning of digestion and is part of the first processes of taste and food breakdown. This bacteria can be picked up from parents, which is great if you have your gums and teeth healthy. What normally happens during pregnancy is that mums forget about their oral hygiene due to nausea or bleeding gums which is really common with all the hormone swings. With the decreased oral hygiene and usually also less dental visits in this critical time, the early stages of gum disease or even tooth decay can set in. This spike in harmful bacteria can then be passed onto the baby, setting them up to be at higher risk of bleeding gums or decay later on.

So the take home message is, if it has been in the parents mouth, it does not go in baby’s mouth next.

2. How do you best care for bub’s first teeth? They can be so young when they get their first ones, it can be so tricky to clean them!

Baby can get teeth really early, and it is important to keep the teeth healthy even though these teeth will be lost later on. The best thing to remember is that a baby should never go to sleep sucking on a bottle of anything other than water. Milk includes natural sugar, called lactose. This has the ability to cause “bottle caries” or “bottle decay” which is literally decay that occurs due to bottle feeding.

Parents do not need to be too worried about feeding, there just needs to be a break between milk sessions (as there naturally is). The problem occurs when parents put the baby to bed with a bottle, so that the baby can suck on the bottle constantly for potentially hours at a time. Another no-no is letting your baby drink fruit juices between milk sessions, for the same reason where the decay rate is likely to go up.

In the early stages, to clean teeth, wiping the gums and teeth with a face washer is all that is needed. The aim is to gently wipe off any plaque that occurs. There is definitely no need to use toothpaste this early. 

As you baby grows up, using a toothbrush is more important. This allows the child to be accustomed to this process. Again there is no need for toothpaste, as diet is more important here. I found with my children that lying the child down with their head in my lap always worked best for me. It helps too if the child is distracted with holding a toy or watching tv just for a minute, so that I can brush teeth without having them pull it out of their mouth.

3. Is it really that important to clean them, they’re only drinking milk after all in the early days?

It is important to keep their teeth clean if they have any, but as mentioned, just a simple wipe with a damp face washer is enough. And the other important thing is do not add sugar, flavouring or any other beverage into their milk except water.

4. What happens if bub’s first teeth do have issues?

Issues with baby teeth very early is uncommon. Having said that accidents can happen and it is important to deal with them, as we do want to keep the teeth in position, and of course we do not want our children in pain. Always seek the advice of your dentist, as there are different techniques that can be used to repair teeth. I remember my youngest patient was 18 months old. The poor boy hit his tooth when he fell over, causing the teeth to have an infection. He happily sat in my dental chair at this young age whilst I did dental treatment for him. We managed to save his front tooth, and he kept it in position until the normal time that the tooth is lost, which is around 6-7 years old. I still see this patient now, and he is 19 years old!

If your child is not so happy to have treatment at the dentist, occasionally we need to refer these young children for care in a hospital setting. This is quite rare though these days as kids are generally happy to visit us, as we like to work with them and be very patient so that we can establish a great relationship.

5. My bub’s first teeth have come out with big gaps in between, is this a problem later on?

I love to see gaps in baby’s first teeth. Gaps are great. I know that magazines and some images of kids show all the baby teeth perfectly lines up, but we need the gaps. This is because the developing adult teeth underneath the gums need to develop, and need space between the roots of the baby teeth to do this. Moreover the adult teeth begin erupting between the ages of 5-6 years old, and these are much larger in size than the baby teeth. If there are no gaps, we are sure that crowding and orthodontics are likely to be on the cards. So rejoice in gaps!

Finally one of the most important things to consider is that although dummys or thumbsucking can seem like a God’s send in putting your baby at ease and to sleep, this may cause a much bigger problem later. When thumb sucking or dummy sucking is sustained through to age three or four, the mouth actually changes shape to accommodate the thumb or dummy. Instead of upper and lower arches being wide with the front teeth touching, the arches will be long and narrow, and there is usually a space between the upper and lower teeth when the child is closing. 

This sets up a number of problems. There is usually a speech problem, with lisping as the tongue doesn’t hit the back of the upper teeth when pronouncing “s”, “r” and “f” sounds. The second big problem is that when the adult teeth start coming through, they also come through where the baby teeth are sitting. So the speech problem will persist, and orthodontically we are going to need to intervene to close the gap between the upper and lower teeth. 

The way around this problem is to try and stop thumb sucking or dummy sucking early, or not to encourage it at all (I know that this can be hard!), say around the age of 3 years of age. This allows the bones to adapt and the permanent teeth an opportunity to come through in the correct position and hopefully not need correction later.

Finally when using toothpaste, only use a very small smear on the toothbrush until you know that your child can reliably spit out. Too much toothpaste at an early age can cause permanent defects on the developing adult teeth, called fluorosis. Fluoride is great for teeth, but it is meant to be superficially applied only, not ingested. So until you know your child can spit out the excess and is not swallowing it, use just a touch of paste.

Thanks for reading!

Written by Giulia D’Anna

BDSc (Melb), MRACDS, Honorary FIADFE (NY), Graduate Diploma Dermal Therapies (AACDS), Cert. Practice Man (UNE), Editor APJ (APAN) + | + 3 Belmore Road, Balwyn North, Victoria, Australia 3104 + | + Founder of iDental and Dermal Distinction

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