2 December, 2020

BABY'S TEETHING

If you are having a baby soon, already have one, or are just curious about the times when babies get (or should get) their first teeth, this post might help you. 

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What is Teething?

Teething is when each tooth breaks through babies’ gums during their eruption. When babies are born, they already have the 20 deciduous teeth (also known as “baby” or primary teeth) completely or partially formed, initially hidden inside their jawbones before appearing in the baby’s mouth.  

Each baby is different, so the timing of teething can vary. This is why it is more important to focus on the order teeth appear rather than the time they are expected to appear.

 

Timing of teeth eruption

According to the American Dental Association, the average of deciduous teething sequence and estimated timing for upper teeth are: 

- Central incisor (8-12 months); 

- Lateral incisor (9-13 months); 

- Canine (16-22 months); 

- First molar (13-19 months); 

- Second molar (25-33 months). 

 

For the lower teeth

- Central incisor (6-10 months); 

- Lateral incisor (10-16 months); 

- Canine (17-23 months); 

- First molar (14-18 months); 

- Second molar (23-31 months).

 

Studies show that the sequence of eruption is the same for boys and girls, however, the timing of eruption shows a significant difference among the genders. 

Not sure which tooth is which? Take a look at the chart below: 

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Teething signs and symptoms

Some of the symptoms that might indicate that the baby is teething are:

- Dribbling

- Red and swollen gums

- Irritability/restlessness

- Slight fever

- Flushed cheeks

- Night crying

- Poor appetite

 

While deciduous teeth are erupting, the permanent teeth are developing underneath the bones of the jaw before appearing in the mouth. Their development usually starts around the age of 3 months or later. 

The good news is that teething complaints are usually related to the eruption of the deciduous dentition (“baby teeth”) and not permanent teeth (“adult teeth”), which is usually free from the symptoms mentioned above.

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Treatments for discomfort

You might also see babies sucking fingers, fists and/or toys. This happens because this relieves the discomfort caused by the eruption of their teeth. Giving the baby clean, hard or cool objects to bite on might also help. Good, safe options include teething rings and rattles, wet flannels, hard vegetables, such as carrots and celery and an ice cube tied in a cloth. 

You can also chill the objects in the fridge to help reduce the discomfort and promote extra relief. 

It is essential to be careful with objects you give to the baby to bite. Make sure they are safe and are recommended by a dentist. 

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Cleaning the babies' mouths

Prevention is key and happens mostly at home. It is recommended to start cleaning babies gums even before the first tooth appears This can be done by gently wiping the gums with a clean wet washcloth or a clean gauze pad after each feeding. Once the first tooth comes through, you can use a small and soft toothbrush with no toothpaste to clean it. 

 

Since 1990, dental fluorosis has decreased significantly in Australia and the main reason is the use of low-fluoride toothpaste in young children, plus the increasing awareness of the correct toothpaste use for children. When the babies reach 18 months, you can start adding a pea-sized amount of low-strength fluoride toothpaste smeared across the toothbrush. For children with 6 teeth or more, you can use a pea-sized amount with standard-strength fluoride toothpaste and encourage the child to spit out, discouraging them from swallowing it. 

 

It is really important to make sure babies' mouths and teeth are clean and healthy, preventing cavities and possibly toothache. If deciduous teeth (“baby teeth”) are infected by decay, this may damage the permanent teeth that are developing right underneath them. Avoid giving biscuits and other food with added sugar is important to prevent the babies from having tooth decay. Also, remember to properly clean any objects after they have been in babies' mouths!

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Visiting the Dentist

It is highly recommended to take babies for a dental visit from the moment the first tooth becomes visible or before that if you notice anything in their mouths that is not right. “Prevention is better than cure” and going to the dentist before any oral issues, like dental caries, come up is the best you can do. 

According to the Australian Dental Association, the first visit to the dentist usually involves performing an exam on babies teeth to check if there are any dental caries. This visit can also involve taking a full medical history and discussing topics like brushing techniques, how the babies’ teeth are erupting and habits that can affect dentition (such as thumb sucking). Prevention measures, potential traumatic injuries to babies' mouths and nutritional advice may also be raised at this visit. 

It might not be easy taking the little one for the first dental visit, but don’t worry… if this happens, it is completely normal! Crying and screaming doesn’t necessarily mean that the baby is in pain, it can just be that it is a new experience for them! Make sure you visit a dental clinic with experienced and professional staff so that your baby, and you, are as comfortable as possible. 

Oh, and remember... in case you have any anxiety about going to the dentist yourself, this is a good opportunity to act positively and optimistically to ensure that the baby has a good dental experience!

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Reference

  1. Government of Western Australia, Department of Health, Healthy WA, https://healthywa.wa.gov.au/Articles/S_T/Teething-and-your-baby
  2. Australian Dental Association, 2020, https://www.ada.org.au/Your-Dental-Health/Children-0-11/Babies
  3. Queensland Government, Queensland Health, 26 August 2019, https://www.health.qld.gov.au/news-events/news/teething-101-is-my-baby-teething
  4. Ashley, M. It's only teething... A report of the myths and modern approaches to teething. Br Dent J 191, 4–8 (2001). https://doi.org/10.1038/sj.bdj.4801078
  5. Department of Health and Human Services in collaboration with the Department of Dentistry at the Royal Children’s Hospital, the Office for Children at the Department of Education and Early Childhood Development, Dental Health Services Victoria, Melbourne Dental School at the University of Melbourne and the Australian Dental Association Victorian Branch Inc., https://www2.health.vic.gov.au/public-health/water/water-fluoridation/water-fluoridation-infants
  6. Australian Research Centre for Population Oral Health 2006, ‘The use of fluorides in Australia: guidelines’, Australian Dental Journal, vol. 51, no. 2, pp. 195–199.
  7. Riordan P 2002, ‘Dental fluorosis decline after changes to supplement and toothpaste regimens’, Community Dentistry and Oral Epidemiology, vol. 30, pp. 233–240.
  8. Spencer A, Slade G 2005, ‘A rationale for the appropriate use of fluorides’. Paper presented at the Workshop on the Use of Fluorides in Australia, The Australian Research Centre for Population Oral Health, Adelaide.
  9. American Dental Association, JADA, Vol. 136, November 2005https://www.ada.org/~/media/ADA/publications/Files/patient_56.pdf
  10. Australian Dental Association, 2016, https://www.ada.org.au/getattachment/Your-Dental-Health/Resources-for-Professionals/Resources-for-Children-0-11/When-should-my-child-first-see-the-dentist/When-should-my-child-first-see-the-dentist_.pdf.aspx