Newborns And Kids

Newborns and Kids

Nothing is more endearing to the parents than seeing the toothless smile of their newborns .The fact however is that your baby actually has 20 unerupted teeth in jaws.And these baby teeth appear through the gums at around 6 months. These help set the stage for future smiles by keeping space in the jaw for adult teeth.

Newborns and Kids

Newborns and Kids

The IDA recommends you to take your little ones for their first dental visit as soon as you are allowed by your paediatrician,or you notice something abnormal in their mouth.

Concerns Unique to Newborns

The jewel of the sky is the sun, the jewel of the house is the child.

Holding their newborn baby is the most happiest moment in a couples lifetime.With this newfound joy comes newfound responsibilities.That of being good parents.The health of the child is of utmost concern for any parents,and childs oral health is a part of his overall wellbeing.

Even though a newborn does dose not seem to have any teeth the IDA recommends you to make a dental visit as and when permitted by paediatrician.There are a couple of dental anamolies which maybe observed in newborns.



Cleft Lip Cleft Palate

Cleft lip is a birth defect in which the parts of the face that form the upper lip remain split, instead of sealing together before birth. Similar splits can occur in the roof of the mouth or palate. Cleft lip and cleft palate can each occur alone or together in the same person (cleft lip and palate). Cleft lip and palate happen early in fetal development. The defect may be genetic or the result of maternal environmental exposures during pregnancy.

Cleft Lip Cleft Palate

 Cleft Lip Cleft Palate
 Along with affecting the appearance of the face, cleft lip and cleft palate can present a variety of difficulties, including:
  • Difficulty eating
  • Speech difficulties
  • Ear infections
  • Misaligned teeth

It is possible to correct both cleft lip and palate through surgery, usually performed between the ages of 3 to 6 months. Depending on the severity of the defect, more than one surgery may be necessary. Cleft lip and/or palate are normally diagnosed at birth, though minor clefting of the palate may be overlooked at first.

The IDA recommends that you talk with your physician and dentist for a physical examination and seek more information about possible treatments if a cleft is suspected.

Cleft Lip Cleft Palate

 Cleft Lip Cleft Palate

 Cleft Lip Cleft Palate

 Cleft Lip Cleft Palate
  • Use Infant with a Cleft Lip and Palate should be fed using a Pigeon system bottle to facilitate ,which encourages “active” feeding for infants with a Cleft Lip and Palate.
  • The baby still has to suck, but not as hard and there is a one way valve that doesn’t allow milk to go back into the bottle after it has been sucked through.
  • Breastfeeding can still be accomplished but it is recommended to consult a lactation educator before attempting.
  • Prevention
    • If you have had a child with a cleft lip or palate, the chance of any more children you have being affected may be slightly increased.
      • Genetic counseling or testing may provide answers.
    • Daily folic acid supplements in the first month before conception and in the first two months of pregnancy is recommended.
    • Avoid alcohol and drug consumption during pregnancy
  • The condition can be corrected with appliances and or surgeries.
  • A cleft lip may require one or two surgeries depending on the extent of the repair needed. The initial surgery is usually performed by the time a baby is 3 months old.
  • Repair of a cleft palate often requires multiple surgeries over the course of 18 years. The first surgery to repair the palate usually occurs when the baby is between 6 and 12 months old. The initial surgery creates a functional palate, reduces the chances that fluid will develop in the middle ears, and aids in the proper development of the teeth and facial bones.
  • Children with a cleft palate may also need a bone graft when they are about 8 years old to fill in the upper gum line so that it can support permanent teeth and stabilize the upper jaw. About 20% of children with a cleft palate require further surgeries to help improve their speech.
  • Once the permanent teeth grow in, braces are often needed to straighten the teeth.
  • Additional surgeries may be performed to improve the appearance of the lip and nose, close openings between the mouth and nose, help breathing, and stabilize and realign the jaw. Final repairs for of the scars left by the initial surgery will probably not be performed until adolescence, when the facial structure is more fully developed.
To know more consult your dentist or paediatrician.

Newborn Oral Pathology

1. Inclusion cysts appear as small white or gray lesions on the mucosa, alveolar ridge and hard palate, and are present in 75% of newborns. All three types – Epstein’s pearls, Bohn’s nodules and dental lamina cysts are asymptomatic and are usually shed within the first three months of life.

Newborn Oral Pathology

Epstein's Pearls

 Newborn Oral Pathology

Bohn's Nodules

 Newborn Oral Pathology

Dental Lamina Cysts

2. Congenital Epulis of the newborn is similar in appearance to a dental lamina cyst, but is usually located in the maxillary anterior region. Although some recede spontaneously, an usually large congenital epulis may cause feeding problems and require excision. Recurrence is unlikely.

3. Melanotic Neurectodermal Tumor of infancy is a benign tumor of neurectodermal origin. The clinical appearance can be similar to congenital epulis of the newborn; an exophytic non- ulcerated mass on the maxillary alveolar mucosa. The tissue may appear to be brown in color (pigmented). Radiographic examination reveals “floating teeth.”

4. Partial Ankyloglossia the lingual frenum which has a short attachment to the floor of the mouth is often called “tongue-tie.” In a newborn, it may be present, but usually resolves over time with tongue use. Unless it is severe, it usually does not present a problem for speech or eating and does not need to be surgically corrected. In the case of ankyloglossia where movement is restricted, such that the child cannot clean the food off their teeth, a lingual frenectomy may need to be performed. An early evaluation for this is necessary to assure proper speech and placement of teeth.

Newborn Oral Pathology

 Partial Ankyloglossia

5. Natal/Neonatal teeth usually lower incisors, natal teeth are present at birth; neonatal teeth erupt within the first 30 days of life. As many as 85% of these are a part of the normal primary dentition and are not supernumerary. Efforts should be made to retain these teeth unless they are hypermobile and there is concern of aspiration.

The IDA recommends that you visit your dentist on the first sign of spotting something unusual in your newborns mouth.

Concerns Unique to Kids

Concerns Unique To Kids

 Concerns Unique To Kids

There's nothing more contagious than the laughter of young children; it doesn't even have to matter what they're laughing about.”

Little kids,with their cute faces and runny noses,their innocent smiles and funny poses,they can mealt the toughest heart and bring back a smile on the saddest face.This is the age group which is probably toughest to handle as a parent..starting from the 'Terrible Twos".This is the time the child begins to form its identity in relation it its surroundings and people.Good and Bad habits are most easily picked up in this age group .Hence Parents have to be extra alert.

This is also the time for teething,believed to be a nightmare by most parents,a time when child learns to walk,falls,and walks again,a time to be visiting playschool and learning to speak and sing.All these important FIRSTS happen in this age group.

When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded.

That’s why starting infants off with good oral care can help protect their teeth for decades to come. The IDA recommends that parents take children to a dentist no later than their first birthday and then at intervals recommended by their dentist.

The First Brush

Start Early

Your child’s baby teeth are at risk for decay as soon as they first appear—which is typically around age 6 months. Tooth decay in infants and toddlers is often referred to as Baby Bottle Tooth Decay. It most often occurs in the upper front teeth, but other teeth may also be affected. In some cases, infants and toddlers experience decay so severe that their teeth cannot be saved and need to be removed.

The good news is that tooth decay is preventable! Most children have a full set of 20 primary teeth by the time they are 3- years- old. As your child grows, their jaws also grow, making room for their permanent teeth.

Cleaning Your Child’s Teeth

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur.

The First Brush

The First Brush

When your child’s teeth begin to come in, brush them gently with a child-size toothbrush and water. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children do not have their first tooth until 12 or 14 months.

For children older than 2, brush their teeth with a pea-sized amount of fluoride toothpaste. Be sure they spit out the toothpaste. (Ask your child's dentist or physician if you are considering using fluoride toothpaste before age 2.)

The First Brush

The IDA recommends that until you are comfortable that your child can brush on his or her own., continue to brush your child's teeth twice a day with a child- size toothbrush and a pea- sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin flossing their teeth daily.

The First Brush
 To know the correct method to brush your baby's teeth consult your dentist.


Teething is one of the first rituals of life.

Although newborns usually have no visible teeth, most baby teeth begin to appear generally about six months after birth. During the first few years of your child’s life, all 20 baby teeth will push through the gums and most children will have their full set of these teeth in place by age 3.


A baby’s front four teeth usually erupt or push through the gums at about six months of age, although some children don’t have their first tooth until 12 or 14 months. As their teeth erupt, some babies may become fussy, sleepless and irritable, lose their appetite or drool more than usual.


Diarrhea, rashes and a fever are not normal symptoms for a teething baby. If your infant has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.



Your child may have sore or tender gums when teeth begin to erupt. Gently rubbing their gums with a clean finger, a small cool spoon, or a moist gauze pad can be soothing. A clean teething ring for your child to chew on may also help. Your dentist or pediatrician may recommend a pacifier or teething ring. IDA recommends that parents and caregivers not use benzocaine products for children younger than 2, except under the advice and supervision of a health care professional. Benzocaine is an over- the- counter anesthetic, usually under the product names Anbesol, Hurricaine, Orajel, Baby Orajel and Orabase Benzocaine has been associated with a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood stream is greatly reduced.

When your child’s teeth begin to come in, brush them gently with a child's size toothbrush and water. A baby’s front four teeth usually push through the gums at about six months of age, although some children don’t have their first tooth until 12 or 14 months. For children between the ages of 2 and 6, brush their teeth with a pea-sized amount of fluoride toothpaste. Be sure they spit out the toothpaste. (Ask your child's dentist or physician if you are considering using fluoride toothpaste before age 2.)

The IDA recommends that you should start regular dental check-ups for your child after their first tooth appears, but no later than their first birthday.

For further discussion on teething see your dentist.


There are lots of good reasons to use pacifiers -- just ask any parent who's gotten a moment of quiet with the judicious use of one. But a bit of peace isn't the only good thing that comes from using a pacifier.

  • Protection against SIDS: Doing so has a protective effect against sudden infant death syndrome (SIDS). Use the pacifier when putting baby down to sleep, but don't put it back in baby's mouth once he's already asleep.
  • Helping babies pacify themselves. A pacifier can be a source of comfort for a crying or colicky baby.
  • It satisfies the suck reflex.
  • Easier weaning. When you're ready for a child to stop, it's much easier to wean him from a pacifier than from his own thumb.
Infants and young children may suck on thumbs,

other fingers or pacifiers.


Reasons to Avoid a Pacifier

- According to a study reported in Pediatrics, pacifiers may lead to 40% more ear infections (called acute otitis media).

- If a pacifier is introduced too early, there's the risk of nipple confusion for a baby who's just learning to nurse.

- Parents can mistakenly offer a pacifier when baby really needs nutrition-based sucking, such as on a breast or bottle.

- Babies who are overzealous suckers may change their tooth alignment or delay speech.

The IDA recommends you to avoid giving pacifiers dipped in sugar, honey, juice or sweetened drinks, as these can lead to tooth decay. Tooth decay can also begin when cavity- causing bacteria pass from saliva in a mother or caregiver’s mouth to the infant. When the mother or caregiver puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.

To know more about the pros and cons about pacifier use consult your dentist.

The First Dental Visit
As soon as your child’s first tooth appears, it’s time to schedule a dental visit.

The IDA recommends that the first dental visit take place within six months after the first tooth appears, but no later than a child’s first birthday. Don’t wait for them to start school or until there's an emergency. Get your child comfortable today with good mouth healthy habits.

First Dental Visit

Although the first visit is mainly for the dentist to examine your child’s mouth and to check growth and development, it’s also about your child being comfortable.

To make the visit positive:
  • Consider making a morning appointment when children tend to be rested and cooperative.
  • Keep any anxiety or concerns you have to yourself. Children can pick up on your emotions, so emphasize the positive.
  • Never use a dental visit as a punishment or threat.
  • Never bribe your child.
  • Talk with your child about visiting the dentist.
First Dental Visit During this visit, you can expect the dentist to:
  • Inspect for oral injuries, cavities or other problems.
  • Let you know if your child is at risk of developing tooth decay.
  • Clean your child’s teeth and provide tips for daily care.
  • Discuss teething, pacifier use, or finger/thumbsucking habits.
  • Discuss treatment, if needed, and schedule the next check- up.
First Dental Visit

 If your child is at the right age visit your dentist NOW.


Fluoride is a mineral that occurs naturally in all water sources, including oceans, rivers and lakes. Fluoride is also added to some community tap water, toothpastes and mouth rinses. Infants and toddlers who do not receive an adequate amount of fluoride may be at an increased risk for tooth decay since fluoride helps make tooth enamel more resistant to decay. It also helps repair weakened enamel. Bottled water may not contain fluoride; therefore, children who regularly drink bottled water or unfluoridated tap water may be missing the benefits of fluoride. If you are not sure if your tap water has fluoride, contact your local or state health department or water supplier.

Flouride Flouride

The IDA recommends that you discuss your child’s fluoride needs with your dentist or pediatrician. They may recommend a fluoride supplement if you live in an area where the community water is not fluoridated.

Excess flouridation is also harmful and causes a condition called flourosis or pitting of tooth enamel.

To know which dental products should be used for your child,consult your dentist.Do not get misled by advertisements.


Enamel fluorosis is not a disease but rather affects the way that teeth look. In the vast majority of cases, enamel fluorosis appears as barely noticeable faint white lines or streaks on tooth enamel and does not affect the function or health of the teeth. In fact, in many cases, the effect is so subtle that, usually only a dental professional would notice it during an examination. Enamel fluorosis occurs only when teeth are forming under the gums. Once teeth break through the gums, they cannot develop enamel fluorosis.



 What can be done to reduce the risk for enamel fluorosis?


The vast majority of enamel fluorosis can be prevented by stopping children from swallowing topical fluoride products such as fluoride toothpaste. The IDA recommends that parents and caregivers should put only one pea- sized amount of fluoride toothpaste on a young child’s toothbrush at each brushing. Young children should be supervised while brushing and taught to spit out rather than swallow the toothpaste. Consult with your child’s dentist or physician if you are considering using fluoride toothpaste before age 2.

Recent evidence suggests that mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis may increase the chance of mild or very mild fluorosis. Occasional use of fluoridated water to reconstitute infant formula should not greatly increase the chance of enamel fluorosis. Mild or very mild fluorosis does not affect the teeth’s health or function, but appears cosmetically as barely noticeable faint, white markings. While there is a chance of fluorosis, it is a fact that drinking fluoridated water helps reduce tooth decay for children and adults.


The IDA recommends that parents and caretakers should consult with their dentist or physician about the type of water to use to reconstitute infant formula.


Milk Bottle Syndrome

Baby Bottle Tooth Decay

Baby Bottle Tooth Decay or Baby Bottle Syndrome or Early Childhood Caries is the rapid decay of baby teeth in an infant or child from frequent exposure (for long periods of time,) to liquids containing sugars. The upper front teeth are most commonly affected.

Milk Bottle Syndrome

 In this situation, parents are often told or think:
  • The child is too young to have the teeth fixed.
  • Wait until your child gets older. The teeth can be fixed when your child is three to four years old.
  • Do not worry, these are only baby teeth and they will fall out.

All of these statements are wrong. A child needs baby teeth to chew food and have a healthy smile. The IDA recommends that if you observe see anything in your child’s mouth that you are concerned about, see a professional who treats children. If your dentist does not provide care for young children, ask for a referral to a child dental specialist. Children are never too young to have their teeth checked! While prevention is best, early detection and treatment of baby bottle tooth decay is very important.

Milk Bottle Syndrome

Once tooth decay begins, it needs to be treated immediately. If it progresses to the point where your child has pain or has dental abscesses, the necessary dental care will most likely need to be done with a general anaesthetic.

The problem is usually caused by a baby falling asleep while nursing a bottle or while breast feeding. While the child is asleep, the sugary liquid pools around the front teeth. The bacteria living in every baby’s mouth then turns the sugars to acid which causes decay.

Milk Bottle Syndrome

 Common sources of liquids high in sugars are:
  • A bottle containing formula, milk, soda, or juice
  • A pacifier dipped in honey
  • Breast milk
You can help prevent Baby Bottle Syndrome by:
  • Cleaning your child’s teeth daily
  • Not allowing your child to fall asleep with a bottle filled with juice, milk, or formula
  • Not allowing your child to sip on a bottle filled with juice, milk, or formula for long periods of time as a pacifier
  • Giving your child plain water when he or she is thirsty
  • Making sure your child gets the fluoride needed to prevent decay
  • Making regular dental appointments for your child beginning when their first tooth erupts.
The treatment options for Baby Bottle Tooth Decay vary depending on the severity of the condition.
  • Discuss the best management option for your child with your dentist.
  • If chalky white spots or lines are detected early, the teeth may be re- mineralized by applying fluoride and modifying the child's diet.
  • If decay is obvious, filling material or stainless steel crowns can be used to cover the teeth.
  • Milk Bottle Syndrome
  • If the decay has reached the pulp chamber, pulp therapy or extractions may be considered.

Concerns Unique to Children

Space Maintainers

Space maintainers help “hold space” for permanent teeth. Your child may need one if he or she loses a baby tooth prematurely, before the permanent tooth is ready to erupt. If a primary tooth is lost too early, adult teeth can erupt into the empty space instead of where they should be.When more adult teeth are ready to come into the mouth, there may not be enough room for them because of the lost space. To prevent this from happening, the dentist may recommend a space maintainer to hold open the space left by the missing tooth.

Space Maintainers

 Space Maintainers

A space maintainer is made of stainless steel and/or plastic. It can be removable. Some space maintainers are cemented onto the teeth on either side of the space in the child's mouth. This is called a fixed space maintainer.

There are several kinds of fixed space maintainers.

A band-and-loop maintainer is made of stainless steel wire. It is held in place by a crown on the tooth next to the space or an orthodontic-type band around one of the teeth next to the open space. A wire loop is attached to the band or crown. It sticks out across the space where the tooth is missing and just touches the tooth on the other side of the open space. The wire loop holds the space open. This allows the permanent tooth enough space to come into the mouth without crowding.

A lower wire known as a "lingual arch" is used when back teeth are lost on both sides of the lower jaw.

Another type of fixed space maintainer is called a distal shoe appliance. It is inserted under the gums. It is used when a child loses the baby tooth in front of a 6-year molar that has not yet come into the mouth.

Space Maintainers

 Space Maintainers

Some children may not be able to cooperate during the process of making the space maintainer. Others may be at risk of injury if the space maintainer comes loose or breaks. These include children with diseases that affect how they breathe or swallow, and children who are very young. The ability to cooperate with the dentist is more important than a child's age. Most young children can have space maintainers placed, if needed. Most of them are able to cooperate during the process.

The IDA recommends you to take your kids to dentist whenever they loose a tooth to decide whether a space maintainer is needed or not.

Fissure Sealants

Sealants are a fast and easy way of protecting your child’s teeth that act as barriers to cavity- prone areas. They are usually applied to the chewing surfaces of back teeth and sometimes used to cover deep pits and grooves. Sealing a tooth is fast and there is virtually no discomfort. As long as the sealant remains intact, the tooth surface will be protected from decay.The chewing surfaces of back teeth have small grooves or fissures which often extend right down into the tooth itself. However well the teeth are brushed, these fissures are very difficult to clean thoroughly. Bacteria and food particles stick to them and eventually cause decay. Fissure sealants completely seal off these grooves, preventing any food particles or bacteria from getting in. They do not affect the normal chewing function of teeth. Sealants hold up well under the force of normal chewing but may have to be reapplied if needed.

Fissure Sealants

Both primary and permanent teeth can benefit from sealants. The IDA recommends that you ask your dentist if sealants will help your child.

How is it done?

First the fissure is checked for decay. Then the process simply involves cleaning the tooth surface, preparing it with a special solution, and then applying the coating. No injections or drilling are needed, and the entire process is pain free.

Fissure Sealants
When should it be done?

The first permanent back molars are usually sealed between 6 and 7 years of age. If required the rest of the molars are usually sealed as soon as they appear which can be any time between 11 and 14 years.

Do the teeth need special care afterwards?

No special care is needed, but the back teeth still need to be brushed regularly with a good toothbrush, preferably using fluoride toothpaste.

The IDA recommends that it is also important to keep going to your dentist or dental therapist for regular check-ups because other teeth might need attention.

To know more on fissure sealants contact your dentist.

Dental Emergencies

Dental Emergencies

Accidents can happen anywhere, anytime. Knowing how to handle a dental emergency can mean the difference between saving and losing your child’s permanent tooth. For all dental emergencies, it’s important to take your child to the dentist or an emergency room as soon as possible.

Dental Emergencies

 Dental Emergencies Bitten Lip or Tongue Dental Emergencies

If your child has bitten his lip or tongue severely enough to cause bleeding, clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling.

Object Caught In Teeth

If your child has something caught between his teeth, use dental floss to gently remove it. Never use a metal, plastic, or sharp tool to remove a stuck object. If you are unable to remove the item with dental floss, visit your dentist.

Broken, Chipped, or Fractured Tooth Dental Emergencies

If your child has chipped or broken a piece off of his tooth, have him rinse his mouth with warm water, then use a cold compress to reduce swelling. Try to locate and save the tooth fragment that broke off.Go to the dentist immediately.

Knocked Out Tooth Dental Emergencies

If your child's tooth has been knocked out of his mouth, find the tooth and rinse it with water (no soap), taking care to only touch the crown of the tooth (the part you can see when it's in place). If you can, place the tooth back in its socket and hold it in place with a clean towel or cloth. If you can't return the tooth to its socket, place it in a clean container with milk. In either case, call your dentist immediately and/or head to the hospital. If you act quickly it's possible to save the tooth.If a baby tooth is knocked out, do not try to push it back too hard in its socket, as this may damage the unerupted permanent tooth.

Loose Tooth Dental Emergencies

If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled.

Toothache Dental Emergencies

 Dental Emergencies

If your child complains of a toothache, rinse his mouth with warm water and inspect his teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children's pain relievers may be taken orally. Schedule an appointment immediately.

Broken Jaw Dental Emergencies

If you know or suspect your child has sustained a broken jaw, use a cold compress to reduce swelling. Call the dentists emergency number and/or head to the hospital immediately. In many cases a broken jaw is the result of a blow to the head. Severe blows to the head can be dangerous and even life- threatening.

Avoiding Injury

You can help your child avoid dental emergencies. Child- proof your house to avoid falls. Don't let your child chew on ice, popcorn kernels, or other hard foods. Always use car seats for young children and require seat belts for older children. And if your child plays contact sports, have him wear a mouthguard.

The IDA recommends that you do not take any of these accidental injuries lightly and visit your dentist or nearby hospital as soon as possible.



Sucking is a natural reflex and infants and young children may suck on thumbs, fingers, pacifiers and other objects. It may helps them relax or makes them feel safe or happy. Most children stop sucking by age 4. If your child continues to thumb suck that after the permanent teeth have come in, it can cause problems with tooth alignment and your child’s bite.



The frequency, duration and intensity of a habit will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs. If you are worried about your child’s sucking habits, talk to your dentist or consult your child's pediatrician

Some long term effects of thumb sucking beyond the age of 5-6 years include:

  • Teeth being pushed around, which might cause an overbite or an under bite to form.
  • A lisp being formed because constant thumb sucking can affect the jaw bone positioning.
  • Germs from your thumb and surrounding areas affecting your body.
  • The roof of the mouth becoming altered or more sensitive.
Here are some helpful tips on how you can stop your child from sucking their thumbs at this point:
  • Do not nag or punish your children for sucking their thumbs as it may create stress and a reason to suck their thumbs more.
  • Teach your children the reasons why they can't continue to suck their thumbs. Explain to them the long term effects of such a habit and what that might entail.
  • Eliminate sources of stress which could be the reason why your children suck their thumbs.
  • When your children suck their thumb, distract them with a toy or a song.
  • Your dentist can help you with specific custom made habit breaking appliances for your child.
  • Discontinue the use of a pacifier by 2 years of age and never dip the pacifier in sugar, honey or other sweetened drinks.

The IDA recommends that you talk to your dentist regarding habit breaking appliances.

Tongue Thrusting

Tongue Thrusting

Tongue thrusting is the habit of sealing the mouth for swallowing by thrusting the top of the tongue forward against the lips.

Just like thumb sucking, tongue thrusting along with other dental abnormalities, exerts further furthur pressure against the front teeth, pushing them even more out of alignment, which causes them to protrude, creating an overbite, and possibly interfering with proper speech development.

If you notice symptoms of tongue thrusting, consult a speech pathologist. This person can develop a treatment plan that helps your child to increase the strength of the chewing muscles and develop a new swallowing pattern.

Tongue Thrusting

A tongue thrusting habit sometimes is a clue that something could be wrong at the back of the mouth,that interferes with normal breathing .Examples of such problems are enlarged tonsils, adenoids, or allergies that can affect the nasal cavity or reduce the size of the throat cavity. Such problems can result in a need for the tongue to adapt by positioning forward at rest or thrusting forward during the first part of a swallow to maintain an open airway for breathing.

The IDA recommends that you discuss this habit with your dentist.

Lip Sucking

Lip sucking involves repeatedly holding the lower lip beneath the upper front teeth. Sucking of the lower lip may occur by itself or in combination with thumb sucking. This practice exaggerates the overbite and the same kinds of problems as with thumb sucking and tongue thrusting.

Here are some helpful tips on how you can stop your child from sucking their lips at this point:
  • Do not nag or punish your child for sucking their lips as it may create stress and a reason to suck their lips more.
  • Teach your child the reasons why they cant continue to suck his lips. Explain to him the long term effects of such a habit and what that might entail.
  • Eliminate sources of stress which could be the reason why your child sucks his lips.
  • When your children suck their lips, distract them with a toy or a song.
Lip Sucking
 Lip Sucking

 Lip Sucking

To discuss this problem further consult your dentist.


Malocclusion, or bad bite, is a condition in which the teeth are crowded, crooked or out of alignment, or the jaws don't meet properly. This may become particularly noticeable between the ages of 6 and 12, when a child’s permanent teeth are coming in. If not treated early, a bad bite can make it difficult to keep teeth and gums clean where teeth are crooked or crowded, increasing the risk for cavities and gum disease.




 Bad bites can also:
  • Affect proper development of the jaws.
  • Make the protruding teeth at risk for chips and fractures.
  • Affect eating and speaking.
  • Make some teeth more likely to wear abnormally or faster than those that are properly aligned.
This condition is definitely treatable.

The IDA recommends that you discuss your concerns with your dentist who if needed can refer you to a specialist or orthodontist.

Mixed Dentition

Mixed Dentition

This is the period when the primary or baby teeth begin to fall out and the permanent teeth start to come through. During this period the jaws grow to make room for the permanent teeth and the roots of the primary teeth begin to be absorbed by the tissue around them. At the same time the permanent teeth under them prepare to come through.

When a primary tooth is lost early before the permanent tooth beneath that is ready to erupt, the nearby tooth may move into that space. This will later make the permanent tooth to erupt out of its position, creating crooked or crowded teeth. Also when a primary tooth does not fall out when it should, it is good to remove them as this may also make the permanent tooth to erupt out of its position. Your dentist or dental therapist can advise you about in this.

Mixed Dentition Mixed Dentition

The first permanent molars usually erupt between 6 and 7 years of age and they do not replace any primary teeth. This erupts at the space next to the back primary teeth. While the first permanent molar should not be mistaken for primary teeth, it is also good to remember that the last set of primary teeth is lost only around 12 years of age.

To avoid future problems with permanent teeth the IDA recommends that you make sure that you follow effective home care routine and limit the frequency and amount of sugar intake from foods and drinks for the children.

The mixed dentition stage is referred to as "The Ugly duckling stage " commonly by dentists as the child is just getting permanent front teeth which look bigger than the tiny white milk teeth.

Anesthesia and Sedation

Some children can become anxious when they see the dentist. As a result, they may not be able to relax or sit still long enough to receive treatment.

Your dentist might recommend that your child be administered anesthesia or sedation to relax them in order to safely complete some dental procedures.

Methods of anxiety and pain control
Analgesia – the diminution or elimination of pain.

Local Anesthesia – the elimination of sensation, especially pain, in one part of the body by the topical application or regional injection of a drug.

Minimal Sedation
 Anesthesia And Sedation

A minimally depressed level of consciousness, produced by a pharmacological method, that retains the patient’s ability to independently and continuously maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected.

Moderate Sedation – A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.

Deep Sedation – a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

General Anesthesia -
 Anesthesia And Sedation

A drug induced loss of consciousness in which the patient is not arousable even after painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required. Cardiovascular function may be impaired.

Before a visit in which your child is to receive oral sedation, you should receive instructions. They will include:

  • Whether to eat or drink before the procedure
  • What to expect during treatment
  • What to watch for after treatment

You may need to carry your child home after sedation. Your dentist also should discuss how your child will be monitored during sedation. You will need to stay for a short time after dental treatment has been completed. During this time, your child will be observed. The dental staff will make sure recovery is complete and look out for any problems.

The IDA recommends that you meet with your child's anesthesia provider before the procedure. This will give you a chance to ask questions. You also can go over some of the risks and benefits you may already have discussed with the dentist.

To discuss the procedure in detail,consult your dentist.

Mouth Ulcers

Mouth ulcers can be uncomfortable. They look similar to small blisters and can be caused by a tooth rubbing against the tongue or cheek, a lack of vitamin B12, anaemia or even stress.

Treatment of ulcers is quite simple and they will usually heal within seven days. If they last for more than two weeks, you should take your child and see your dentist..

Mouth Ulcers

 Mouth Ulcers

 Mouth Ulcers

 Mouth Ulcers

If your child has a mouth ulcer, you can help clear it up by using a special antiseptic mouthwash or gels. These are available from most pharmacies. Having a healthy diet can help prevent mouth ulcers and ensure ensures that your child, keeps in good health generally. Remember to include five portions of fruit and vegetables a day. If your child has an ulcer, avoid citrus fruits and tomatoes as the acid may aggravate it.

There are many systemic conditions which manifest themselves as ulcers in the mouth,thus the cause of ulcer should be diagnosed.

1. Traumatic Ulcer

The most common oral ulcer found in young children, traumatic ulcers are caused by mechanical, chemical, or thermal injuries to the oral tissues. Located on the peripheral borders of the tongue, buccal mucosa, lips, or palate, lesions vary in appearance depending on the source and intensity of the trauma. Burns on the anterior palate may occur after eating foods such as hot pizza or drinking liquids that are too hot.

2. Recurrent Aphthous Ulceration

Commonly known as chancre sore, recurrent aphthous ulceration is most common in young adults, but children also may be affected. The cause is unknown but probably is an immunologic alteration. Local trauma, food allergies, stress, viral illness, or hormonal changes may trigger these recurrent lesions, which heal within 10 days.

The IDA recommends that you do not ignore ulcers in your childs mouth and if they persist inspite of routine treatment please consult your dentist.

Fear of Dentist

As parents we not only pass our good looks through our genes onto our children but also our anxieties and fears.If as a parent you have deep seated fear of dentist chances are that you have knowingly or unknowingly conveyed the same to your child.

Fear of Dentist

Children learn by imitating parents,hence work on your own fears first if you want the same for your children.

Fear of Dentist

Dentists will do all they can to help put your mind at rest if you're nervous or anxious about treatment.

Fear of Dentist

 Fear of Dentist

First of all, talk to your dentist about your/childs concerns. They will be able to explain the treatments and what each of the instruments does. They might also have 'diversions' - a fish tank, background music, even videos - to take your/childs mind off the treatment.

Fear of Dentist
Fear of Dentist
Fear of Dentist

 Fear of Dentist

As well as listening to your concerns, dentists can offer more practical solutions too. Some dentists offer something called conscious sedation, where you stay awake but special drugs mean that your anxiety levels are lowered. Other practices offer hypnosis or acupuncture either to get you over your fears or to distract you from them. If your anxiety is severe, you may want to consider specialist counselling or anxiety management courses.

The IDA recommends that if you're worried that your childs treatment might be painful, talk to your dentist about pain relief, either conscious sedation or local anaesthetic.

Tooth Eruption Sequence

Development of teeth is a complex process which begins with teeth formation from the stage of embryonic cells growth to the eruption in the mouth. Deciduous teeth start to develop in the embryo\uterus between the sixth and eighth week and permanent teeth in the twentieth week.


These are the first teeth of a child. They are twenty in number, ten in each jaw. When a child is born the teeth are already formed in the jaw although they can't be seen. The baby starts teething around six months of age and by three years all twenty teeth have erupted. The characteristic feature of the primary dentition is the presence of spaces between the teeth and the absence of premolar teeth.

  • Mastication or chewing food is a very obvious function. The chewing helps to break- up food for easy digestion.
  • Speech is developed with the help of tongue, cheek and the primary teeth.
  • Aesthetics depends on attractive, well aligned healthy teeth. Missing or damaged teeth affects your child's personality and self- esteem.
  • Space maintenance for the permanent teeth to erupt.
Primary Teeth Eruption Chart
Tooth Eruption Sequence

First permanent teeth that erupt in oral cavity are molars . The first permanent molars are the most important teeth for the proper development of adult dentition. From six to 12 years of age, the dentition consist of both the primary and permanent teeth, hence it is called mixed dentition.


When the child is about twelve years of age, all the primary teeth have exfoliated and the permanent teeth continue to erupt. The dentition now consists only of the permanent teeth hence called the permanent dentition. The second permanent molars erupt at about 12 -14 years of age and the third permanent molars at 17- 21 years of age, hence called wisdom teeth.

Permanent Teeth Eruption Chart
Tooth Eruption Sequence