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Dental Care

All twenty (20) primary and some permanent teeth begin to form before birth. The purpose of this section is to acquaint the parents of infants and children as well as expectant parents with information to aid in healthy dental development.

Dental Growth Before Birth

Teeth begin forming during the fifth week of pregnancy and by birth all twenty (20) primary teeth and the permanent six year molars have begun to calcify (mineralize or harden.) Certain drugs taken during pregnancy may have an effect on the developing teeth. If you become ill during pregnancy, check with your physician about this potential problem. Proper prenatal nutrition will also benefit those developing teeth.

Postnatal Care and Nutrition

Cleaning your new baby’s mouth should become a part of your daily routine. Use a soft toothbrush to brush the gums, cheeks, tongue, and teeth as they erupt.
The crowns of newly erupted teeth are only partially calcified (hardened). Clean teeth and a healthy mouth will aid in their final maturation.
REMEMBER: If your child is bottle-fed he should be off the bottle completely by around 12 months of age unless otherwise suggested by your pediatrician. Continuing with the bottle beyond this age can lead to a serious dental decay problem known as “milk bottle syndrome” or “nursing bottle caries.” Bedtime bottles or sippy cups with milk, juice or sugary drinks are especially damaging.


All children are different and some children may have more problems with teething than others. Discomfort from teething may be helped by providing them with frozen wash clothes, a chilled teething ring, rubbing the gums, or children’s Tylenol. Teething may lower your child’s resistance and make him more susceptible to other minor health problems. Severe discomfort, fever, nasal discharge, etc. should be a signal to see your physician.

One to Two Years

Your child should have approximately eight erupted front teeth by one year of age. Also, sixteen of the permanent teeth will have begun to calcify by one year and by age two, four more permanent teeth will calcify. Most children will have sixteen erupted primary teeth by age two.

Your twelve to eighteen month old child should be examined by a pediatric dentist and your role in preventing future problems should be discussed.

Tooth brushing should begin during this time and can best be accomplished by laying your child on the changing table while you brush. After eighteen months, a small amount of fluoride toothpaste on a soft toothbrush will enhance prevention. Brushing should always be done by the parents at bedtime as a child should not go to bed with even small amounts of food or drink in his mouth. The teeth should also be well cleaned after breakfast. While cleaning a child’s teeth, special attention should be paid to cleaning the gingival margins (gum line).

As your child becomes more active, bumps to the teeth are inevitable. If there is any question as to damage to the teeth your child should be examined by the dentist as soon as possible.

Three to Five Years

By age three most children will have all twenty primary teeth erupted and twenty-four permanent teeth will have started to calcify.
At age three a child should have his teeth re-examined for decay as well as his growth and development evaluated. His teeth should be cleaned and fluoride applied to further enhance decay prevention. Between ages three and four many primary teeth will be close enough together to begin using dental floss with your child and a proper method of flossing should be demonstrated to you. During this stage your child’s mouth and teeth should not change at any noticeable extent. There are, however, situations in which orthodontic care may be extremely beneficial even at such a young age.

Age Six and Above- About age six to age seven your child should erupt the first permanent molars and begin to lose and replace the front baby teeth. Your dentist should acquaint you with these events and offer suggestions to assist you and your child through this period. Parental assistance with brushing and flossing should continue until your child’s manual dexterity is adequate to complete these tasks independently. This age will vary but usually occurs about eight or nine years of age.

As the permanent molars completely erupt into the mouth, sealants should be seriously considered as an additional method of preventing decay. A sealant is an acrylic substance which adheres to decay-susceptible areas in deep grooves and pits in the tooth surface and isolates those areas from decay-producing foods and substances in the mouth. Remember, permanent first molars (six year molars) may decay faster than any other teeth and sealants are very effective in preventing that problem.


Any injury to lips, gums, or tongue will initially bleed heavily but with the application of gentle pressure most bleeding should stop within three to five minutes. After bleeding stops, then re-evaluate the severity and nature of the injury. Many times an injury that appears severe initially may require only minimal care. SO BE CALM. Any injury to primary front teeth resulting in displacement or fracture should be reported immediately to the dentist. Primary teeth that are knocked out (avulsed) should be reported as well but it is likely that the primary tooth cannot be reimplanted. Displacement or fracture injuries to permanent teeth should be treated immediately. In the event a permanent tooth should be knocked out, locate the tooth immediately and, touching the tooth as little as possible, rinse off any large debris in cold whole milk. Replace the tooth in the socket if possible, or as an alternative place the tooth in cold white milk and seek immediate dental care. Most avulsed permanent teeth can be saved at least for a while if prompt responses as above are followed.

What is a Pediatric Dentist?

A pediatric dentist has received at least two years of additional specialty training following dental school, and is especially proficient in the following areas: Care of the very young, ill, or child with special needs, including management of difficult situations; treatment of injuries; guidance of growth and development; and prevention of decay and oral disease.

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