Even though most children that age have a number of teeth, some children may have delayed tooth eruption. There is usually no cause for concern about this.

2. My child's permanent lower front tooth is coming in behind his baby tooth. What should I do?

If the baby teeth are moderately to very loose, there is no immediate treatment. Patience is recommended. This is a normal process. The tongue will push the permanent lower front tooth forward. If the teeth are not very loose, your child should be taken for a x-ray and the situation evaluated. The milk tooth may have to be extracted if your dentist feels it may not fall off on his own.

3. My son sucks his thumb or finger. What effect can it have on the bite, and when should I work on stopping the habit?

Most children stop sucking their fingers between the ages of three to five. If your child continues this habit past the time of the eruption of the first permanent tooth, then it can have a permanent effect on the adult bite. The habit should be stopped before these teeth come in. From a preventive point of view, infants should be given pacifiers, as they will do much less harm than finger habits, and most children will discontinue their use earlier.

4. I have heard that a nursing bottle can cause cavities on toddlers, at what age should I take my child off the bottle?

Your child should stop using a bottle when he is old enough to hold a cup. This usually occurs around one year of age. After this age a child should NEVER be placed to sleep with a bottle because this may cause dental decay, increase the incidence of ear infections, and prolong the use of the bottle. If your child is habituated to sleeping with a bottle, the best way to stop this habit is by placing only water in the bottle, or progressively diluting it until it is all water. Then be firm with the child, give juice or milk in a cup, which will not cause as severe a decay.

5. What are the signs of teething, and what can I do to make my child more comfortable?

The signs of teething are drooling, irritability, restlessness, and loss of appetite. Fever, illness, and diarrhea are not symptoms. If your child presents with the latter signs, they need to be evaluated by your doctor. The best solution to comfort the child is to have the child chew on a cold or frozen rubber teething ring. Topical anesthetics/ gels are NOT recommended.

6. Why are baby teeth important? Don't they fall out?

Baby teeth serve the important function of eating, speech, and esthetics (self-image). These teeth not only help form the developing jaws, but they hold space for the permanent teeth to make normal bite possible. The last baby tooth falls out at about twelve years of age. A decayed baby tooth can become so badly decayed that it can do damage to the permanent tooth. At times severe infections of the face, head, and neck can be caused by infected baby teeth, necessitating care of baby teeth knowing they will eventually fall off.

7. When should I expect my son to brush and floss on his own?

We recommend that parents brush their children's teeth for the first five to seven years of life, since young children lack the manual dexterity of proper tooth brushing. The toothbrush should be a child's size, with soft nylon rounded bristles. Toothpaste should not be used until the child is able to spit (three to four years of age) to avoid swallowing it. A pea-sized drop should be dispensed by the parent for young children. Flossing should be performed by the parent prior to brushing. Most children lack the proper manual dexterity to floss on their own until the age of ten and will need a parent's help and supervision.

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