Your Child’s Teeth – A Primer

While most guys are only unfamiliar with the medical development and needs of their kid, they are utterly lost about their kid’s mouth.  This is the child’s business end since the dollar cost of not caring for it properly can be huge.  Dollars aside, the child can become very insecure and embarrassed by their mouth’s condition as they age.

Baby Teeth Basics

Over the next 20 or so years, your child – who we’ll call Ramona – will first gain a full set of 20 baby (also called primary) teeth.  These will last until they are finally replaced by the adult complement of 32 teeth.  You will probably start to see the first tooth "erupt" at several months of age in the front of the mouth.  These are the incisors and they will later be flanked by the canines.  This process continues until all 20 teeth have arrived at about two years of age.  They will then remain intact until the first adult teeth start arriving at roughly six years of age.  Something which confuses most parents is the arrival of the six year molars, located immediately behind the primary molars.  These do not  replace the original primary molars, so their arrival isn’t preceded by the loss of any primary teeth.

You can expect that the first teeth lost will be the lower incisors (front teeth) at age six, followed by the upper incisors.  Molars and canine teeth are generally not lost until 10 – 12 years of age.  From the loss of the incisors, you then have several years in which to arrange financing for the coming orthodontia.

What is Teething, and How Many Buckets Will I Need?

Teething is the time when Ramona gains a new tooth and covers the period from its approach to the gum from below to its final arrival.  You’ll hear the term erupt to describe when the gum is breached; this is a misnomer penned by some sadist to induce you to hold out hope for some uninterrupted sleep.  You’ll know Ramona’s teething by:

  • increasing amounts of drool, as though this were possible;
  • a marked desire to chew and gnaw;
  • a shriek from Mom while breastfeeding.  Welcome to Extreme Nursing.

If you suspect that she has started teething, look in her mouth and you’ll find the gums inflamed.  An arriving tooth will also physically appear to be pushing through the gum as though a finger were pushing through a balloon.

You can help relieve Ramona’s pain – and it does hurt – by giving her a cold teething ring, available at any grocery or pharmacy.  You can give her a cold, damp washcloth to suck on, or even your clean finger.  Only consider using any form of pain reliever, like infant acetaminophen, after speaking with your doctor.  Oh, and remember to wipe the drool from her face or you’ll add insult to injury by allowing a rash to develop on her face.

How Do I Care for My Child’s Teeth?

Start mouthcare long before the first teeth arrive.  After feeding, whether breastmilk or formula, use a clean and damp gauzepad or cloth to wipe the gums.  This removes bacteria from the food and also gets Ramona used to the practice of doing something to keep her mouth healthy.

Because a toothbrush might cause undue distress to the baby with only a few teeth, continue to use a clean, damp washcloth to wipe the teeth.  When you do decide to move to a toothbrush, get one with soft bristles on a small head so as not to irritate the gums and create even more unnecessary problems.  Replace the brush every four months and also after any time that Ramona’s been sick.  Even after you start brushing her teeth, toothpaste shouldn’t be introduced until the third birthday when she has a clue about how to spit.  Even then, use a non-flouridated training toothpaste; she’s still going to swallow a fair amount of paste and the flouride can upset her stomach as well as potentially cause flourosis.  This condition will eventually show itself by a discoloration to the permanent teeth.  The training toothpaste is available in the baby section of any grocery or pharmacy and be sure that it’s approved by the American Dental Association.

And see?  Now you have a reason to teach your little girl to spit.

When Should My Child See the Dentist?

Today’s rule of thumb is that Ramona should see the dentist at about her first birthday, something endorsed by both the ADA and the American Academy of Pediatric Dentistry.  It might seem overprotective, but the dentist can advise on how you’re doing with mouthcare and see if the mouth and teeth provide insights into future problems.

These early visits would encompass an examination of her mouth and teeth, as well as what to expect with the sequence of eruptions.  The dentist can also advise you on childhood habits such as thumbsucking and pacifiers, as well as the use of sippy cups and bottles.  Excessive use of these cups with juice has led to a major rise in early childhood cavities, which is not something that you want.  Because not all water sources are created equal, you can also consider whether to supplement the flouride available to Ramona to forestall later teeth problems.

For additional information, visit the website of the American Academy of Pediatric Dentistry at

Many Thanks to Dr. Maria Meliton for her review and comments to this article.  You can visit Dr. Meliton’s website at


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