Primary Teeth

Jan 13

Word of Mouth
Primary Teeth
By Dr. Wade Newman D.D.S

The primary teeth (commonly referred to as “baby teeth”) are far more important to your child’s future dental health than you may imagine. In addition to providing a proper chewing surface until age 12 or 13, normal healthy primary teeth form pillars that allow young mouths to develop correctly. Without the primary teeth, the permanent teeth, which replace them, could not assume their proper position in the mouth. The primary teeth help guide the permanent teeth into their final position. In this article I’ll answer some of the most commonly asked questions about primary teeth.

Which teeth come in first and how many will there be?
In total there are twenty primary (baby) teeth, which is twelve less than the full set of thirty-two permanent teeth adults have. Most children have a full set of primary teeth by the time they are around two or three years old. These teeth usually last until about the age of six, when the teeth that were first to appear become loose and fall out as the second teeth begin to push through the gums. The primary teeth continue falling out until roughly the age of twelve. Again, these ages mentioned above are only averages and your child may follow an earlier or later pattern. The following is the most common pattern in which your baby’s teeth will usually appear.
Age Teeth Position
6 to 7 months Incisors Two central bottom & Two central top teeth.
7 to 9 months Two more incisors Top & bottom; making four top & four bottom teeth in all.
10 to 14 months First molars Back teeth for chewing
15 to 18 months Canines The pointed teeth or “fangs”
2 to 3 years Second molars The second set of teeth in the back

At what age should I take my child to the dentist for his/her first visit?
Let the first tooth, which will surface between six and twelve months, remind you that it’s time to see your pediatric or general dentist. Though this may seem early, 40% of toddlers between two and three have some inflammation of the gums and/or cavities. Be sure to get advice on tooth cleaning, pacifiers, fluoride and preventing tooth injuries for young walkers.

When should my child begin to brush their teeth?
Brushing should actually begin before children are capable of doing it themselves. A wet cloth or gauze effectively cleans gums and removes plaque after nursing and establishes a good habit early on. Gentle brushing with a soft bristle brush begins with the first tooth. Flossing starts when most primary teeth are in. It is 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. Most children also lack the proper manual dexterity to floss on their own until the age of ten and will need a parent’s help and supervision.

When should my child begin to brush their teeth on their own?
At six or seven, children can brush on their own, with careful supervision. And by nine or ten, they can floss on their own too. The American Academy of Pediatric Dentistry says a good rule of thumb for this is: “When children are accomplished enough in caring for their own needs that they can get up, bathe and dress themselves and comb their hair without your help – then they are ready to accept full responsibility for brushing and flossing.”

What should I do if my child chips or knocks out a tooth?
If a tooth is broken, save any fragments and make an emergency visit to your dentist’s office. If a permanent tooth is knocked out, find it, and if it is not broken, rinse it in cool water and gently replace it in the socket. Hold it there while you hurry to see your dentist. If the tooth does not seem replaceable, bring it with you to the dentist in a glass of milk or cool water. Never delay – the faster you get to the dentist, the better your chances of saving a tooth. Remember that the dentist should examine all injuries to the mouth. A chipped or broken tooth can usually be repaired.

When should I stop feeding my child with a nursing 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. 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.

What effect does thumb sucking have on teeth?
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.

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 to the dentist for the situation evaluated. The primary tooth may have to be extracted if your dentist feels it may not fall out on his own

Dr. Newman is a family dental practitioner in Bellefonte and is accepting new patients. You may contact Dr. Newman at his office: Bellefonte Family Dentistry, South School St. Bellefonte PA 16823, 814-355-1587 or visit

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