Infants' oral problems require attention of parents

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

When I ask older people, what is the secret to a healthy life, most of them say "take care of your teeth".

Today, we will talk about the development of teeth, delayed dental eruption, dental cavities and prevention, and also trauma- care in case of teeth being knocked out.

Teeth are important to the health of every child. Many older children have regular dental examinations, but the oral problems of infants that require dental referral are typically recognized through routine visits to a physician.

Primary teeth start to form at the 12th week of fetal life and permanent teeth form start at the 5th month of gestation (pregnancy). At the time of tooth bud formation, each tooth begins a continuous movement outward in relation to the bone.

Parents are often concerned when their baby's first teeth have not erupted (come into the mouth) on time. A baby's first teeth, the lower central incisors (lower front teeth), normally erupt between five and seven months of age. The mandibular (lower jaw) teeth usually erupt before the maxillary (upper jaw) teeth, and generally earlier in the case of girls than boys.

Delayed eruption can be associated with prenatal, natal or postnatal factors: * Prenatal environmental factors may affect the development and eruption of teeth. Maternal illness during pregnancy can also affect a baby's dental development. * The complications of premature birth are correlated with delayed dental eruption in infants. The complications include a long period of intubation (use of a breathing tube in the hospital), neonatal infections and delayed initiation of full oral feedings. * Postnatal (after birth) factors are also correlated with delayed eruption in infants.

These factors include: low birth weight, nutritional deficiencies, hypothyroidism, and hypopituitarism. In some families, the children have early or delayed dentition without other signs of retardation or acceleration of growth.

Infants with syndromes or birth defects may experience delayed eruption of primary and/or permanent teeth.

Parents who are concerned about the delayed eruption of their baby's teeth should consult a pediatric dentist.

Remember that a child's first dental visit should take place around the age of one.

The pediatric dentist will attempt to diagnose the problem and determine its cause.

The lower central teeth typically are the first to appear in children, usually at about six months, and the first to fall out, usually at about the age of six.

Baby teeth fall out on their own to make way for permanent (adult) teeth. The first permanent teeth erupt on average at six years and they may be mistaken for primary teeth. The first permanent molars stabilize the dental arch and have a great deal to do with the ultimate shape of the jaw and orderly arrangement of teeth. Cavities or other defects in them should receive prompt attention, extraction of these teeth should be avoided.

Since your child's permanent teeth can last a lifetime, it is important to take good care of them. Continue teaching your child to brush his or her own teeth after each meal. It is also a good time to start demonstrating how to floss at bedtime. Schedule visits to your child's dentist about twice a year.

As soon as the permanent back teeth have broken through, your child's dentist may cover them with a brush-on sealant. This can help protect them against tooth decay.

Tooth decay is the primary cause of toothaches for most children and adults.

Bacteria that live in the mouth thrive on the sugars and starches in the food you eat. These bacteria form a sticky plaque that clings to the surface of teeth.

Acids produced by the bacteria in plaque can eat through the hard, white coating on the outside of your teeth (enamel), creating a cavity. The first sign of decay may be a sensation of pain when eating something sweet, very cold or very hot. A toothache often indicates that your dentist will need to work on your teeth.

Next week we will talk about ECC (Early Childhood Cavities) and how to prevent them from occurring.