Your Child's Oral Health  

Most children will have teeth beginning to erupt between 3 and 9 months old.  (Photo: Contributed)
Most children will have teeth beginning to erupt between 3 and 9 months old. (Photo: Contributed)

Common teething questions: Part 1

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Most of us don’t recall from childhood the events surrounding teething.  There are a great many questions generated by parents regarding this topic, which happens in several stages, and so, here we will provide some insights as to when, how and why teething occurs. 
One of the most common questions about teething is regarding when baby teeth start to erupt.  What is normal?  The best answer to this question is that there is a very wide range of normal.  Most children will have teeth beginning to erupt between 3 and 9 months old.  There are variations to this timeframe, however, and it is not unusual for babies to have a tooth erupt within the first month of life, or even more rarely, to be born with a tooth.  On the other hand, some children do not have any teeth before their first birthday...but rest assured, they will come!  Normally, the first teeth to arrive on the scene are the lower incisors, or the lower two middle teeth.  These are generally followed by the upper incisors.  This is not to say that this is the only pattern, but it is the most common.
The general pattern for the 20 baby teeth (10 on top, 10 on the bottom) is: the four incisors (squares) first, followed by the first molars at about 1 year old, then the canines (pointed teeth) at about 1 1/2 years, and then finally the second molars at about 2 1/2 years old.  As mentioned, though, there is variation with both the pattern and timing.
Another common question is about spacing and alignment.  Generally, the most favourable configuration for baby teeth is for children to have spacing between all of the teeth.  This pattern also shows a great deal of variation.  The two biggest reasons that spacing is good are 1) ease of cleaning, and 2) relief of crowding.
As has been previously discussed, cleaning between teeth can be challenging, and really only accomplished with floss if there is no space.  If there are spaces between the teeth, however, the between-teeth surfaces become much more cleansable, and more likely to benefit from the brushing action of the toothbrush.  Also, studies show that children with no extra space between their baby teeth, or crowding, experience a great deal more crowding when permanent teeth begin to come in, and are much more likely to require orthodontics (braces) in the future if straight teeth are desired.  Interestingly, studies also show that the plethora of issues, such as fevers, and rashes to name a few are not attributable to teething directly...however, irritability, that’s another story.
On occasion, baby teeth can erupt so that they are not perfectly straight, regardless whether there are spaces or not.  Primary teeth alignment can change over time as the child grows and the muscles of the lips and tongue help the teeth find their equilibrium position in the arch.  This does not necessarily mean that when permanent teeth come in they will the same.  There is very little predictive value between how the baby teeth look from an alignment standpoint and how the permanent teeth will look, other than what we have already discussed about spacing.  
The bottom line is that there is a great deal of variation with regard to baby tooth eruption times, and spacing or alignment.  The best thing to do if you have questions about these or other related issues, is to make an appointment to see your dental professional.  He or she will take the time to put your mind at ease and let you know what to expect in the future.

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About the Author

Dr. Alan Milnes is a pediatric dentist with 35 years of practice experience and 20 years of experience as a full time University Professor at the Universities of Manitoba and Toronto. He has operated a full time pediatric dental practice in Kelowna since 1997, the only pediatric dental office in either the Interior or Northern Health Authorities.

Dr. Terry Farquhar  completed his pediatric dental residency training in Halifax, Nova Scotia and Rochester, New York. Prior to entering Dentistry, Dr. Farquhar  worked as a pediatric nurse at Alberta Children's Hospital in Calgary.

Their pediatric dental specialty practice provides a complete range of dental services for ALL children and teens including treatment in-office using various forms of behaviour guidance, oral, inhalational and intravenous sedation and treatment in hospital under general anesthesia.

"We are dealing with an epidemic of tooth decay in children, a condition called early childhood tooth decay. Many children with dental disease have a poor quality of life because of chronic pain and infection which makes sleeping and eating difficult. Providing information through our column to parents of children in the Interior of BC will be helpful in giving them important tools to prevent dental disease in their children."

Please visit our website for a look at what we do each and every day and our qualifications - www.okanagandentalcareforkids.com; email: [email protected]

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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