“The Middles” Oral Health

Dental Health for the “Middles”

When will my child start to lose their baby teeth?

All of your child’s baby teeth should be in by around 2-3 years old. After, you’ve typically got a few years to wait before baby teeth start falling out and adult teeth come in. Both of these happen around 6-7 years old, with the front baby teeth coming out first, and the first set of permanent molars coming in behind the baby molars in the back. After that, there is a pretty steady flow of teeth coming and going until around 13 years old.

What’s the best way to wiggle out a baby tooth?

Just keep wiggling! As soon as your child notices a loose tooth, you can give them a daily “wiggle goal” to help get their tooth out in a timely fashion. If loose baby tooth stay in too long, they can start to crack and break, which may mean a visit to see us for some help.

Whoa—my child hasn’t lost his/her baby tooth and there is an adult tooth coming in right behind it—what do we do?

Don’t worry! We call this double-parking, or “shark teeth” and its pretty common. When it happens to bottom teeth, we encourage your child to work on wiggling those baby teeth for a few weeks to try to get them out on their own. If it happens to top teeth, give us a call—the tongue can’t help reposition these teeth quite as easily, so we usually like to help with these.

What about all that teeth grinding?

A: Yup, we know—its loud! Its pretty normal for kids to grind their teeth while sleeping as they have what we call

“mixed dentition”, or baby and adult teeth in at the same time. We don’t worry about it too much until all of their permanent teeth are in, at which time it usually stops naturally.

When do you start taking x-rays?

A: We usually start taking dental x-rays around the age of 4, based on the eruption of your child’s teeth. Dental x-rays are always specifically diagnosed for your child by the dentist following guidelines produced by the American Academy of Pediatric Dentistry.

Braces Already?

A: Yup, it may be time to talk about orthodontics once your child’s permanent teeth start to come in. Orthodontists typically like to begin evaluating the need for treatment around 7 –8 years old. An orthodontist may recommend two phases of orthodontic treatment for your child—one around the age of 6-10, and another later in the teen years. This first round of treatment can include an expander, a retainer, or partial braces, and may mean needing a few baby teeth extracted to help those permanent teeth come in. The goal of two-phase orthodontics is usually to make more room for the permanent teeth as they are erupting.

About Brushing & Flossing

When can my child start brushing on their own?

Children can start brushing on their own around the same time they can tie their own shoes. We want to make sure they have great dexterity to be able to reach all of their teeth easily, so usually around 5 or 6 years old. From 3-6 years old, its great to allow them to brush for a minute or two, and then brush their teeth yourself for a minute or two.

How important is flossing at this age?

SO important. “Kissing cavities”, or cavities on the touching surfaces of teeth, are one of the most common types of cavities we see in primary and permanent molars. As soon as your child’s molars are in, make sure to floss every day to keep sugar bugs out of those hiding spots.

Tooth brushes: Electric or Manual?

Any tooth brush is a great tooth brush! For the “middle” in this age range, whatever brush makes them excited is the one we prefer. If you do have an electric brush, we still find that it works great to brush one time a day with a manual brush and once with an electric for the best overall cleaning.

Any changes for tooth paste at this age?

Around the age of 3 or 4, or when your child is spitting well, they can start to use a pea size amount of fluoridated tooth paste instead of a smear.

About Sealants

What are sealants?

Dental sealants act as a barrier, protecting teeth against decay-causing bacteria.

A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth—premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by “sealing out” plaque and food.

How do we care for my child's sealants?

The life span of a dental sealant varies based on multiple factors, but typically last about 3 years. To help your child’s dental sealants stay in place, make sure your child does not chew on anything hard, like ice or hard candy. We will check the dental sealants at your child’s regular 6month dental checkups, and we can touch up sealants when needed. After 3 years, they may need to be replaced.

What is the success rate of sealants?

According to the Comprehensive Review of Pediatric Dentistry (September 7, 2012), after 4.5 years the sealed permanent molar teeth of children ages 5-10 had caries reductions in over 50% of occlusal surfaces compared to nonsealed teeth; caries reductions ranged from 86% at 12 months to 57% at 48-54 months.