Teething in babies occurs mostly in pairs and in a predictable manner, with the two upper or lower central incisors emerging first, followed by lateral incisors, canines, first molars and second molars. By the time the child is three years old there will be 20 primary teeth in total. Though there is no exact age for babies to start teething, most babies have the first two teeth within five to twelve months of age.
In few rare instances however, babies can be born with few teeth. These are called Natal Teeth or Fetal Teeth and are most often present on the lower jaw at the time of birth. Natal teeth are irregular in shape, wobbly in nature and do not have strong roots. They may cause injury to the newborn’s tongue while nursing and also cause discomfort to the mother. Natal teeth are generally removed at the hospital often before discharging the baby after birth.
In case the natal teeth are not removed, they should be kept clean by gently rubbing the teeth and gums with a damp cloth daily. In the event of the gums or tongue appearing injured or the teeth looking loose or if the baby appears to be at risk of losing them or choking on them, consult a paediatric dentist immediately.
Neonatal teeth are similar in nature to natal teeth and erupt within the first month of a baby’s life.
Signs that indicate onset of primary teething:
- Swollen gums
- Drooling in excess
- Crankiness or irritability
- Gnawing at random objects within reach
- Mild temperature (below 101?F)
- Loose and frequent passing of stool
The most effective way of soothing a baby during the preliminary stages of teething is by offering a chilled teething toy or sticks of cucumber or blanched carrot to chew on. Gently massaging the gums occasionally with fingertips is also helpful. Some dentists and paediatricians allow the use of soothing gels to alleviate discomfort.
Primary teeth can grow crooked due to genetic factors inherited from the parents or due to sucking of pacifiers and thumbs, and can be corrected at proper age through appropriate orthodontic intervention.
Preventing tooth decay: Milk teeth are as susceptible, if not more, to decay and dental caries. It can happen due to irregular or improper cleaning of the oral cavity, teeth coming in regular contact with sugar content in the baby’s food or from milk that has not been swallowed remaining in the mouth for long durations. The ideal way to prevent decay is by maintaining proper oral hygiene and that includes:
- Removing the breast from baby’s mouth after nursing at night.
- Regularly swabbing the baby’s gums and tongue with a soft damp cloth wrapped around the index finger to prevent formation of plaque.
- Avoiding sugar in baby’s food. Milk and water given through feeding bottle should preferably be unsweetened.
Brushing teeth: The baby’s gums and tongue should be cleaned daily with a piece of gauze or soft damp cloth every day. Disposable finger brushes are also an effective alternative. Apart from helping in preventing dental issues, this practice will set precedent for lifelong good oral hygiene practices. The first few teeth can be cleaned by following the same procedure after which the baby should be introduced to brushing teeth and cleaning the tongue twice a day using a soft-bristled toothbrush and a fluoride based toothpaste.
Apart from brushing, regulating the natural and artificial sugar intake of the baby, ensuring that the baby is getting enough phosphorous, calcium, some amount of fluoride and Vitamin C, using a cup instead of bottles to make the baby drink milk and juices, minimal use of pacifiers, discouraging sucking of thumbs and never letting the baby go to sleep with a bottle or breast inside the mouth are few proactive steps that will go a long way in ensuring healthy teeth and gums.