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As a baby transitions into childhood, oral care needs change because the risk of developing cavities increases with age. The risk of gum disease, such as gingivitis, and dental pulp infections is also higher. Between 6 and 13 years of age, primary teeth fall out and permanent teeth begin to grow in. This is the time children should learn sustainable oral hygiene habits to keep their mouths in tip-top shape as they grow into adulthood.
All primary (baby) teeth should erupt between 6 months to 2-3 years of age. They shed, or fall out, at different times throughout childhood, beginning around age 6. As baby teeth fall out, permanent teeth start to erupt around the same time (age 6) and fully grow in by age 13.
When a child’s dentition consists of some primary teeth and newly erupted permanent teeth, it is called the “mixed dentition phase.” Wisdom teeth, also referred to as third molars, should erupt between 17 and 25 years of age. Although, dentists typically remove third molars before age 20.
The normal chronology of the permanent dentition is as follows:
During the “mixed dentition” phase, children should take extra care of their teeth to ensure the newly erupted permanent teeth are healthy. For example, good oral hygiene practices include:
Children are prone to developing early childhood caries (ECC), especially in primary teeth. This is because baby tooth enamel is more fragile than permanent tooth enamel. ECCs begin as white spots on the teeth. Over time, the spots turn brown or black.
Cavities most commonly appear on the biting surfaces of primary molars. Common causes of cavities include poor nutrition, low fluoride consumption, bad oral hygiene, and dry mouth. Even though primary teeth fall out at a young age, it is important to take care of them.
If children develop cavities in their baby teeth, the bacteria can affect the permanent teeth once they erupt into the mouth, making them more susceptible to decay.
Dental fillings are the most common restorative treatment option for minor cavities in primary and permanent teeth. Treatment options include composite, amalgam, or glass ionomer fillings.
Stainless steel crowns are typically used to restore primary teeth with large cavities. Dental crowns, including porcelain-fused-to-metal, gold alloys, and ceramic crowns, are typically used to restore permanent teeth with large cavities.
Teeth may need to be extracted due to decay, trauma, or other oral health conditions. However, if a primary tooth is removed prematurely, space maintainers are typically placed to ensure the permanent teeth grow in the correct position. They prevent the misalignment of teeth and overcrowding.
Sealants are particularly useful for preventing cavities in children. They form “physical barriers” on newly erupted permanent teeth and keep food particles, acid, and cavity-causing bacteria out of teeth surfaces. They are particularly beneficial for children who do not have cavities yet or have a high risk of tooth decay.
Fluoride is a naturally occurring mineral that helps prevent and control cavities. Small traces are in most tap water and certain kinds of toothpaste. Other fluoride modalities include supplements, mouth rinses, varnishes, and gels. The use of fluoride should be based on a child’s age, history of dental conditions and diseases, and the availability of fluoridated tap water.
Children and adolescents are commonly diagnosed with gingivitis, the mildest form of gum disease, especially around puberty. This is because puberty and menstruation can cause increased inflammation and gum sensitivity. Common symptoms of gingivitis include swollen, red, and tender gums.
When the tissues, vessels, and nerves inside a tooth’s root become infected, pulpectomies are performed to save a severely infected primary tooth. The procedure involves the complete removal of dental pulp from the roots of teeth.
Mouthguards, also referred to as mouth protectors, are protective devices that minimize the risk of injuries to the teeth, jaw, face, jaw, lips, gums, and dental arches.
Children involved in athletics also benefit from mouthguards because they provide protection from both indirect and direct blows.
In addition, mouthguards protect a child’s teeth against bruxism, which is defined as the action of clenching and grinding teeth, typically during sleep.
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Berg, Joel H., and Rebecca L. Slayton. Early Childhood Oral Health. Wiley Blackwell, 2016.
Koch Göran, et al. Pediatric Dentistry: a Clinical Approach. John Wiley & Sons Inc., 2017.
Nowak, Arthur J. Pediatric Dentistry: Infancy through Adolescence. Elsevier, 2019.