Dental Care Basics for Pregnant Women & Babies (Life Stages)

Dental Care for Babies

As we get older, oral care needs change. Dental care is different for pregnant women, babies, children, teens, and adults. A baby’s first tooth erupts at 6 months old, and typically no later than 1 year of age. Dentist visits should begin within six months of a baby’s first tooth eruption.

Understanding Basic Teeth Anatomy

Throughout life, everyone has two different phases of teeth (dentitions):

• Primary Dentition — the first set of teeth, also referred to as “baby teeth.”
• Permanent Dentition — the second set of teeth, also called the “permanent teeth.”

Primary Teeth (Baby Teeth)

The primary dentition phase consists of 20 primary teeth, including:

• Eight Incisors — used for cutting and tearing.
• Four Canines — used for tearing hard foods, such as meat.
• Eight Molars — flat biting surfaces used for chewing, crushing, and grinding food.

For reference, teeth are arranged in the upper jaw (maxillary teeth) and lower jaw (mandibular teeth):

• Incisors refer to the four front maxillary teeth (upper) and the four front mandibular teeth (lower).
• One canine tooth (four total) on each side of the second incisors in both the upper and lower jaws.
• Four molars (eight total) in both the upper and lower jaws.

The first primary tooth erupts when a baby is about 6 months old. The two bottom front teeth (central incisors) are commonly the first teeth to erupt in infants. After all of the incisors erupt in the upper and lower jaws, a child’s “12-month” primary molars grow in. Then canines erupt, along with second molars, which are also called “24-month” molars. Baby teeth do not include premolars. This is because permanent premolars replace a baby’s primary molars.

A child will lose their first primary tooth at age 6 or 7. The last primary tooth sheds at around age 12. Even though primary teeth aren’t permanent, it is still crucial to take care of baby teeth as early as possible. Doing so helps build healthy habits as they become teenagers and young adults. Encouraging children to care for their teeth also reduces the chance of gum disease and cavities in permanent teeth.

Permanent Teeth

After a child is out of the “mixed dentition” phase, when they have a mixture of baby teeth and permanent teeth, they will move into the permanent dentition phase. During this transition, it is essential to make sure your child has an established dental care routine to keep their new permanent teeth healthy. This includes brushing, flossing, fluoride, and regular dental exams.

There are 32 permanent teeth, including:

• Eight Incisors — same function as primary teeth.
• Four Canines — same function as primary teeth.
• Eight Premolars — biting surfaces with two cusps or points used for crushing and tearing food.
• Twelve Molars — same function as primary teeth.

As children lose primary teeth, larger permanent teeth replace them. The main difference between the two dentitions is that there are four wisdom teeth (third molars) and eight premolars in a permanent set of teeth. Permanent teeth begin to grow in at age 6 or 7 and stop erupting at age 13. Third molars, or wisdom teeth, do not grow in until 17 to 21 years of age and are often removed before erupting.

Dental Care Stages for Babies

The earlier a child begins dental treatment, the better off they are in the long run. As one reaches adulthood, they will have healthy dental habits ingrained into their lifestyle. In turn, they are less likely to develop gum disease or deep cavities.

Oral Care During Pregnancy

Staying on top of oral health and dental care during pregnancy is crucial to ensure a newborn has a healthy start. This includes:

• Making regular dentist appointments.
• Brushing two times a day with a fluoride toothpaste.
• Drinking fluoride tap water daily.
• Talking to a dentist about disease prevention.

Many new mothers don’t realize how important dental care during pregnancy is. Just as negative food choices, alcohol, and drugs negatively impact a child’s health in the womb, poor oral hygiene has an extreme impact as well. A mother’s oral health standing is a strong predictor of how her child’s oral health will be as they grow up.

Dental Cavities

As behavior, diet, and nutrition change throughout pregnancy, a common result is the production of dental caries. If a pregnant woman has a higher risk of tooth decay, it’s more likely that her child will develop them as well. A mother may unintentionally pass cavity-causing bacteria to a susceptible newborn, increasing their risk for cavities, tooth decay, or even gum disease.

• Pregnant women between 15 to 24 years of age have a significantly higher amount of untreated dental cavities than non-pregnant women.
• A child is three times more likely to have tooth decay or cavities if their mother has high levels of untreated tooth decay.

Periodontal Disease

If gingivitis is left untreated, it can turn into periodontal disease (PD), which affects the supporting tissues of teeth. The primary symptom of PD is when the gums become red and swollen from inflammation. Risks of PD during pregnancy include:

• Poor pregnancy outcomes, such as low birth weight or preterm birth.
• Cavity-causing bacteria can be transferred from mother to baby, PD bacteria can as well.

"Roughly 60 to 75 percent of pregnant women have gingivitis."

Protecting Your Child’s Teeth

Paying close attention to oral hygiene during pregnancy is a key factor in preventing gum disease, cavities, or tooth loss. If a mother has a history of poor oral health before becoming pregnant, it is vital to take extra care of the mouth and teeth, focus on nutritional needs, and visit the dentist regularly. These efforts help protect the baby’s teeth during the prenatal phase and after they are welcomed into the world.

Baby Dental Care (0-4 yrs)

A “baby” refers to any child that is 4 years old or younger, including newborns, infants, and toddlers. New parents should educate themselves about the importance of oral hygiene for babies as early as possible. The standing of a baby’s oral health depends on feeding habits, medical history, newborn oral care practices, and behavior during pregnancy.

First Pediatric Dentist Visit

Infants begin teething between 3 and 9 months of age as primary teeth begin to emerge in the mouth. Children may become fussy and uncomfortable during this period, but teething is a normal stage of life and is typically nothing to worry about.

The American Academy of Pediatric Dentistry (AAPD) recommends that an infant should begin visiting a dentist around 1 year of age, within 6 months after the first tooth eruption.

Visiting a pediatric dentist, who specializes in treating only children’s teeth, ensures a child receives the highest quality dental care:

• Pediatric dentists provide care for infants and children through adolescence, as well as children with special needs.
• They must complete two to three years of additional training after dental school.

During the first visit, the dentist will check for cavities and tooth decay. Parents often ask for advice on how to care for their infant’s teeth correctly, such as brushing, fluoride use, and cavity prevention.

Early Childhood Caries (ECC)

Early-in-life risk factors (listed above) play a huge part in determining the likelihood of a child developing dental caries as they grow up. Properly brushing an infant’s teeth, using fluoride regularly, and cleaning gums greatly reduces a child’s risk of developing cavities.

Causes of Cavities and Tooth Decay

Improper infant feeding and neglected oral care promote the growth of cariogenic bacteria. Streptococcus mutans, a cavity-causing bacteria, are the most common. When teeth erupt in an infant’s mouth, who has high levels of cariogenic bacteria, demineralization of teeth (decay) often occurs. Common causes of cavities include:

• Baby Bottles and Tooth Decay — excessive bottle-feeding or allowing a baby to drink from their bottle in bed has extreme oral health risks. If the substance in the bottle is anything but water (or high in sugar), the incisors will bathe in it, ultimately causing cavities.
• Excessive Pacifier Use — sucking is a normal occurrence for babies, especially in the first years of life. If a child sucks on a pacifier long-term, dental problems are likely to occur. This includes crooked teeth and bad oral hygiene. If the pacifier is flavored, excessive use can lead to cavities and decay.
• Poor Diet — a diet high in sugar and refined carbohydrates.
• Low Fluoride Consumption — drinking water that is low in fluoride for a long period of time.

Early Signs of Cavities in Babies

• Tooth sensitivity when eating sweets or drinking cold beverages.
• Formation of white spots, which means the enamel is beginning to break down.
• Tooth pain or pain in the areas around the cavitated tooth.
• Early cavities are light brown and become darker as the cavity gets deeper.

How to Prevent Tooth Decay in Babies

Preventing tooth decay in babies begins with establishing good habits early on. If babies have poor oral hygiene as newborns, infants, and toddlers, they are more likely to develop dental issues as they reach early childhood. Utilize these tips to prevent tooth decay:

• Visit a pediatric dentist for regular check-ups, beginning when a baby’s first tooth erupts or around their first birthday.
• Check baby teeth on a regular basis for signs of decay (common signs listed above).
• Drink water with fluoride and use fluoride toothpaste.
• Clean their gums directly after breastfeeding or bottle-feeding and never send them to bed with a bottle.
• Eliminate sugary drinks, such as fruit juice, from their diet.
• As a child’s teeth grow in, help them brush correctly until they are about 8 years old.