TAKE CARE OF YOUR BABY'S TEETH

The age at which the first tooth appears differs greatly from child to child. It commonly appears in the middle of the lower jaw at around six months of age. Children may not develop any teeth until they are more than a year old. The set of twenty primary teeth is usually complete by the age of two and a half years. The first permanent teeth appear at around six years of age. These are the incisors in the middle of the lower jaw and the first permanent molar teeth. The molars come up behind the primary teeth; they do not replace them.

You should start taking care even before the teeth appear. You can get in the habit of wiping your baby's gums with a soft damp cloth after your baby has fed. When teeth appear, start using a soft children's toothbrush twice a day. In preschool-age children, use a tiny dab of fluoride toothpaste. Do not cover the brush with toothpaste, a pea-sized amount is just right. Young children tend to swallow most of the toothpaste, and swallowing too much fluoride toothpaste can cause permanent spots on their teeth.

Fluoride is a naturally occurring mineral that is very effective in protecting teeth against decay. When teeth first start to decay, minerals in saliva help mend the teeth, but the mending process requires fluoride to work properly. Most people do not get enough fluoride from the water supply, therefore fluoride is useful when added to toothpaste. Most packs will tell you how many parts per million (ppm) of fluoride the toothpaste contains - 500ppm is a low level and 1000-1500ppm is high.

Low fluoride toothpaste should be used for children under seven because it is important to avoid too much fluoride while permanent teeth are still forming as it can mark the teeth.

Diet does make a difference to your child’s teeth. Avoiding sweets, sticky foods and between-meal snacks is advised. Saliva in the mouth can clean teeth, but it needs time to work. A child who snacks constantly during the day never gives saliva the chance to clean the teeth.

Milk or other liquids taken from baby bottles can create special problems particularly when it stays in contact with the teeth for a long time. Never put a baby to bed with a bottle. Don't let your child walk around during the day with a bottle. Teach your child to use a drinking cup around the first birthday.

When teeth come through the gums, a child may feel a little soreness and act a little fussy. Some children enjoy chewing on a firm object or having their gums rubbed with a finger. Teething does not appear to cause fever, rash, diarrhoea or other illnesses. If your baby has any of these symptoms, talk it over with your doctor.

The first visit to the paediatric dentist should be around the child's first birthday. This gives the dentist a chance to look for early problems with the teeth. It is a good time to review important advice about diet, bottles, tooth brushing and fluoride use. It also helps your child become comfortable and get started with regular dental check-ups.

Some teeth come through with no trouble at all. In other cases, the gum may be sore and red where the tooth is pushing its way out. A child may gnaw and chew a lot or just be fretful, but it is difficult to tell if this is really due to teething.

• It can be helpful to give the child something hard to chew on
• Start brushing as soon as teeth appear
• Brush thoroughly twice a day, just before bed is important
• Help your child brush until they are able to do it well by themselves, usually around the age of seven
• Use fluoride toothpaste and encourage your child to spit after brushing; do not rinse afterwards as this reduces the benefits of the fluoride in the toothpaste
• Use a tiny smear of toothpaste for babies and a pea-sized amount for children
• Young children will swallow the toothpaste; use a children's toothpaste with reduced fluoride until they are able to spit well
• Visit a dentist regularly to get your child used to the surgery
• Reduce the amount of sugary food or drinks you give your child and limit these to mealtimes
• Only give water or plain milk in a bottle. Juices should be diluted and given in a cup
• Limit fizzy drinks and natural fruit juices as they contain sugar and are acidic. This causes decay and erosion, which will dissolve the teeth
• Teach your children how to brush their teeth and tell them the importance of keeping their teeth clean.