10 frequently asked teething questions answered

Expert answers for all your questions about teething. By Camilla Rankin


Why are a baby’s first teeth also called “milk” teeth?

For a long time, it was believed that baby teeth only grew after the mother’s milk had washed over the gums, hence the name. Another reason for the name is their milky colour. Milk teeth are also called temporary or primary teeth, or deciduous since they fall out.

When can you expect your baby’s first tooth, and what are the signs that a tooth is coming?

“Baby teeth can start to erupt from about three months,” says dentist Dr Marie-Louise Weber, “and it takes about two to three years for all 20 baby teeth to grow in.”
Dr Jolandi Engelbrecht, also a dentist, advises looking for signs like increased drooling – which may result in a rash around the mouth – gum discomfort, or soreness that may cause your baby to refuse food, constantly rub her cheeks or bring her fists to her mouth.

Track your little one’s teething with this teething chart.

Is teething painful and does it really cause a fever?

Despite many parents’ reports, it seems that there is no real evidence connecting teething with the symptoms we often associate with this rite of passage. These include congestion, irritability, difficulty sleeping, diarrhoea, vomiting, coughing, rashes or fever.
On sciencebasedmedicine.org, researcher Clay Jones points out that first teeth grow in over a period of about two years, with one tooth appearing each month, so the likelihood of being exposed to a number of illnesses during that time is high. Before the late 19th century, when little was known about the true causes of illness, teething was blamed for all manner of symptoms, and many of these beliefs persist. At most, Clay claims, teething may cause some discomfort or itchy gums, but this also depends on the individual child’s sensitivity to pain. He cautions parents whose children have a fever, diarrhoea or significant changes in behaviour to speak to their doctor before blaming teething.

Are some babies born with teeth?

“Yes, these teeth are called natal teeth,” says Dr Weber, “but it’s extremely rare,
and only occurs in about one in every
3 000 babies.” Although all 20 of a baby’s primary teeth are almost completely formed at birth, they are hidden in an infant’s jawbone, explains Dr Engelbrecht. A natal tooth’s root structure is underdeveloped, so it is usually loose and can easily be removed if it’s causing problems with breastfeeding or ulcers on the baby’s tongue. In general, they are left to fall out on their own.

ALSO SEE: Everything you need to know about baby’s first teeth

When should you start taking your baby to the dentist?

“It is recommended that dental visits start by the age of two,” says Dr Weber. “The dentist will monitor your child’s dental growth and development, and teach your child how to maintain proper oral hygiene. Most importantly, your child’s first dentist visits must be positive. Never leave the first visit until your child has a problem or pain, as she will forever associate the dentist with fear and trauma.”

ALSO SEE: Your toddler’s first dental visit – what to expect

Is it OK to let my child fall asleep with a bottle in her mouth?

“Only if the bottle just contains water,” says Dr Weber. “Everything your child drinks, except water, contains sugars. When using a cup, the liquid passes quickly over the teeth, but with a bottle the liquid lingers in the mouth. Oral bacteria break down the sugar, turning it into acid which, over time, eats away at the tooth enamel. This is known as baby bottle decay. In severe cases, the teeth are destroyed, making it harder for a child to chew and talk properly, and can lead to years of dental and orthodontic treatment.”

How vigilant should I be about my toddler brushing her own teeth?

Until your child loses her milk teeth, they play a vital developmental role in eating and speaking, so it’s important that they are looked after. “Supervise teeth brushing until at least the age of six, or even as late as 12,” says Dr Engelbrecht, “because children do not yet have the manual dexterity to properly clean all around their mouths.” Use a pea-sized amount of toothpaste on a soft-bristled toothbrush, and brush in small circular movements over the surface of the teeth, gums and tongue for three minutes. “Remember that not all primary teeth are lost at the same time, so there is a period of six or seven years when your child will have mixed dentition. If you neglect baby teeth, you also neglect permanent teeth,” says Dr Engelbrecht, “and while most developmental, accidental or congenital damage does not usually affect permanent teeth, dental decay or ‘caries’ can spread down through the tooth and damage the permanent tooth bud, causing long-term structural damage. This is called ‘Turner tooth’.” Dr Weber also explains that “baby teeth are important ‘placeholders’ for permanent teeth. Losing teeth prematurely due to trauma or decay can lead to orthodontic problems later in life”.

ALSO SEE: 5 toddler teeth myths busted

Does sucking a dummy affect the development of adult teeth?

“Many studies by the American Academy of Pediatric Dentistry and other researchers have shown that long-term dummy use does influence the shape of a child’s mouth and jaw, and can alter the alignment of the teeth” explains Dr Weber. “Try to wean your baby off a dummy by the age of one and, until then, only use orthodontic-approved pacifiers and never dip them into sweet liquids.”

When will my child lose her first tooth?

“On average, the first tooth is lost when the child is six or seven years old and the last by the age 12 or 13, but each child is different,” cautions Dr Weber. “The loss of teeth usually follows the pattern in which they first erupted, so if the bottom incisor came through first, it will usually be the first to fall out.” It is rare, but if your child’s teeth have not fallen out within expected time frames, visit your dentist. “An X-ray will be able to see if there are any congenital missing teeth, or damage to the pathways,” says Dr Engelbrecht.

When should you start brushing and flossing your baby’s teeth?

Brushing teeth is about forming a habit, so Dr Weber suggests that you start cleaning your baby’s gums before any teeth even appear. Wrap your finger in a clean, damp facecloth or cotton gauze and gently rub your child’s gums.
“After the first tooth has erupted, brushing is essential,” says Dr Engelbrecht. “You can use a small soft brush, gauze or cloth to mechanically remove plaque or food, but toothpaste is not necessary.” Flossing can start when there are no gaps between your child’s teeth.

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