Useful Information

Women & Children

Pregnacy and Gingivitis

Most women show some degree of gingivitis during pregnancy. Pregnancy tends to exaggerate the body's normal response to dental plaque. Hormonal increases create a heightened immunological response to the bacteria in plaque, leading to an increased likelihood for pregnant women to develop gingivitis. It is important to note, that it is the plaque (bacteria) not the increased levels of hormones that is the major cause of pregnancy gingivitis.

A general swelling of the gums is usually noted in the second month of pregnancy and generally reaches its peak by the middle of the last trimester. The gums can remain swollen for up to 3-6 months after delivery. Pregnancy generally tends to make preexisting gum conditions worse.

 

Tips For Pregnant Moms

Pregnancy is an especially vulnerable time for your teeth and gums. With pregnancy come a whole host of hormonal changes (increased levels of estrogen and progesterone). These changes in hormones translate to an increase in the plaque that builds up on the teeth. Plaque that is not removed can cause gingivitis and swollen gums that are tender and prone to bleed. In most women, gingivitis begins to appear around the second trimester. It's important to note that without treatment, preexisting gum conditions generally worsen through the course of pregnancy.

Before you get pregnant It’s a good idea to have a dental examination prior to getting pregnant so that any potential problems can be handled well in advance without complication.

Check - Ups - Visit your dentist for a checkup in your first and second trimesters to control plaque and maintain good oral health. It's always a good idea to complete any dental treatment prior to pregnancy. All elective procedures should be completed after the delivery.

X-rays (radiographs) - It's a good idea to avoid them during pregnancy. Special care will be taken by your health practitioner if it is essential to have x-rays.

Decay - Studies have shown that the bacteria responsible for tooth decay is passed from the mother to the child - so eliminating decay in your mouth before you get pregnant may help protect your baby.

Gagging - Women often change their brand of toothpaste during pregnancy, preferring ones with a more subtle, bland taste. Try cleaning your back teeth while breathing slowly; this usually helps to reduce some of the nausea.

Bleeding gums - Pay particular attention to any changes in your gums during pregnancy. Hormonal changes can cause gum sensitivity but it's important to let your dentist check your gums and offer advice on minimizing problems. Gum problems due to pregnancy will resolve after childbirth. Make sure your gums are healthy before pregnancy to minimize the likelihood of any problems.

Cravings - The more frequently you snack (particularly with sweet foods) the more likely you are to get decay.

Morning sickness - If you vomit frequently during pregnancy it's important to just rinse your mouth out with water or a mouth rinse afterwards. Brushing your teeth immediately after vomiting can cause your teeth to wear away. Stomach acids soften the tooth thereby making brushing more abrasive.

Calcium - Calcium isn't lost from your teeth because your baby is developing. However, additional calcium and phosphorous are needed during pregnancy. Healthy diets containing dairy products, cheese and yogurt are a good source of these essential minerals. Fluoride is found in almost all brands of toothpaste and in foods originating in areas with fluoridated water. Talk to your dentist before you take fluoride supplements.

Dental Emergencies - If you do experience a dental emergency during pregnancy, you can be treated at any time; however, consult your doctor if anesthesia is required or a medication is prescribed to you. Avoid X-rays during pregnancy, unless they are critical to the treatment of the emergency. Tell your dentist or doctor if you suspect you're pregnant. Certain drugs, such as tetracycline, can affect the development of your child's teeth.

Children Thumb Sucking

Questions often arise concerning infants and non-nutritive sucking, that is sucking thumbs, fingers, pacifiers and other objects. Numerous studies indicate that most children spontaneously discontinue sucking their thumbs and fingers between the ages of 2 and 4. Children often combine a sucking habit with another repetitive activity such as carrying a personal blanket or toy while sucking their thumb or playing with their hair. Tired, stressed or hungry children are more likely to suck their thumbs. Generally, sucking on fingers, thumbs and toys is healthy and normal through infancy. Most embryos actually suck their thumbs while in their mother's womb. Thumbsucking and pacifier use give children a sense of security and help them become more comfortable with their environment. They’re normal habits which most kids forego long before any damage can be done to their teeth and jaws. So, stop worrying! Effects Of Thumb Sucking The effects of thumb sucking on deciduous teeth are usually totally reversible up until the age of 6 to 7 years when the permanent teeth start to erupt. Beyond the age of 7, dental problems may occur due to changes in bone structure. Extensive sucking of fingers or thumbs has a tendency to push the front teeth out of alignment causing teeth to protrude. This may alter the growth of the face and cause an open bite. Preschool children who suck their thumbs or fingers may develop a lisp. The lisp may also be created by a condition called tongue thrust which is a habit of sealing the mouth for swallowing by thrusting the top of the tongue forward against the lips. Tongue thrust exerts pressure on the front teeth, increasing the likelihood that the teeth will be pushed out of their normal position; thus interfering with the correct pronunciation of certain sounds during speech.

How To Help Children Break The Habit

Thumb sucking and pacifier use are quite normal for small children and should not concern parents until the child's permanent teeth begin to erupt. Usually most children have given up the habit by this time. Children must make the decision to stop sucking their thumbs or fingers before the habit will cease. Parents and dental clinic staff can assist children to achieve their goal through a variety of methods. Remember, what is effective depends on the child and their situation.

Tips For Getting Them To Stop!

Using bitter nail solutions or using tape to secure your child’s fingers is often not as effective as providing positive reinforcement. Put up a calendar and place a star for each day they successfully avoid the habit. After a certain number of days, reward them with a treat. When they do suck their thumb or use a pacifier, give them a gentle verbal reminder. Avoid using negative reinforcement or punishment; this often causes the child to further embrace the habit. Negative reinforcement is particularly ineffective since thumb sucking and pacifier use are security mechanisms. Punishing a child increases their desire for security and drives them back to the habit. Instead, consider giving them a teddy bear, a blanket, or just lots of affection. If they’re still having a hard time beating the habit, try gradually increasing the number of hours in which they’re not allowed to use the pacifier or suck their thumb. You should continue increasing the number of hours until they’ve been weaned of the habit. Phase out bed time pacifier use last, as this is the time they need it the most.

How Often Should Rewards Be Given?

The younger the child the more frequent the reward must be given. A five to six-year-old may need some special reward after the first difficult night. Reward periods can gradually be stretched out to several nights, a week and eventually a period of 30 nights without sucking. Many children need a number of small rewards before they lose the impulse to suck until they have

Thumb Sucking Versus A Pacifier

Studies have shown that children who suck their thumbs have greater difficulty breaking their habit than do children who use pacifiers.

Can Parents Become Overly Concerned About This?

Yes. Frequent repetition by parents to take the child’s thumb out of their mouth can be counterproductive. If children feel they are being nagged they will become defensive and view parents as the opposition and not an ally.

What Frustrations Do Children Face When They Attempt To Break This Habit?

A child’s first days without sucking their thumb are usually the most difficult. Like all habits, the yearning diminishes slowly and eventually becomes easier. Parents and other family members can offer encouragement and rewards. Family members need to be patient. It may take several attempts before the habit is completely broken.

Lip Sucking

Sucking of the lower lip may occur in isolation or in combination with thumb sucking. When the lower lip is repeatedly held beneath the upper front teeth the result is usually an open bite. As discussed above, stopping the habit relies on the child wanting to stop.

Tooth Eruption Dates

It's important to note that eruption times vary form child to child just as the individual growth rates between children vary. Normally, no teeth are visible in the mouth at birth. Occasionally, however, some babies are born with an erupted incisor (neonatal tooth), but these are not true teeth and are lost soon after birth.

The first baby teeth to erupt are usually the lower two front incisors (mandibular central incisors) at about 6 months of age. They are followed by the 4 upper front teeth. The remainder of your child's teeth will appear periodically, usually in pairs on each side of the jaw, until all 20 baby teeth have come in at about 2 1/2 years of age. The last teeth to emerge are the top two molars (maxillary second molars at 30 months). The complete set of baby teeth are in the mouth from 2 years to 5 3/4 or 6 years of age (when no permanent teeth are present). Shortly after your child's 4th birthday, their jaw and facial bones will begin to grow creating spaces between their teeth. This is frequently a concern to parents, but it’s a perfectly natural process of providing the necessary space for the larger permanent teeth to emerge.

A good rule of thumb concerning baby teeth is that for every 6 months, approximately 4 teeth will erupt. So, if your child is 12 months, you should expect 8 teeth.

Though baby teeth are only in the mouth for a short time, they play a vital role in reserving space for their permanent counterparts. The primary teeth are crucial to your child's normal facial appearance and the formulation of clear speech. Missing or decayed baby teeth often cause children to reject foods that are difficult to chew. Decay and infection in baby teeth can cause dark spots on the permanent tooth developing beneath it.

The following diagram shows approximately when each baby tooth should erupt. Many variations occur, but the usual order of appearance is as follows

Eruption Patterns

Teeth tend to erupt in pairs

Lower teeth usually erupt before the upper teeth

Girls generally preceded boys in tooth eruption

The teeth in both jaws usually erupt in pairs - one on the right and one on the left.

By the time the child reaches the age of two to three years, all the deciduous (baby) teeth should have erupted.

 

Eruption Dates for Baby Teeth

Tooth	Lower	Upper
Central Incisor	6 1/2 months	7 1/2 months
Lateral Incisor	7 months	8 months
First Molar	12 - 16 months	12 - 16 months
Canine	16 - 20 months	16 - 20 months
Second Molar	20 - 30 months	20 - 30 months

Permanent Teeth

At about 6 years of age, the first permanent molars (upper and lower) and lower permanent incisors begin to erupt. Between the age of approximately 6 and 12 years, children have a mixture of permanent and deciduous teeth. This is known as the mixed dentition stage. By the age of 12 most children have all their permanent teeth, except for their wisdom teeth.

Eruption Dates for Permanent Teeth

Tooth	Lower	Upper
Central Incisor	6 - 7 years	7 - 8 years
Lateral Incisor	7 - 8 years	8 - 9 years
Canine	9 - 10 years	11 - 12 years
1st Premolar	10 - 12 years	10 -11 years
2nd Premolar	11 - 12 years	10 - 12 years
1st Molar	6 - 7 years	6 - 7 years
2nd Molar	11 - 13 years	12 - 13 years
3rd Molar	17 - 21 years	17 - 21 years

Development of Baby Teeth

Calcification begins during the fourth month of fetal life. By the end of the sixth month, all of the deciduous teeth have begun to calcify. By the time the deciduous teeth have fully erupted (2 to 2 1/2 years of age), calcification of the permanent crowns has begun.

A Little on the Importance of Baby Teeth...

As a rule, baby teeth that become decayed should be restored and preserved until their normal time of exfoliation. Though the issue of cost is relevant (baby teeth are temporary), they’re all your child has to chew with, speak with, and smile with for a number of years. They play an important role in their social development. The deciduous second molars are particularly important. It is imperative that the deciduous second molars be preserved until their normal time of exfoliation. This prevents the mesial migration of the first permanent molars.