Frequently Asked Questions

When will my Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general the first baby teeth are usually the lower front (anterior) teeth and usually begin erupting between the age of 6-8 months.

When should I start brushing my baby’s teeth?
You should start cleaning your child’s teeth as soon as they appear. A small, pea-size dab of fluoride toothpaste can be used. On outer and inner surfaces of the teeth, place toothbrush at a 45-degree angle and start along gum line; use gentle, short, strokes against the gumline. On chewing surfaces, hold the brush flat and brush back and forth.

When should I floss my child’s teeth?
Flossing daily removes plaque and food particles between teeth and below the gumline. You should start flossing your child’s teeth even when they have only their primary teeth, especially their teeth have no or minimal space between them. You will have to help your young children to floss as many children do not have the manual dexterity of manipulate the floss.

Are x-rays safe?
Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow us to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you. We recommend radiographs and examinations every six months for children with a high risk of tooth decay. On average, most dental professionals request radiographs approximately once a year for moderate risk children, and once every 2 years for low risk children.

Pediatric dental professionals are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure. Many dental offices are utilizing digital x-rays that further reduce radiation by 50%

When do the first teeth erupt?
Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies. Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.

Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).

Why are baby teeth so important?
It is very important to maintain the health of the primary (baby) teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (canines and molars) aren’t replaced until age 10-13.

What should I do if my child is in pain?
Teething: Everyone is familiar with teething when the baby teeth erupt. Children will also get teething pain when the permanent first molars erupt (around 6 years of age) and when the 2nd permanent molars erupt (around 12 years of age). Non-steroidal anti-inflammatory medications help keep teething discomfort to a minimum.

Toothache: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. If the pain still exists, contact your child’s dentist. DO NOT place aspirin on the gum or on the aching tooth. To keep your child comfortable, pain relief may be sufficient until your child is able to see the dentist. If the face is swollen apply cold compresses and contact your dentist immediately.

Swollen, red gums, inability to eat: This is most commonly primary herpetic stomatitis, a viral infection that usually has a two week course. Contact your child’s dentist to verify the diagnosis. Keep your child hydrated with cool drinks, Popsicles and soft bland diet. Non-steroidal anti-inflammatory medications is usually sufficient to keep your child comfortable. If your child has a medical condition, your child’s dentist may also prescribe antiviral medications. Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to hospital emergency room.

What should I do if my child falls and knocks out a tooth?
The important thing is to remain calm. Find the tooth/fragments if possible.
Knocked Out Primary Tooth: Do not attempt to replant. Keep it light hearted and show your child enthusiasm that the tooth fairy will be coming early! Your child should still be seen by their dentist to assess any effects to neighbouring teeth.

Knocked Out Permanent Tooth: Find the tooth. Handle the tooth by the crown, not the root portion. You may rinse the tooth but DO NOT clean or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have your child hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing your child’s saliva or chilled milk. If your child is old enough, the tooth may also be carried in his/her mouth. Your child must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

Fractured Teeth: Find any tooth fragments. Check to see if there is any pulp exposure. Look for pink or red dots in the fractured area. Your child must see a dentist immediately particularly if it is a permanent tooth. If there is no pulp exposure, timing is not as crucial however your child’s teeth will be sensitive and should be seen by their dentist.

Is fluoride safe?
Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

  • Too much fluoridated toothpaste at an early age.
  • The inappropriate use of fluoride supplements.
  • Hidden sources of fluoride in the child’s diet.
  • Two and three year olds may not be able to spit out fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.
  • Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride-fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatric dentist. Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:
  • Use baby toothpaste on the toothbrush of the very young child.
  • Place only a pea sized drop of children’s toothpaste on the brush when brushing.
  • Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
  • Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.

How do I stop my child from grinding his teeth at night?
Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding when they develop more permanent teeth, between ages 9-12. If you suspect bruxism, discuss this with your pediatric dentist.

How do I get my child to stop thumb sucking?
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your dental professional.

A few suggestions to help your child get through thumb sucking:

  • Instead of scolding children for thumb sucking, praise them when they are not.
  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
  • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
  • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
  • Your dental professional can encourage children to stop sucking and explain what could happen if they continue.
  • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your dental professional may recommend the use of a mouth appliance.

Are Mouth Guards effective?

  • When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.
  • Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw and severe injury to the head (such as concussion). A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
  • Ask your dental professional about custom and store-bought mouth protectors.

How Do I Prevent Cavities?
Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water.

For older children, brush their teeth at least twice a day. Saliva is a buffer that helps prevent cavities. It is especially important to go to bed with clean teeth since salivary flow is reduced while sleeping. Also, watch the number of snacks containing sugar that you give your children.

The Australian Academy of Pediatric Dentistry recommends six month visits to the pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.

Your dental professional may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.


On Implants & Cosmetic Dentistry with Dr Saade.