Justin Lay, M.D.

Teething and dental hygiene are frequently encountered topics in the Pediatric Office. In today’s article, we will discuss these topics and hopefully alleviate any fears or concerns associated with both tooth eruption and appropriate dental care. 

Let’s start at the beginning. Primary tooth eruption typically begins at 6-7 months of age. The first teeth to erupt are usually the lower central incisors followed by the upper incisors and then the molars. Teeth erupt at roughly the rate of one tooth per month (although unfortunately as most of you know, multiple teeth can erupt simultaneously) and your child should have 20 new teeth erupt over the next 2 years. Contrary to popular belief, teething does not directly lead to fever, diarrhea, or upper respiratory infections. Permanent teeth will typically begin showing up at around 6 years of age and will continue to erupt until your child’s mouth will eventually be filled with 32 permanent teeth. 

At tooth eruption, you should begin using fluoride toothpaste. The amount of fluoride toothpaste that you can use at this age should roughly equal a grain of rice. This regimen should be done 1-2 times daily and can continue until 3 years of age when you should increase the amount of fluoride toothpaste to a pea sized amount twice daily. Let your Pediatrician know if your local water source is not fluoridated (or is only partially fluoridated) and they can provide options on daily Fluoride supplementation after 6 months of age in an attempt to prevent dental caries (cavities). Surprisingly, your child is 5 times more likely to develop cavities than they are to have asthma. Also, roughly one quarter of all children aged 2-6 will develop dental caries. These numbers are staggering and are evidence of an ongoing epidemic of poor dental care in the United States. 

Like most childhood activities, brushing of the teeth needs to be a supervised activity and fluoride toothpaste should be kept in high cabinets as ingesting large amounts of fluoride can lead to a condition called fluorosis, where the teeth become white streaked. However, this concern should not deter you from brushing with fluoride toothpaste due to the benefits that fluoride has on overall oral health. Although there continues to be ongoing discussion about your child’s first dental visit, most experts in the dental and pediatric communities continue to recommend finding a dental home between 1-2 years of age. 

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