Oral exam: Caring for baby's teeth

Study up
Did you know that your baby’s teeth have been forming since her fifth month in the womb? In fact, it’s rare but not unheard of for a baby to be born with a tooth already showing! Typically, though, teething begins a few months after birth, and baby’s pearly whites make their first appearance when she’s about 6 months old. When the teeth begin to emerge, they often appear in symmetrical pairs. The bottom two front teeth are generally the first to debut, followed by their counterparts on top, which often emerge between months 8 and 13. From there, baby will add more incisors to the count, followed by molars, until she finally has her full set of 20 primary teeth by age 3.
What does it mean if baby cuts teeth earlier or later than average? Probably not much. Some babies exhibit teething symptoms for months before the first tooth pops up; others seem to sprout chompers overnight without much pain or fuss. Either way, it’s nothing to worry about. Check with your doctor or pediatric dentist if you have particular concerns, but don’t let yourself lose sleep if the other tots in the playgroup look toothier than yours. In fact, a late teether can mean more comfortable nursing and fewer chewed-up knickknacks, so count your blessings!
Come prepared
Every mother aches when she sees her baby in pain for the first time, but if you’re ready to handle it, the suffering doesn’t have to last for long. For starters, stock up on pain relievers and teethers even before baby starts to show signs of teething. (It’s actually a good idea to register for these items and build your supply before baby arrives and all chaos breaks loose.) Because different babies will prefer different types of teethers—and it never hurts to have options—select several varieties. Frozen teethers are perfect for cooling inflamed gums, wooden teethers are extra firm for applying pressure, and cloth teethers are satisfyingly chewy and sometimes absorbent. If you’re ever out and about and caught without, letting baby chew on a damp washcloth or rubbing a clean finger along her gums can also do the trick.
When the pain goes beyond mild inflammation, it’s helpful to have a topical anesthetic such as Baby Orajel on hand, but call your doctor first to discuss how often this gel can be used. More intense pain or fever can be treated with baby-grade ibuprofen (Advil) or acetaminophen (Tylenol) after your doctor gives you the go-ahead. Remember that aspirin is not recommended for anyone under age 20; its use has been linked to Reye’s syndrome, a rare but serious disease.
Ace the test
Your baby may show early signs of teething weeks or months before she cuts her first tooth. Look for excessive drooling and gnawing on fingers, toys, clothing or anything else within reach. Irritability and restless behavior at night often hint that a tooth will be breaking through in the next few days. As teeth push up through the gums, causing sensitivity and inflammation, you’ll likely notice redness and puffiness. Fever and diarrhea are often attributed to teething, but recent studies show that these symptoms are sometimes coincidental illnesses not linked to—or caused by—teething.
When you’ve identified the symptoms, start with your first line of defense: teething toys. As the teeth get closer to the surface and toys cease to do the trick (this could be hours, days or weeks later), turn to your topical treatment, then move on to baby Tylenol or Advil as a last resort. (Of course, make sure your baby’s feeding, napping and diapering needs are met before you attribute her cries to teething!)
As baby’s teeth do at last begin to appear, don’t delay early dental care. It’s important to take good care of those primary teeth from day one and avoid problems later on. Clean baby’s teeth (or tooth) once or twice a day using water and a baby toothbrush, finger brush or washcloth. Massage gently over the teeth and gums in a circular motion. Infant toothpaste is OK but not mandatory; save the fluoride toothpaste until age 2 or 3.
Remember, even if you’re completely on top of baby’s dental hygiene, it’s still important to get a professional involved by the time baby turns 1. William C. Berlocher, DDS, MA, President of the American Academy of Pediatric Dentistry (AAPD), describes baby’s first dental appointment as an “informational visit”—a chance for parents to learn how to keep their baby’s mouth healthy and for the dentist to get a first look at baby’s oral development. In addition, Berlocher says, “Studies have clearly indicated that in some areas of the U.S. almost 30 percent of children ages 2 to 5 will already have dental cavities. The age 1 dental visit … allows the dentist to employ effective measures to prevent any cavities that might develop.” So get your baby in for a visit—she’ll thank you later.