Getting to Know You. Babies love to suck and there are no teeth yet. It is a beautiful time to get to know your child’s mouth, watch the development of the teeth, and learn how to look around in that dark space. With the child cradled in your arms or lap, let her/him suck your finger in to her/his mouth. Gently pull your finger sideways into the cheek area and gently massage the gums on the cheek side. This massage feels good. As you do this more, each day she/he will allow you to massage the gums a little farther so soon you will be able to massage the gums all the way around the sides and front of the mouth. Your child will come to enjoy this as a part of cuddle and tickle time.
Over a period of days and weeks you will become comfortable lifting the cheeks and lips away so you can see the ridge of gums where teeth will be developing. You will find you can slip your finger under the tongue and hold it left of right to see under there. This all can be done as massaging movements that your child will enjoy. She/He may start playing tongue games with your finger. After all, the child’s tongue is one of her/his primary tools in discovering the world. Just wait until they are agile enough to put things in their mouth and taste their way through the world.
This little technique will be handy for a lifetime with your children. There will be numerous occasions over the years when you will want a good look around their mouth, whether it is to check their toothbrushing, evaluate a trauma or look at something your child feels that is different. You have learned gentle ways to get the cheeks, lips and tongue out of the way to take a good look.
It is also fascinating to watch the bulges grow in the gum ridge as teeth develop and eventually emerge as tiny pearly white teeth.
Teeth! During this time the 8 front teeth (4 upper & 4 lower) will emerge. The first tooth may show as early as 4 months, typically shows between 6 – 10 months, and may not show until 14 months. However, by now you have been watching the little bulges develop under the gums so if they are late, you can relax and wait.
These teeth are pretty easy to wipe clean with a washcloth, towel, gauze or something similar. A tooth brush is OK if you like, but the child at this age still sucks her/his lips around such things, making them hard to manipulate. There is a very effective rubber toothbrush sleeve that slips on your finger that can be incorporated into your mouth massage. The kids “usually” like this.
The most common issue that results in cavities starting on these teeth is food/milk/formula trapping in the curved indent of the backside of the upper front teeth. The curve of the teeth and the slight bulge of the gums behind create a significant tiny pocket where bacteria and food collect. Cleaning efforts should include a distinct effort to clean this area. A sideways rubbing of the cloth or brush is typically most effective. This is one of the prime areas your dentist/hygienist will check at your child’s first well baby dental exam at age 1.
That curve behind the upper teeth is also the place where milk or formula will collect when the child goes to sleep and the protective saliva flow stops. If your child is falling asleep with a bottle of nutrition in her/his mouth and teeth are present, it is critically important to wipe these teeth clean so there is no food trapped in that curved pocket behind the teeth causing a cavity. Ideally, any container in bed should have only water! Cavities behind the upper front teeth can grow large enough to penetrate the nerve of the tooth and cause an abscess even though you cannot see the cavity from the front.
Milk, formula or water in the bottle only. DO NOT start your child on juice in bottles, sippy cups or anything else. If your pediatrician is treating a medical problem and prescribes juice for medical reasons, OK. And only under those circumstances. There is no place for juice in a child’s nutritional balance. The medical and dental risks of juice and other sweet beverages in a child’s diet are explained in multiple other places in this website and in brochures in your medical and dental offices.
Molars. Most children will skip the next tooth space and grow their 1st molars next. Though these can be cleaned with the washcloth in the early months too, the kids have begun to realize they can and want to mimic you so they recognize about now that the toothbrush is the appropriate tool. I still recommend you do this in your lap with a plain toothbrush (no toothpaste). You have learned to see the mouth completely in this lap or arm cradle position. You will find it easy to see as you brush the back teeth, especially upper teeth, which are nearly impossible to see if the child is standing in the bathroom. The brush is what does the cleaning and toothpaste is not necessary.
In the bathroom, your child will want to brush alongside you, mimicking what you do. That is how they learn. So, in the bathroom give them their toothbrush with a small pea size of baby gel toothpaste on it and let them start practicing. The actual cleaning will be getting done at cuddle time where you have developed a very efficient use of a few seconds of your time. So other than the playful times helping them learn to handle a mouth full of foam, or spitting (actually into the sink…), you have no oral health responsibility in the bathroom as they learn from you by mimicking and having fun.
After the molars have grown in, the cuspids (sharp little fangs) will emerge to fill the space between the molars and front teeth. Typically 16 to 20 months. Please be aware, teeth have a mind of their own and will grow according their own rhythm. We have not been able to correlate the tooth growth rate with any other of the growing “systems” in the body. The sequence is also unique so if the teeth are emerging in a different order than you interpret from this or other sources, don’t worry about the sequence.