Oral and Dental Diseases

Milk Teeth


  • They are the first set of teeth to appear in a baby. There is 20 of them.
  • It is important to understand the teething phase to make it as easy as possible for the baby. 
  • Most common milk teeth problems: tooth decay, pain, infection, thumb sucking and long-term use of pacifiers.
  • Injuries to the baby's face and teeth may affect the permanent teeth that will replace the affected milk teeth.
  • You must follow the correct instructions to care for the health of your child's mouth. 

What are milk teeth?
It is the first set of teeth that a baby gets. They eventually fall out and get replaced by permanent teeth.

Teeth number: 20 teeth

Other names: Baby teeth, temporary teeth, primary teeth, milk teeth

What is the importance of milk teeth?
  • They help babies chew food 
  • They help with proper speech and vocalization
  • Milk teeth occupy space in the jaws to allow the permanent teeth to come out in their correct places. If a child loses a milk tooth too early, this may affect the shape and arrangement of the permanent tooth that will replace it.
  • Milk teeth give children self-confidence and a good-looking smile.

When do milk teeth develop and fall out?  
Milk teeth develop gradually, starting at the age of 6-7 months. The lower incisors grow first until they erupt at the age of two and a half years.

Milk teeth eruption (teething): 
It is the process when teeth break through the gum line in a child. It is usually a stressful time for the child and parents, so it is important to learn as much as possible about this stage and make it a less painful experience for the child.
Teething symptoms: 
Sleep disturbances
Anxiety and discomfort
Loss of appetite
More drooling than usual
Constant need to bite and chew on things
Swelling and redness of the gums, especially where the teeth are erupting

When to see a doctor?
  • In the case of: 
  • Fever
  • Diarrhea
  • Skin rash

Common milk teeth problems: 
  • Tooth decay: A bacterial disease that results from the interaction of some types of bacteria with sugars in food, causing the formation of acids. Over time, these acids cause tooth decay.
  • Tooth decay is one of the most common dental problems, especially in children.
  • Baby bottle tooth decay: It is a type of early childhood tooth decay, and most often begins in the upper front teeth, but can also affect other teeth. 

  • Frequent and long-term exposure of a child's teeth to liquids containing sugars. One of the most popular ways this happens is using the baby bottle to get the baby to sleep or using it instead of a pacifier to sooth an anxious baby. 
  • The decay-causing bacteria can be transmitted through saliva. It may pass from mother to baby when they share the same spoon to eat or when another baby’s pacifier or bottle is used.
  • Baby does not receive enough fluoride to help protect their teeth from tooth decay. 

  • Immediately clean your baby's pacifier or bottle and keep it away from reach of other children. 
  • Avoid sharing your spoon with the baby, especially if you have tooth decay. 
  • Thoroughly clean your baby’s gums before the eruption of milk teeth using a wet cloth. And gently rub their gums after they are finished getting their milk. 
  • Once milk teeth erupt, use a soft brush or a wet clean cloth to clean them, especially after meals. 
  • Once your baby turns 1, you should start brushing their teeth using a fluoride toothpaste and an amount as small as a rice grain. This amount can increase to be pea-sized as the child turns 3. Make sure your child doesn't ingest too much toothpaste by wiping their teeth if they cannot spit it out. 
  • Avoid using the milk bottle for any other drinks (e.g. Juice, other sweet drinks, etc).
  • Make sure your baby gets their milk before sleep so you have enough time to clean their teeth. 
  • Avoid applying foods or other materials on your baby’s pacifier (e.g. Honey). 
  • Encourage your child to use cups to drink liquids once they turn 1. 
  • Encourage your child to adopt healthy eating habits (e.g. eating vegetables and fruits, eating at regular times, reducing consumption of sugar, etc.)

Pain and Infection (abscess):  
It is a cyst of pus that causes a bacterial infection and inflammation of the root of a tooth.

A tooth abscess occurs when bacteria invade the pulp of the tooth (the innermost part of the tooth that contains blood vessels, nerves and tissue) as a result of neglected tooth decay. 

  • Severe and persistent toothache that may spread to the jawbone, neck or ears.
  • Teeth sensitivity to hot and cold foods. 
  • Teeth sensitivity to any pressure resulting from chewing or biting.
  • Fever.
  • Swelling in the face or cheek. 
  • Swollen lymph nodes under the jaws or in the neck.
  • Sudden foul taste and smell of the mouth.

  • Risk factors:
  • Neglecting dental hygiene 
  • Not treating tooth decay

  • The abscess spreading to the jaw and other areas in the face and neck. 
  • Neglecting this problem can cause infection and sepsis, a serious condition that may spread throughout the entire body.
  • If a person has a weak immune system, the risk of infection and its spread in the body may increase.

  • Clean teeth at least twice a day using fluoride toothpaste. 
  • Floss teeth once a day. 
  • Replace toothbrush every 3-4 months or whenever the bristles seem damaged. 
  • Eat healthy food, limit sugar intake and snacks between meals.
  • Get regular check-ups by the dentist. 

Thumb sucking and long-term use of pacifiers:
Thumb sucking is natural in children. Children sucking their thumbs or other objects is a habit that makes them feel happy and secure. It is also one of the ways they explore their surroundings. It also helps keep them calm and fall asleep more easily.  

Effect of sucking thumbs or pacifiers on teeth: 
  • When a child sucks their thumb after their permanent teeth erupt, this can affect proper teeth development and alignment, as it may affect the shape of the roof of the mouth (palate).
  • Pacifiers have the same effect as thumb sucking on teeth but is easier to get rid of as a habit.
  • The effect of this habit on the child’s teeth varies according to their sucking force. When a child puts his thumb or pacifier inside their mouth without sucking on it, they are much less likely to have oral and dental problems, unlike children who suck their thumbs with more force. The greater the intensity and duration of sucking, the greater the damage.

  • When do children stop thumb sucking?
    • This habit usually stops when permanent teeth erupt. If it continues, take your child to a dentist.
  • When to see a doctor?
    • When you notice problems or changes with permanent teeth. 
  • How can you help your child stop this habit?
    • Praise your child when they stop the habit. 
    • Recognize the things that cause your child to become anxious or scared and keep them away from them. Children usually resort to sucking their thumbs when they are worried or scared. 
    • Give your child the chance to choose the way they’re most comfortable with to stop sucking their thumb. 
    • Have the dentist explain to your child the harms of this habit and the advantages of stopping it to motivate them. 
    • Have your child wear gloves when sleeping and remind them to take their thumb out of their mouth when they do it (while avoiding saying it loudly or in front of other people). 

Reducing teething pain: 
  • Dry the drool: the skin around the mouth, particularly the chin area, can become irritated. Gently wipe this away with a soft cloth throughout the day.
  • Massage – gently massage the gum with clean fingers or a soft, wet cloth, and ensure everything your child gets into their mouth is clean.
  • Chilled (not frozen) teething rings or rusks – pressure from a cold object can relieve discomfort from teething (For example, you can wet a cloth and put it in the freezer for 30 minutes or an hour before it is frozen to avoid hurting the gums). Ensure the size of the object is too big to be swallowed to avoid choking hazard. Give your child foods they can chew on, and break them into smaller pieces first (e.g. Bits of biscuits). Thoroughly clean the objects you give your child or dispose of it after use. 
  • Rubber teething necklaces are a good option for relieving teething pain. Avoid buying ones that have liquids inside as they can be torn and can leak. 
  • Before giving a teething necklace to your child, put it in the fridge. Avoid putting it in boiling water to clean it. Temperatures that are too high or too low can damage the plastic and lead to a leakage of the materials inside. 
  • Teething biscuits or cold solid foods (such as carrots or cucumbers) should only be used when the child starts eating this type of food (usually when they’re older than 6 months). Your child should be monitored while eating these foods to prevent choking.  
  • If your child is older than 6 months of age and is very anxious or finds it difficult to sleep due to teething, ask the doctor about special painkillers for children to relieve the pain, while ensuring you adhere to the prescribed dosage.
  • Avoid rubbing your child's gums with aspirin tablets or anything that may contain alcohol or fragrance.
  • ​Avoid tying the rubber teething ring around your child's neck or any other area of their body. It could get stuck to another object around and suffocate your child or bruise their body.
  • Avoid amber teething necklaces (they look like a rosary). There is a risk of suffocation or choking on its beads in case of breakage.
  • Avoid using teething gels without prescription. They may be unsafe for your child. 

How to care for milk teeth?
  • Starting from a few days after birth to the age of 14 months, you can start cleaning your child’s gums using a wet cloth. Gently wipe their gums after drinking milk, especially if they're drinking formula milk, as it increases the rate of tooth decay when milk teeth erupt.
  • Take your child for regular check-ups at the dentist's from the time their teeth erupt (before the age of 2).  
  • Train your child to use a toothbrush and toothpaste (from the age of 3). Early adoption of this habit makes it easier to care for permanent teeth when they erupt.  
  • Your child will need your help at an early stage to brush their teeth properly and reach tricky areas. 
  • Ensure your child doesn’t swallow toothpaste and make sure they learn to avoid it.
  • Until your child begins to brush their teeth correctly using the proper amount of toothpaste, you must monitor and help them with the brushing.

Milk teeth injuries: 
When your child begins moving around and exploring their surroundings, injuries are bound to happen (e.g. falling and bumping into furniture), which may cause some harm to the face and teeth area. When milk teeth are injured at that age, permanent teeth that will erupt later can be affected. Such injuries can also cause teeth fractures, deep implantation into the jawbone, partial displacement, or complete loss of a tooth.

To protect your child from these injuries, follow the instructions below: 
  • Avoid baby walkers (walkers without seats). 
  • Do not let your child use skateboards or go cycling without wearing protective equipment (helmet, mouth guards, etc.).
  • Teach your child the importance of: 
    • Teeth and caring for them. It is especially important to teach them to avoid throwing heavy tools or jostle in crowds to avoid injuries to the face, especially the mouth. 
    • Paying attention while playing games or doing sports (especially sports that require quick movement, like running, jumping, etc). This is especially important if they're running on uneven or slippery ground, or in unstable weather conditions (e.g rain, dust, etc). 
    • Sitting still on a swing and not jumping when it’s moving. 
    • Using pool ladders to get out of pools.

  • Is it safe to use a numbing gel or pills for teething children? 
    • Do not use them for children under the age ​of 2 unless the doctor says otherwise. 
  • Does breastfeeding reduce the risk of tooth decay in children? 
    • Breastfeeding as the only source of food for a child can red​uce tooth decay because the amount of sugar found in breast milk is less than the amount found in formula.

Myths & Truths
  • Myth: Some parents believe that milk teeth are not important because they will eventually be replaced by permanent teeth.
    • Truth: Milk teeth are important in early childhood for the aforementioned reasons. When they fall out too early, permanent teeth can be affected as follows: 
      • There won't be enough space for permanent teeth and this means that braces may be needed in the future. 
      • Permanent teeth erupt too late. 
      • Child’s mental health is affected. 
  • Myth: Breastfeeding does not cause tooth decay. 
    • Truth: Although breastfeeding is very useful for the health and development of a child, taking care of and cleaning your child's mouth and teeth is important, even if your child drinks only breast milk. Tooth decay happens for various reasons. 
  • Myth: Using pacifiers causes teeth problems.  
    • Truth: Using pacifiers at a normal rate during the first two years of a child's life does not cause long-term dental problems. Long-term use of pacifiers can lead to problems with teeth alignment. 

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Last Update : 21 June 2021 05:29 PM
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