| Teeth at Birth?
Soon after an infant is born, a physician or nurse practitioner thoroughly examines his or her body, including the mouth. Most of the time a baby's gums, tongue and soft palate are normally developed and ready for action. But sometimes there are harmless variations that may surprise some parents. - Epstein's pearls — These small, white, pearl-like spots appear on the roof of the mouth. These bumps are harmless and tend to disappear within a few weeks.
- Bohn's nodules — These small, whitish bumps or cysts look like Epstein's pearls, but they develop on the sides of the gum ridge rather than the roof of the mouth.
- Inclusion cysts — These small bumps appear along the crest of the gum ridge. They are harmless.
- Natal and neonatal teeth — Some infants are born with one or more teeth, called natal teeth. Some babies have teeth emerge into the mouth within the first 30 days of life. These are called neonatal teeth. Because these are primary (baby) teeth, not extra teeth, it is a good idea to keep them if possible. However, natal or neonatal teeth may have to be removed if they are at risk of becoming detached, interfere with feeding or significantly irritate the tongue or lip.
Caring for Your Infant's Mouth
Just because your baby doesn't have teeth yet doesn't mean that you shouldn't clean his or her mouth. As soon as your baby is born, it is a good idea to get in the habit of cleaning his or her gums. Although there may be a little fussing at first, your infant will get used to having his or her mouth cleaned like other parts of the body. Many children grow to enjoy toothbrushing as part of their daily routine. To clean your baby's mouth: - Lay your infant in your lap with his or her head close to your chest so you can look down directly into your child's mouth.
- Clean the gums and the teeth — when they arrive — by rubbing a clean, damp, washcloth along the baby's upper and lower gums. You can also use terrycloth finger cots, which fit over the finger and are made for this purpose. They are sold in many drugstores.
- Do this at least twice a day — once after breakfast and once after the last feeding of the day. You can continue using cloth or switch to a soft-bristled, infant-sized toothbrush after teeth first come into the mouth. By the time the molars (back teeth) first appear around age 1, it is best to use a toothbrush all the time.
Teething
Between 3 and 9 months, your infant's baby teeth will begin to erupt (emerge into the mouth), starting with the lower two front teeth (incisors). While the timing varies considerably among children, the order and symmetry is very predictable. After the four incisors come in on both the lower and upper jaw, the first molars erupt, followed by canines (eye teeth) and then the second molars further back in the mouth. Most children have a full set of 20 baby teeth by age 2½ or 3. The time when a baby's primary teeth begin to emerge into the mouth can go by almost unnoticed or can be stressful for parents and children alike. Teething may make your child irritable or fussy and may cause restlessness, drooling or loss of appetite. However, teething has not been shown to be responsible for other childhood symptoms such as fever, vomiting or diarrhea. You can ease your child's teething discomfort by: - Giving him or her a hard or frozen teething ring to chew on
- Applying pressure over the gums by rubbing them with a clean finger
- Using a small dab of an over-the-counter teething gel (following the manufacturer's instructions) to temporarily numb the gums
Sucking Habits
It is completely normal and healthy for your baby or young child to suck on a thumb, finger or pacifier. It's not something you need to be alarmed about or discourage. Sucking is a natural reflex and something he or she did in the womb. Children usually give up sucking habits on their own by the time they are 4 to 5 years old. If they stop the habit at this age, the shape of the jaw is usually not affected and the teeth grow in normally. However, some children find the sucking habit hard to break. Children who are still sucking on a pacifier, finger or thumb when their permanent (adult) teeth start to come in are more likely to have bite problems. Sucking can cause: - The top front teeth to slant out
- The bottom front teeth to tilt in
- The upper and lower jaws to be misaligned
- The roof of the mouth to be narrowed
The amount of distortion caused by sucking depends on the intensity, frequency and duration, as well as the object that the child is sucking on. To help an older child break a sucking habit, it is important to explain clearly why the habit can be harmful, to be supportive and encouraging and to provide positive acknowledgment of efforts to end the habit. If the child sucks a finger or pacifier because of a stressful situation, it can be very helpful to address the source of the stress. When needed, dentists can provide appliances that correct distortions created by the sucking habit and help the child stop the habit. Here are a few ways parents can encourage their child to quit sucking a finger or thumb. - Use positive reinforcement.
- Track progress by noting every successful day using a sticker or star on a chart.
- Put an adhesive bandage (Band-Aid and other brands) on the finger as a reminder or have your child wear a mitten when sleeping.
- Take the finger out of your child's mouth after he or she falls asleep.
Pacifier Tips
If your child uses a pacifier, make sure it is always used safely. Never fasten a pacifier on a string or necklace around your child's neck; your child could accidentally be strangled. Choose a pacifier that: - Is one piece rather than several parts
- Has ventilating holes on the sides
- Is large enough so that your child can't swallow it
- Is made of a flexible, nontoxic material
- Has a handle that is easy to grasp
Always check the pacifier before giving it to your child. Make sure there are no tears. If there are, replace it. Never dip a pacifier in honey or any other sweet substance before giving it to your baby. This could lead to serious tooth decay. ©2002-2005 Aetna, Inc. All rights reserved.
Reviewed by the faculty of Columbia University College of Dental Medicine | 
