Shark Teeth

My child has two rows of front teeth. Is something wrong?

Well, yes and no. Yes, it needs to be addressed and no, your child is not really a baby shark! It looks strange and does often cause parents concern. I actually see this quite often. The baby teeth have not come out like they were supposed to - it is most common with the lower front teeth when the child is six years old.

In the normal course of events, the permanent tooth slowly dissolves the root of the primary tooth as it comes up underneath. Eventually, there is not much root left, the baby tooth gets loose and falls out. The permanent tooth then comes in where the baby tooth used to be. Well, it just doesn't always happen like that.

If the child doesn't have enough room for the permanent teeth, then the permanent tooth may not come in right up under the baby tooth. Even when there is lots of room, the new tooth may not be able to resorb the baby tooth root fast enough. It then takes the path of least resistance, which is to come in behind the baby tooth. That means there is nothing "pushing" the baby tooth and there may be quite a lot of primary root left.

The good news is the permanent tooth will tend to move forward into the correct position on it's own IF there is nothing in the way and there is enough room. A lot of parents hold out hoping the baby tooth will fall out on it's own. Some children are very aggressive in wiggling their teeth. Some just let them hang there! This can create a not so nice plaque trap, which leads to red and irritated gum tissue.

Often the retained baby teeth need to be taken out. This may involve making more room by removing the adjacent baby teeth or making the baby teeth more slender by "disking" them. If the new tooth hasn't come in very much (you haven't waited too long), then the new tooth will slowly move forward. This takes a few weeks or months. The tongue is a strong muscle and with the pressure it applies you may be surprised how quickly these teeth move into a better position!

Independent Brushing

My toddler wants to brush her own teeth, what do I do?

There is one very important point to be made here. No matter how talented your toddler is, they cannot EFFECTIVELY brush their teeth by themselves. Children don’t develop the muscular control and skill required for good brushing until sometime between the ages of 5 and 7. Until then they need your physical help each and every time.

That being said, start with your toddler modeling you as you brush your teeth. At this stage of the game most little ones want be just like mommy and daddy. Give your toddler their own toothbrush dampened with water and just a touch of toothpaste. They will do more sucking than brushing so reserve that small pea sized amount of fluoridated toothpaste for the time that you are actually doing the cleaning. Using a team approach is a win for both of you. Decide with your toddler if they are going to brush first or second. This gives them the freedom to choose and you the control of a thorough brushing.

A good way to get all of the tooth surfaces clean is the “AAHHSS” and the “EEEES” method. Have your toddler open wide and say “AAHHHHH” to get the top surfaces and insides of the teeth. To brush the sides of the teeth ask your toddler to bite together and say “EEEEEEE”. This loosens up the cheek musculature and allows you effectively clean the outsides of the teeth.

Now for the fun part! Perhaps your toddler wants nothing to do with you brushing their teeth. I remember my oldest daughter, Olivia often (actually quite often) having a fit at brushing time. I was a tired young mother trying to talk her into opening her mouth. Well that got me zippo and so yes, I would hold her down to brush and yes we both survived.

As a professional I understood that the mouth is a personal space. As a mom all I wanted was to avoid a battle with my daughter. What I believe and what I tell parents is all you can do is your best. You know that you love your child. You know that brushing in the morning and evening is important. However, you get to pick your battles and if you miss a night of brushing once in awhile it won’t be the end of the world.

I promise both you and your child will make it though this challenge. I like the analogy of putting an uncooperative toddler in a car seat. Just because they don’t want to do it doesn’t mean you don’t give them a gentle push and buckle them up! Remember, I had a very strong willed toddler and brushing was a battle. She is now 14, brushes her teeth regularly and is not traumatized by “my mommy loves you method!” Happy Brushing!

To Seal or Not to Seal?

My dentist suggested sealants on my child’s teeth. What are they & are they really necessary?

Great question! As a mom and dentist I believe that all options that will help prevent cavities are worth learning more about. The chewing surface of your child’s permanent teeth are covered with deep grooves (referred to as pits and fissures). Food particles accumulate in these grooves, come in contact with bacteria and lactic acid is released. This lactic acid destroys tooth enamel which leads to cavities.

A sealant is a protective coating between the lactic acids and the tooth enamel.
Sealants themselves are a polymer resin brushed on the chewing surface of your child’s teeth. They are bonded to the surface of teeth with an ultra violet light. Sealants are preventive dentistry for the biting surfaces of teeth. They are painless and easy to apply.

Are sealants necessary? Let me put it this way. Removing an appendix is necessary. Sealants are a choice. However, I strongly I they are a benefit. I chose to place them on all four of my own children’s teeth. I have seen too many unprotected teeth come in without sealants and in place are big cavities!