By Astrid Van Den Broek
From the print edition, October 2011
After being sent to the dentist with her dad to investigate the mouth aches my six-year-old daughter was routinely complaining about, we had the answer. The culprit was her six-year molars (first permanent back molars). Weren’t we long done with teething issues, I wondered? As it turns out, no—and it’s just one of a few dental surprises your child may develop at this age. So we asked Dr. Clive Friedman, a London, Ont.-based pediatric dentist, and Dr. Leonard Smith, a Calgary-based pediatric dentist to, er, fill us in on other dental-related red flags to watch for.
As we discovered, the erupting of the first permanent back molars, or six-year molars, behind the last baby teeth can cause discomfort in some children. If pain is a problem, opt for a pain reliever such as acetaminophen or ibuprofen rather than a topical analgesic (numbing agent). “Those medicines are still drugs and oftentimes too much is used and children swallow it and then they get that freezing effect all the way down the throat,” says Dr. Smith. Cleaning these molars can also be an issue if a flap of tissue is still sitting on top of the tooth. Dr. Smith recommends using an irrigation syringe (available through your dentist) to squeeze water under the flap to clean out any food debris.
Has your six-year-old lost eight teeth already? Then your child is probably a girl. “In this age group, girls are generally ahead of boys in teeth coming into the mouth,” says Dr. Friedman. Keep in mind that if your child’s primary teeth erupted early it’s likely his permanent teeth will come in earlier too, notes Dr. Smith. But if you see your child’s permanent teeth coming up on the inside of the upper primary teeth, book an appointment with the dentist. If by chance your child does lose a baby back molar, he may need a space maintainer. “Teeth from the back shift forward,” says Dr. Smith. “So if your child loses his first baby molar to decay or another reason, you may need to maintain that space to allow for the alignment for the erupting permanent teeth.” And don’t fret about the colour of his permanent teeth, which may be shades of yellow to grey—primary teeth are usually lighter in colour.
Your child’s baby teeth may clue you in as to what their permanent teeth will look like. “If the baby teeth are spaced then there is a very good chance that the permanent teeth will come in straight,” says Dr. Friedman. “If they are crooked, the likelihood is very close to 100 percent that the permanent teeth will be crowded.” As for using braces to solve spacing problems, Dr. Friedman notes that many orthodontists prefer to wait until your child’s permanent teeth have erupted or close to erupted. “It’s often a personal preference for orthodontists. Because your child is still growing and their face is still growing, many orthodontists don’t like to get in until that growth is completed, so you know exactly what you’re dealing with.” However, he adds, there are some orthodontists who will start treatment at age six or seven, and in certain instances, this is a much better time.
Maybe your little Beckham likes to down sports drinks at half-time. Or maybe he enjoys the sticky Halloween treats that cling to teeth. The bacteria in our mouths love carbohydrates and can utilize them to produce acid that causes the calcium to leach out of the enamel and create cavities. This process of acid production can occur in 20 minutes or less following food consumption, says Dr. Friedman. The damage to the tooth depends on how long and how often food is in the mouth, not if it contains a lot of sugar. “In fact, items like bread, crackers and granola bars can be just as bad, if not worse than eating pure sugar,” says Dr. Friedman, who explains it is really about the oral clearance—the amount of time it takes for a food to enter into the esophagus once it has been introduced into the mouth—of the food source, rather than what’s in it. That’s why lollipops are the worst item for your child’s teeth, he says. Ideally, your child should brush after every meal, but once in the morning and just before bed will do. Remind your child to drink a glass of water after eating to help wash away some of the food from inside his mouth.