Do you swear to tell the tooth?


What’s the big deal with baby teeth?

Baby teeth come with many names. Milk, deciduous, primary  all mean the same set of teeth. The teething guidelines below, vary with every child. Some kids will be later than these posted ages and some with be way ahead and have a full mouth of chompers by their first birthday. I’ve seen 9 year old children with all of their permanent dentition with the exception of wisdom teeth. (I can’t help but think the trickle down effect of the foods we eat plays a major role in the eruption of kids teeth today. All those hormone infused foods have an end point don’t they?)teething chart.png

You may be thinking, kids lose these first teeth so what’s the big deal about taking care of them?

  • S/he doesn’t like it when I brush her/his teeth. So? Get in there and do it. You can make brushing fun. If they start screaming and crying, well, you have better visibility now don’t you?
  • Who cares if they get a cavity? Pull it out. That’s an easy and cheaper fix than having a filling done. No, be responsible and get the tooth repaired. Cavities hurt, can make eating painful and also give nasty breath. Do you really want those things for your precious little one? (Please don’t threaten your child with a trip to the dentist if they don’t behave. This does not serve any purpose other than vilify the people who are there to help. Dental environments can be scary enough on their own, with the weird smells and sounds, without a parent filling a little mind with terrifying images.) Decay in a baby tooth can also affect the permanent tooth waiting to erupt.
  • What if a tooth gets knocked out? Another tooth will grow in to replace it right? Well, yes and no.

Yes. In the right circumstances, an adult or permanent tooth will take the place of the shed baby tooth. If you are lucky, it erupts into the correct position in the mouth. Hooray!

No. Sometimes Mother Nature throws a curveball your way and simply does not form an adult tooth under a baby tooth. Seek the opinion of an Orthodontist. Not a general dentist who also does braces. You want a specialist for this job. This may involve having the baby tooth removed and spaces closed or keeping the primary tooth as long as possible and preparing for a dental implant once growth is complete.

Yes. The permanent tooth will erupt either in front of or behind the baby tooth providing you with a shark-look (rows of teeth). This could possibly lead to some crowding out of the adult teeth. You may need the baby teeth removed to help with this scenario.


No. There may very well be an adult tooth lurking under the gums, but for some reason, it has decided to grow in a different location. (picture Bugs Bunny tunnelling underground and arriving inthe middle of a bullfight, expecting to find himself at Pismo Beach, “I knew I shoulda taken a left turn at Albuquerque”)


Teeth can be impacted in the roof of the mouth, causing damage to the roots of the surrounding teeth. Sometimes, teeth can fuse themselves to the jawbone and will not move up and into occlusion. This is called an ankylosed tooth. These cases are best handled by an Orthodontist as well.


Mother Nature designed our baby teeth to act as guides for the permanent teeth. In an ideal world, the adult tooth erupts directly below the baby tooth causing the root to resorb. As the permanent tooth moves toward the gum line, the baby tooth becomes loose and is shed. The adult tooth shouldn’t be far behind the baby tooth falling out. If a baby tooth is lost prematurely, (many a trampoline can boast of claiming a tooth or two) it is important to preserve that space to prevent a loss of arch length and the subsequent crowding. You may be thinking the holding appliance the dentist recommends is just a money grab. No, it’s not. Holding appliances serve a great purpose and not just to pad a wallet. They maintain the space to allow the permanent tooth the best chance to erupt where it is supposed to. (think of saving a place in line at the movies for your friend)

Both the Canadian and American Orthodontic Associations recommend an early assessment by a certified Orthodontist around age 7.

  • Why see them so young? Some bite issues and habits can be corrected and modified during a child’s growth.
  • Why an Orthodontist and not my regular dentist? These women and men have had several years of education and training, specific to orthodontics, in addition to their regular dental degree.

Initial consultations may involve a Panorex x-ray. Regular bite-wing x-rays (the ones taken at the check-up and cleaning appointment) do not provide all the necessary information about what is happening in your child’s mouth. This image is a fantastic diagnostic tool to alert you of missing teeth, extra teeth (yes, that can happen) ankylosed and impacted teeth.

We’ll chat more about teeth and how they fit together another time.



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