They always cut the bottom two incisors first so just feel the bottom
ridge of gums with your finger and you will feel the sharp teeth. The
swellings come and go and does not indicate the teeth are coming in.
The next teeth are usually the top center two incisors but 5% of the time
they cut the outside two incisors and looks like fangs. Those are not
the canine eye teeth.
No not lay them in bed with a bottle or sippy cup of milk
or juice or this will happen. It can occur also with frequent breast
feeding in the night.
can cause methemaglobinemia. Methemaglobinemia is a change in the hemoglobin
molecule of the red blood cell causing it to not deliver oxygen to the
body. Signs and symptoms of methemoglobinemia (methemoglobin >1%) include
shortness of breath, cyanosis, mental status changes (~50%), headache,
fatigue, exercise intolerance, dizziness and loss of consciousness. Severe
methemoglobinemia >50% patients have irregular heartbeats, seizures, coma
and death (>70%). Medications that can cause this are: antibiotics (trimethoprim,
sulfonamides and dapsone), local anesthetics (especially articaine and
prilocaine), and others such as aniline dyes, metoclopramide, chlorates and
bromates. Ingestion of compounds containing nitrates such as bismuth nitrate
can also cause methemoglobinemia. Benzocaine applied to the gums or throat
(as commonly used in baby teething gels).
teething gels sparingly and infrequently like once or twice a day. I do
not recommend teething tablets. Just use Tylenol and if in a lot of pain,
it may not be the teeth causing all the crying. See:
Warnings from FDA on Teething Tablets.
"Our research has shown that permanent damage to the tooth
enamel will occur within the first 30 seconds of high acidity coming into
contact with the teeth. This is an important finding and it suggests that
such drinks high acidity levels in soft drinks, fruit juice and sports
beverages pose a threat to youngsters' teeth are best avoided," study
corresponding author Dr. Sarbin Ranjitkar, of the Craniofacial Biology
Research Group at the University of Adelaide in Australia, said in a
university news release. "If high acidity drinks are consumed, it is not
simply a matter of having a child clean their teeth an hour or 30 minutes
later and hoping they'll be OK -- the damage is already done," he added.
The findings were recently published in the Journal of Dentistry.
Triclosan was in the news recently with concerns about it
affecting the endocrine system of our body. The research is borderline and
controversial with some suggesting it does and some suggesting it does not.
I am not convinced either way but using toothpaste without it will not
greatly change the effectiveness of the toothpaste. It was mostly the
Colgate brands that contained it.
pH and source and availability of nutrients are the critical factors in the
development of dental caries. Bacteria digest carbohydrates and produce acid
that causes demineralization of the tooth enamel. The demineralization
phases are followed by periods of alkalinization, which help restore the
integrity of the enamel. Dental caries occurs when the acidification phases
outweigh alkalization phases. The more frequent sugar and even food is put
into the mouth, the more likely cavities occur. We do not recommend parents
put the infant to bed with bottles, sippy cups or breasts with the milk
pooling around their mouth. Frequent juice or food in the older children
during the day will cause cavities… it is the frequency all day long.
Some research is looking into finding bacteria that produce
more alkaline substances rather than acidic ones thereby decreasing dental
So brush teeth frequently with toothpaste approved by the
American Dental Association (“ADA approved” is on the package). After 2
yrs. old, a toothpaste that has flouride, bacteria killing properties, and
an alkaline pH is preferred. Arm and Hammer and Aquafresh toothpaste might
be a better choice but there are others.
Gum Crayola for kids no fluoride pH<5
Oragel for kids no fluoride <5
Colgate for kids fluoride <5
Crest for kids fluoride <5
Toms for kids fluoride <5
Aquafresh for kids fluoride 8
Arm&Hammer fluoride 8
At 1-2 years old use non fluoride toothpaste since they
swallow it and gives them too much fluoride. The difference between adult
and kids toothpaste is flavor and cute packaging. So 3 and older could use
"What time of the day should you go to the dentist? At
The AAP now came
out and gave new
recommendations for fluoride toothpaste.
In their review, the authors identified a few new
recommendations regarding fluoride. They included the following:
All children should use fluoridated toothpaste after
tooth eruption, which is when teeth first become visible in the mouth.
Children younger than 6 should not use fluoride rinses
because they could swallow them and ingest too much fluoride.
Parents should help their kids with getting the right
amount of toothpaste — a dot the size of a grain of rice before age 3
and a pea-sized dot after that.
Years ago the
“authorities” recommended fluoride supplement in infants below one year who
where strictly breast fed but that stained their teeth. So they changed
their mind and said no fluoride supplement until one year old. In most
formula fed babies the mom’s prepared the formula with fluoride containing
tap water. (Yes I strongly recommend fluoride in tap water…. It definitely
decreases cavities. Why people are starting to take it out of tap water….
it is like not vaccinating your children. If you don’t want to give your
child fluoride, use bottle water. If you still prefer bottle water but want
your child to have fluoride, then ask your pediatrician for fluoride
containing chewable vitamins.) Now they are suggesting fluoride containing
toothpaste when the first tooth erupts… usually 6-9 months. If it was my
child, I would start fluoride toothpaste at 1-2 years old and only enough to
wet the bristles or your finger tooth scrubber.
Roger Knapp MD