As soon as teeth appear

you can start using toothpaste

Teeth development

As all parents are aware, babies are dependant on their parents for all of their day-to-day needs. Feeding, changing nappies and keeping them warm are the obvious and most highlighted aspects for a baby’s general well-being. Meanwhile, tooth care and on-going dental maintenance are often overlooked during the early years. This is because, baby teeth (also knows as primary teeth or deciduous teeth) are treated as dispensable teeth, as we all know that there will be a second set of adult teeth replacing them. This, however, is an incorrect assumption as baby teeth have important physiological and functional purposes. They are not only important when it comes to biting and chewing in the early years, but also play an important role in your child’s development of the jaw bones and facial muscles, speech, nutrition and aesthetics. Primarily though, they act as place maintainers for the adult teeth until those are ready to come through the gums.

The first permanent teeth do not appear in the mouth until your child is around the age of 6 years old. The classic signs for their initial approach are a wiggly baby tooth. Generally, a wiggly baby tooth gets wigglier and wigglier as the adult tooth dissolves the root of the baby tooth. Once the majority of the baby tooth root has been dissolved, it exfoliates or falls out. As we all grow at different rates, the adult teeth erupt into place at slightly different times, providing a range of dates for when these teeth are expected to erupt. Generally, they should follow a common trend (see chart). The first to erupt are the lower incisor teeth around the age of 5-7 months, followed by the upper incisor teeth. This continues until twenty adult teeth replace all twenty upper and lower baby teeth. In addition, the permanent set of teeth include the eruption of the 6-year old molars, 12-year old molars and wisdom teeth. The last permanent teeth to erupt (excluding the wisdom teeth) come through around the age of 12-13 years. From this, you begin to appreciate that some of your child’s baby teeth actually need to last up to 12 years!

What happens if your baby loses a tooth early?

One of the key functions of baby teeth is that they serve as natural space maintainers for the adult permanent teeth, acting as a guide to the new tooth’s eruption. Loosing a baby tooth when the adult tooth is more than 6 months away from eruption causes drifting and space loss as the other baby teeth begin to move. This movement can ultimately result in crowding and, if significant, can cause some teeth to stay buried under the gums due to a lack of space – often referred to as impacted or trapped teeth. This unwanted movement and eminent crowding results in changes to the bite and teeth positions, which can predispose to needing complex and costly orthodontic treatment when your child is older.

Something else worth considering is that a child with early loss of teeth may loose chewing efficiency or affect aesthetics, speech and/or bone and tooth development. Tooth decay can cause your child significant discomfort, causing them to refuse certain foods or limit the food he or she is consuming. From a psychological point of view,  a child with pain from extensive decay, who must attend a dental visit, is likely to associate unpleasant feelings with visiting a dentist. This is because more complex procedures, including extractions if necessary, are often required to address the decay. In some children, the anxiety build-up can be significant enough to cause life-long dread with future dental visits.

We encourage the following oral health habits for children.

These habits need to be forged early in order to maintain healthy baby and permanent teeth. As such, good oral hygiene practice must be taught and highlighted from a very young age.

To maintain the health of your children’s teeth, the following recommendations have been made by numerous regulatory bodies, dental associations and dental specialist organisations including the New Zealand Dental Association. Cleaning your child’s teeth should start as soon as the first tooth erupts into the mouth. This usually occurs around 6 months of age. As children are all different individuals and so grow differently, be on the lookout for these lower incisor teeth anywhere between 5-7 months. When starting out for the first few weeks, be extra careful and gentle when cleaning your child’s teeth. The oral cavity is very sensitive and you want your child to have a comfortable experience. Use a small and very soft children’s toothbrush and massage the teeth and gums using a pea-sized amount of fluoridated children’s toothpaste. Make sure you do this both morning and night to ensure that food does not build up on the teeth causing them to weaken. As your baby grows, make sure to look carefully into the mouth for any markings on the teeth, including any demarcations or white lesions on the teeth close to the gum line as signs for possible early decay. Remember, you are not necessarily looking for black spots!

It is important to routinely monitor how your youngsters are brushing. Using a mouthwash made up of a tea-spoon of any food dye in half a cup of water can clearly stain areas of plaque that your son or daughter may be missing. Try this at home and give your kids feedback about their tooth-brushing and the areas they are missing or not covering well with their toothbrush. The aim should be to teach your child so that they may learn and master brushing their own teeth. Using the “tell, show, do” technique has been recommended and shown to work exceptionally well – tell them how to do it and explain the process of getting the teeth polished and cleaned. Show them how to brush the teeth and finally, let them do it all by themselves.

Maintenance of teeth does not just involve brushing them. In fact, it starts with the food that your little one is introduced to. Make sure to choose healthy foods that are low in sugar and acids, as foods that are sugary, sticky and high in carbohydrates are damaging to the teeth. Soft drinks are best completely avoided especially in the early years, while fruit juices should be very limited – water is the best drink to give.

Maintain the routine

These important day-to-day habits, along with regular check ups with a dental professional, will maintain your child’s teeth and will ensure that their dental health remains in optimal shape.

Dr. Adriana Perez

BDS (Ven/Esp) | MDS-Orth (Arg)
 
Dr. Adriana Perez grew up in Caracas, Venezuela. She is one of the registered specialist orthodontist working at Shakespeare Orthodontics in Auckland.

 

In 2008, Adriana graduated with a Bachelor of Dental Surgery from Santa Maria University in Caracas, Venezuela. After graduation, she worked in Venezuela in private practice, at the Orthopaedic Children’s Hospital (Dentistry/Orthodontics unit), and as a lecturer in the National Experimental University of the Armed Forces.

In the year 2011, Adriana moved to Argentina to specialise, gaining the Specialist Orthodontist degree from the University of Buenos Aires in 2013. While in Argentina, she worked as a part-time lecturer at the Orthodontics Department in the University of Buenos Aires, private practice, and at the Craniofacial Unit in the Paediatric Hospital Garrahan, looking after cleft lip new-born, children, and adolescent patients.

Adriana is a Spanish speaker. On her spare time she likes going to the beach, travelling, socialising with friends, playing video games, cooking, and going to the gym.

Orthodontist Adriana Perez

Dr. Azza Al-Ani

BDS | DClinDent | MRACDS-Orth | MOrthRCSEd

Dr Azza Al-Ani, grew up in Christchurch, is a registered specialist orthodontist working at Shakespeare Orthodontics in Auckland. You can find her at one of the clinics in the city, or at their Takapuna clinic on the North Shore. 

In 2009, Azza graduated with a Bachelor of Dental Surgery with Credit from the University of Otago.

She worked as a dental house surgeon at Auckland, Greenlane and Middlemore Hospitals; and as a dental officer at Sydney’s Westmead Hospital.

In 2012, she completed the Royal Australasian College of Dental Surgeons (RACDS) primary examinations.

Before commencing her specialist training, she held a part-time Professional Practice Fellow position at the Faculty of Dentistry, while working as a dentist in private practice.

In 2016, Azza graduated from the University of Otago with a Doctor of Clinical Dentistry in Orthodontics. She passed examinations to gain memberships into the Royal Australasian College of Dental Surgeons and the Royal College of Surgeons of Edinburgh.

She is also certified with the Australasian Orthodontic Board, and is a member of the New Zealand Association of Orthodontists, and the New Zealand Dental Association.

Azza’s area of research interest is hypodontia.
She has presented about this topic at the European Orthodontic Society Congress, and at the International Association Dental Research ANZ Scientific Meeting, and has been involved in the publication of numerous articles in peer-reviewed journals.

Outside of work, Azza loves spending time with her son and Mo (her husband), socialising with family and friends, overseas travel, and tries to keep up with Mo mountain biking.

Dr. Mo Al-Dujaili

BDS | DClinDent | MRACDS-Orth | MOrthRCSEd

 

Mo is a Specialist Orthodontist. He grew up in both New Zealand and Australia.

After completing a year in Health Sciences, and later physiotherapy, he qualified as a dentist in New Zealand. He spent the next four years working alongside his father in Sydney where he practised general dentistry. Mo then returned to Dunedin to specialise, gaining his specialist degree – Clinical Doctorate in Orthodontics from the University of Otago.

During the three years of specialist training, Mo had the privilege of learning from the best. The combined clinical and academic acumen of professors, doctors and staff provided an invaluable experience.

Meanwhile, Mo published and presented significant research and clinical cases at both national and international forums, including the International Association of Dental Research, the Australasian Begg Society of Orthodontics, the European Orthodontic Society and the New Zealand Dental Association conference.

A firm believer in maintaining high clinical standards, Mo successfully completed further examinations to become affiliated with the Royal College of Surgeons (Edinburgh) and the Royal Australasian College of Dental Surgeons (Sydney).

Mo is currently a part time senior lecturer at Auckland University of Technology, a Fellow of the World Federation of Orthodontists and also holds professional memberships with the New Zealand Association of Orthodontists, the New Zealand Dental Association and American Association of Orthodontists.

He has also been involved in the supervising and lecturing of students at the Auckland University of Technology.

Outside of work, Mo enjoys the precious time with his young family and the outdoors. He especially loves mountain biking, running, fishing, diving and, in winter, snowboarding.

Traveling along with his best friend and wife (Azza) around the world has also been a big part of Mo’s life. Mo is primarily based in Shakespeare Orthodontic’s city clinics and on the North Shore.