Common Issues with Children’s Teeth

There can be A LOT of questions when it comes to a child’s teeth. Are they coming in right? Are they too crowded? Why did my child’s tooth turn gray? These can be difficult to understand without an exam with a dentist, but we asked our hygienist, Erin, to give us an idea of some of the more common issues with children’s teeth. Here is what she had to say:

Trauma/Tooth Discoloration: If a trauma has occurred, such as a fall or being hit in the mouth with an object, and the child’s front teeth have been hit, the damaged tooth/teeth may change color to a gray or black shade. Typically, only one tooth is affected and the discoloration is caused by a short period of internal bleeding within the tooth. Trauma may also cause the tooth to start resorbing the nerve or pulp chamber. Resorption is when the body removes mineralized tissue within the tooth, resulting in a loss of part or all of the tooth’s scructure. If the tooth is not bothering the child and there are no signs of infection (indicated by a bump or pimple type lesion near the root of the tooth or in the gum tissue and/or pus present) the most common recommendation is to leave the tooth as is until it falls out on its own. This helps “hold” the place for the permanent tooth that will replace it.

Decay: Early decay in your child’s baby teeth may be caused by a variety of things, such as poor brushing habits, lack of fluoride, genetics and ‘baby bottle decay.’

Poor brushing: Many people don’t know that brushing should begin before an infants baby teeth begin erupting. Using a damp towel or cloth to clean your infant’s gum tissue will help remove any plaque that is acquired during feeding. Creating a routine with a toddler will help make sure all areas of their teeth are being properly cared for.  Letting the child brush first and then taking turns and helping concentrate on molar teeth and gum line areas will help prevent plaque from forming in these areas.

Baby Bottle Decay: This is classified as a wide spread decay caused from milk, pop or juice in a bottle or sippy cup that is left for the child to sip on throughout the day or that is sent to bed with them. When this happens, the sugar is allowed to sit on the teeth for long periods of time, which in turn causes decay. This type of decay mainly affects the upper front teeth, upper and lower molars, and the lower canine teeth. It is characterized by brown colored cavities toward the gum line. These areas may begin as white demineralized areas that have a chalky type appearance.

Grinding: Grinding is most common in children ages 4-8 and 10-14 when the primary and permanent teeth are coming through and the different heights of the teeth cause a feeling of unbalance. The child’s instinct (which is most common while the child is sleeping) is to grind the teeth together to create a more uniform feeling. If the grinding continues into adulthood, once all permanent teeth are fully erupted, a night guard may be recommended to maintain the health and shape of the teeth.

Anterior Supernumary Teeth: This is the presence of extra teeth and is most common in the upper arch and more likely to occur in males. This is most commonly diagnosed using a panorex x-ray that shows all erupted and un-erupted teeth. If left untreated the extra tooth (or teeth) may affect the eruption and/or development of the permanent teeth.

Malocclusion: How a child’s teeth fit together when they bite is evaluated at each visit. The lower jaw can protrude or retrude, causing the teeth to bite together in an unideal way. While children have all of their baby teeth, the bite is most commonly monitored until the eruption of permanent teeth begins. A referral to an orthodontist may be made at this time to continue monitoring the eruption of the permanent molars and pre-molars, so early intervention can be made at the proper time. If left untreated, the teeth may be more at risk for breaking, fracturing, or wearing abnormally. The teeth that are out of alignment may be also more difficult to clean, and can cause gingivitis (inflammation and bleeding of the gums), and difficulty eating or speaking.