Your Infant'sMouth

Teeth at Birth?
Caring for Your Infant's Mouth
Teething
Sucking Habits

Teeth at Birth?

Soon after an infant is born, a physician or nurse practitioner thoroughly examines his or her body, including the mouth. Most of the time a baby's gums, tongue and soft palate are normally developed and ready for action. But sometimes there are harmless variations that may surprise some parents.

• Epstein's pearls — These small, white, pearl-like spots appear on the roof of the mouth. These bumps are harmless and tend to disappear within a few weeks.
  
  
• Bohn's nodules — These small, whitish bumps or cysts look like Epstein's pearls. However, they develop on the sides of the gum ridge rather than the roof of the mouth.
  
  
• Inclusion cysts — These small bumps appear along the crest of the gum ridge. They are harmless.
  
  
• Natal and neonatal teeth — Some infants are born with one or more teeth. They are called natal teeth. Some babies have teeth emerge into the mouth within the first 30 days of life. These are called neonatal teeth. Because these are primary (baby) teeth, not extra teeth, it is a good idea to keep them if possible. However, sometimes natal or neonatal teeth may have to be removed. Removal may be best if they are likely to come loose or if they interfere with feeding or significantly irritate the tongue or lip.
  
  

Caring for Your Infant's Mouth

Your baby doesn't have teeth, but you should still clean his or her mouth.

As soon as your baby is born, it is a good idea to get in the habit of cleaning his or her gums. Although there may be a little fussing at first, your infant will get used to having his or her mouth cleaned like other parts of the body. Many children grow to enjoy toothbrushing as part of their daily routine.

To clean your baby's mouth:

• Lay your infant in your lap. The head should be close to your chest so you can look down directly into your child's mouth.
  
  
• Clean the gums and the teeth — when they arrive — by rubbing a clean, damp, washcloth along the baby's upper and lower gums. You can also use terrycloth finger cots, which fit over the finger and are made for this purpose. They are sold in many drugstores.
  
  
• Do this at least twice a day — once after breakfast and once after the last feeding of the day. After teeth come into the mouth, you can continue using cloth or switch to a soft-bristled, infant-sized toothbrush. By the time the molars (back teeth) first appear around age 1, it is best to use a toothbrush all the time.
  
  

Teething

Between 3 and 9 months, your infant's baby teeth will begin to erupt (emerge into the mouth). The process starts with the lower two front teeth (incisors). Timing varies considerably among children. However, the order is very predictable. After the four incisors come in on both the lower and upper jaw, the first molars erupt. They are followed by canines (eye teeth) and then the second molars further back in the mouth. Most children have a full set of 20 baby teeth by age 2½ or 3.

Teething can go by almost unnoticed or can be stressful for parents and children alike. It may make your child irritable or fussy and may cause restlessness, drooling or loss of appetite. However, teething has not been shown to cause other childhood symptoms such as fever, vomiting or diarrhea.

You can ease your child's teething discomfort by:

• Giving him or her a hard or frozen teething ring to chew on
• Applying pressure over the gums by rubbing them with a clean finger
• Using a small dab of an over-the-counter teething gel (following the manufacturer's instructions) to temporarily numb the gums

Sucking Habits

It is completely normal and healthy for your baby or young child to suck on a thumb, finger or pacifier. It's not something you need to be alarmed about or discourage. Sucking is a natural reflex. It's something he or she did in the womb.

Children usually give up sucking habits on their own by the time they are 4 to 5 years old. If they stop the habit at this age, the shape of the jaw is usually not affected. The teeth should grow in normally. However, some children find the sucking habit hard to break. Children who are still sucking on a pacifier, finger or thumb when their permanent (adult) teeth start to come in are more likely to have bite problems.

Sucking can cause:

• The top front teeth to slant out
• The bottom front teeth to tilt in
• The upper and lower jaws to be misaligned
• The roof of the mouth to be narrower side to side

The amount of distortion caused by sucking depends on how often, how long and how intensely the child sucks. It also is affected by the type of object that the child is sucking on.

To help an older child break a sucking habit, it is important to explain clearly why the habit can be harmful. Be supportive and encouraging, and praise your child's efforts to end the habit. If the child sucks a finger or pacifier because of a stressful situation, it can be very helpful to address the source of the stress.

When needed, dentists can provide appliances that correct distortions created by the sucking habit and help the child stop the habit.

Here are a few ways parents can encourage their child to quit sucking a finger or thumb.

• Use positive reinforcement.
• Track progress by noting every successful day using a sticker or star on a chart.
• Put an adhesive bandage on the finger as a reminder, or have your child wear a mitten when sleeping.
• Take the finger out of your child's mouth after he or she falls asleep.

Pacifier Tips
If your child uses a pacifier, make sure it is always used safely.

Never fasten a pacifier on a string or necklace around your child's neck. Your child could accidentally be strangled.

Choose a pacifier that:

• Is one piece rather than several parts
• Has ventilating holes on the sides
• Is large enough so that your child can't swallow it
• Is made of a flexible, nontoxic material
• Has a handle that is easy to grasp

Always check the pacifier before giving it to your child. Make sure there are no rips or tears. If there are, replace it. Never dip a pacifier in honey or any other sweet substance before giving it to your baby. This could lead to serious tooth decay.