Baby Teeth Count!

As a pediatric dentist, I often encounter the question, “Why should I be concerned about my child’s baby teeth if they will fall out anyway?” Allow me to explain the significance of healthy baby teeth. Most newborns appear toothless. Teeth begin to emerge from the gums at about 6 months of age and continue doing so for the next 2 to 3 years, totaling 20 baby teeth. These initial teeth, termed “baby teeth” or “milk teeth” (because of their exceptional whiteness), are destined to be replaced by adult or permanent teeth. The roots of a baby tooth, which are anchored in the jaw, slowly dissolve, leading to the loosening of the tooth and its subsequent loss and replacement by an underlying adult tooth. Baby teeth fall out in the same order that they emerged. Adult teeth make their debut when the child is 6 years of age. The adult molars come in behind the baby teeth as the jaws grow. By the age of 12 to 14 years, most children have all permanent teeth.

Baby teeth are important for many reasons:

1. Eating: Although an obvious statement, baby teeth allow a child to chew his/her food and to develop proper chewing and swallowing habits, which will continue when the baby teeth are replaced with adult teeth.

2. Speech: Teeth serve as a “fence” to prevent the tongue from wandering in the mouth, especially important during the early years when the child learns to speak.

3. Proper Alignment of Adult Teeth: Under normal circumstances, a baby tooth remains in your child’s mouth until replaced by the emerging adult tooth, developing and growing underneath it and ready to break through the gums. The baby tooth serves as a placeholder, maintaining the appropriate amount of space for the underlying, soon to emerge, adult tooth. Loss of a baby tooth, for whatever reason such as cavities, trauma, or heredity, leaves a space. This unoccupied space may lead to the shifting of other teeth, encroaching upon the empty space and hindering the proper emergence of subsequent adult teeth. The result is that the child develops adult teeth that are misaligned, i.e. are crooked.

4. Self Esteem: Children are cognizant of their appearance, as compared with their peers. Crooked teeth, possibly coupled with bad breath due to oral bacteria, or ugly teeth with large cavities reduce a child’s self-confidence in smiling, and other interactions with their peers. Children may tend to shy away from photos or group activities. Their entire personality can be altered secondary to a poor dentition. 

5. Healthy Baby Teeth Lead to Healthy Adult Teeth: The lifestyle choices developed in the early years of a child’s development are usually maintained with the emergence of adult teeth. The main cause of damage to baby teeth is acidic products produced by the oral bacteria in their metabolizing (“digesting”) the foods, drinks, and snacks ingested by the child. Enamel, the hardest material in the human body, forms the outer covering of each tooth. Bacterial-derived acids eat away the enamel, leading to tooth decay, colloquially referred to as a cavity. The U.S. Center for Disease Control and Prevention estimated that 25% of North American children between the ages of two and five years old develop cavities, with the incidence steadily increasing. It cannot be over emphasized that care of the first set of teeth sets the stage for the second set of permanent teeth. With proper care, adult teeth should last a lifetime. Large cavities and abscesses in the primary teeth establish a bacterial petri dish environment in which the permanent teeth need to erupt and flourish. If the immediate oral environment is not ideal, the permanent teeth will forever be more susceptible to cavities and dental problems. In summary, healthy baby teeth are important for the child’s self-esteem, to chew properly and for speech development, to ensure proper alignment of adult teeth, and to prevent periodontal disease. With the proper care, the child will have a beautiful and healthy smile and be well on his or her way to a future of dental health with a confident smile.