Six of the most common questions parents ask about their children’s teeth

Leading children’s orthodontist, Dr Chaw-Su Kyi, answers six of the most common questions parents ask about their children’s teeth 

Orthodontists estimate that roughly 45% of children need braces to fix problems like a misaligned bite, but up to 75% of children could benefit from treatment to straighten their teeth and improve the shape of their face.

People need braces for any number of reasons, including crooked, overlapping, or overcrowded teeth, or a ‘bad bite’ (known as malocclusion).

Tooth and jaw problems occur for a number of reasons including, accidents, habits such as thumb sucking, inherited factors (if mum or dad have had braces their children often also need treatment too) and, perhaps surprisingly too many baby teeth falling out too soon.

Here are some of the questions I am asked most frequently by my patients.

1) How important are my child’s baby teeth?

A child’s baby teeth – known as their primary dentition – are as important to infants as permanent teeth are to adults. Like adult teeth, they are necessary for the important functions of chewing and speaking. However, they also serve an additional, very important role of acting as a ‘space saver’ for future permanent teeth; ensuring that adult teeth develop in the correct locations. 

Healthy baby teeth tend begin to ‘fall out’ at around the age of 6, with the majority shed by around 12 years of age. Teeth are generally lost in the order they first erupted. 

Regular brushing of teeth, two minutes, twice a day with fluoride toothpaste will help ensure kids keep their baby teeth for the right amount of time, as there is a much lower need to extract decayed teeth (the leading cause of hospital admissions amongst 5-9 year olds).

I tend to find that kids brush longer if they are enjoying the experience, and have been known to pop on a catchy tune for my kids to brush along to (songs tend to be two minutes so it works well!).

2) Will my child need braces if they have wonky or gappy baby teeth?

It’s almost impossible to look at your child’s baby toothed grin and know if they will need a brace in future years. A ‘gappy’ smile in infant school photos is pretty normal, and shouldn’t see you rushing to the dentist.

This is because, as your child grows, gaps will start to develop between their front baby teeth (incisors). This is indicating that their jaw is growing to accommodate the adult teeth, (which are larger than their deciduous predecessors.) 

Issues can arise when baby teeth are lost too early, and the area that the tooth occupied is not maintained. If your child loses a tooth a few years before it would naturally have been shed, for example, an extraction of a tooth due to decay or injury, the teeth either side of the gap can, over time, move into the space left behind.

This can result in a loss of room for the developing adult tooth to erupt into, resulting in misalignment of the teeth. I would always recommend any non-permanent tooth which has cavities, is only extracted as a last resort and would always place a filling in the first instance. If extraction was the only option, I would suggest considering having a ‘space maintainer’ made and fitted in the child’s mouth until their adult teeth have begun to appear.

3) Is it normal for my child to have an adult tooth and a baby tooth coming through at the same time?

It’s not uncommon for parents to notice a permanent tooth erupting either in front or behind their child’s baby tooth, meaning the child has two teeth in a spot designed for one. 

Most permanent teeth grow directly underneath the baby teeth. The adult tooth reabsorbs the roots of the baby tooth, which triggers it to become loose and ultimately fall out. The permanent tooth continues to grow in its’ place.

If the permanent tooth does not grow directly beneath, the root of the baby tooth may remain intact and not get pushed out as it usually would. This occurrence causes the permanent tooth to grow in behind the baby tooth resulting in what is often referred to as a ‘shark tooth’ appearance.

This can be resolved, if assessed early, by simply removing the baby tooth, however, the longer both teeth remain in place, the greater the chances for the child to need realignment treatment.

4) Can thumb sucking affect my child’s teeth?

If your child is still sucking their thumb once they have adult teeth beginning to appear, it can cause impact the direction the teeth grow. If the thumb is placed in the mouth for prolonged periods of time, the thumb itself is acting as a brace – pushing the upper front teeth forwards and the lower front teeth back.

As the thumb is resting in-between the upper and lower teeth, it can also prevent the normal eruption of the front teeth, affecting how the teeth bite together, leaving open gaps between the upper and lower arches of teeth, and in some cases meaning the two front teeth do not meet. If the habit is stopped early, the teeth can start to return to their normal positions as children grow and development.

As a parent I appreciate habits such as thumb sucking can be tricky to break. There are a number of products on the market that can help encourage children to stop sucking their thumbs, and your orthodontist may even be able to fit a type of brace that acts as a reminder to remove the thumb.

5) When should children go to the orthodontist?

This is one of the top questions we’re asked! As a general rule, we typically recommend you take your child to see an orthodontist around the age of 9 or 10 when they’ve nearly lost all their baby teeth. 

They will be able to assess the development of the teeth and check the teeth are erupting well and will then be able to advise as which treatment options are best for your child.

6) Do teeth straighten themselves out?

Potentially, the teeth may straighten as the jaw develops but, typically, only in very mild cases. The extent of any natural ‘straightening’ is usually seen at the age of 14-15 years, which is when an assessment can see if any – or which – orthodontic treatment is advised.

For further guidance from Dr Chaw-Su Kyi visit West London Orthodontist.

Photo by Tim Mossholder