The following article is only a general guide to parents regarding their children’s dental care. Queries and suggestions for further topics are welcome and will be dealt with in future issues of this magazine.

Age 0 to 6 months

No tooth exists and cleansing with moist gauze swab to massage gummy ridges is sufficient. This may stimulate healthy gum development and prevent thrush.

Orthodontic dummies are recommended to prevent bad teeth positioning and malformation of the jaws although prolong usage should still be discouraged.

Age 6 to 12 months

Deciduous (baby) teeth starting to emerge and around one year old 8 to12 front teeth should be visible. Teeth may appear to be too close or have too big gaps between them which is normal. Cleansing with gauze swab is sufficient.

Age 1 to 2 years

Deciduous teeth continue to come through and may reach the full set, ie 20 teeth around 2 years old. These include the central incisor, lateral incisor, canine, premolar and the 2-year old molar to each half of the jaws.

Baby toy toothbrush may be introduced for your child to play with and also to copy adult tooth brushing habit. Tooth paste is not recommended while adult supervision is important especially in removing food debris that is caught between teeth. Compliance from child at this stage is poor but acceptable.

Age 2 to 6 years

This is the best time to help your child develop good chewing habit by feeding chewy, crispy, crunchy and fibrous food to promote good healthy gum and jaw growth. Always encourage tap water drinking because of its fluoride content and try to avoid/filtered water.

Tooth brushing should be supervised to ensure proper brushing. Toothpaste with fluoride for kids can be used at least twice a day half an hour after meals.

Regular checks to ensure there are no black/brown spots especially between teeth. Kids do not usually complain about their teeth, and when they do, you listen! Visiting the dentist should be done only when you the parents are going so that your child may just watch and get used to the ambiance of a dental surgery.   

Age 6 to 7 years

Around 6 years of age, the first 4 adult molars, namely the six-year-old molars will come up behind the baby molars (2nd premolar) of each quarter. These molars are permanent teeth and good dental care will make sure they last the whole life time. The 4 front central incisor teeth will start to become wobbly. The lower 2 are the usual ones to fall out first follow by the upper ones. The permanent central incisors will cut through not long after the baby ones have fallen out. Sometimes the permanent incisors may not be coming up straight which will cause the baby teeth to remain in place for much longer time. The appearance of double row of shark-like teeth is not uncommon and has driven many parents to ask the dentist to take out the baby teeth. This is usually not necessary since premature loss of baby teeth will always lead to more crowding of permanent teeth and hinder proper jaw growth.

This is the best time to start seeing the dentist for regular 6-monthly check-ups and may be a good clean with fluoride application if the child is co-operative.

It is also recommended that as soon as the molars are up, the deep pits and fissures on them should be sealed by dentist to prevent future decay.

Age 7 to 8 years

The 4 permanent lateral incisors will come through after the 4 baby ones have fallen out at this stage. Signs of crooked teeth will indicate that braces or orthodontic treatment may be necessary later on.

Age 8 to 9 years

The adult canines (the pointy teeth) or sometimes the first premolars may come through first at this stage. Your dentist may advise your child to see the orthodontist for some interceptive treatment which may help to promote jaw growth and uprighting teeth in order to create more space for simpler and more satisfactory future corrective treatment.

Age 9 to 10 years

By now, the canines and the first premolars should have come up and fully visible. Your child should manage unsupervised tooth brushing and flossing at this stage.

Age 10 to 11 years

The 4 second premolars should be up and chewing by now and no more baby teeth left. This is the best time to visit the orthodontist so that your dentist can help to supervise the progress. Between now and up to the age of 14 is the optimal time for orthodontic treatment.

Age 11 to 12 years

The second molars should be coming through and your child’s teeth should be looking much like a full set by now. Proper brushing, flossing and rinsing habits should be well established.

Pits and fissure sealant should have been performed by your dentist at this stage. Regular check-ups with scale and cleaning plus a fluoride application every 6 months is recommended.

Age 12 and Onwards

Normally, your child should have 28 teeth by now, 8 to each quarter of the jaws. The last molars or the third molars, ie the wisdom teeth are already in the making at this time but they do not usually come up until after the age of 18. Impacted wisdom teeth means that they may have trouble cutting through due to a variety of reasons. Your dentist may take X-radiographic pictures to ascertain the cause of impaction.

A  6-monthly visit to the dentist together with good oral hygiene programme at home are important. Regarding tooth brushes, it is always important to use the softest bristle brushes with a small head. A gentle small circular massaging action at 45 degrees towards the gum area should be the way to brush teeth. It is better to spend more time brushing, 2-3 minutes is good, instead of rushing through the process with harsh scrubbing pressure. Generally, when your tooth brush bristles are flaring out to become a ‘shaggy dog’ even after 4 months is indicative of a harsh heavy brushing technique.