About milk (temporary) bite, as well as teething and changing teeth in children

The eruption of the first teeth of a child is a holiday for proud parents, but at the same time it generates a number of concerns, because already at the stage of the formation of a milk bite, sometimes there are certain problems that require a quick solution.

Therefore, let's analyze in detail the most frequently asked young parents questions related to the first teeth of the baby and care for them. And also see what is the norm, and in what cases should contact the experts.

 

Stages of dairy and permanent bite formation

Orthodontists decided to divide the stages of the child's bite formation into several specific periods, and each of them has its own important features.

As is well known, a child is normally born without teeth - instead of them, the newborn has only round-shaped gum rollers.The structures of the temporomandibular joint are not yet developed, but the child can actively suck the mother’s breast, which in turn contributes to the growth and development of the jaws.

The first temporary teeth begin to erupt in the baby to 6-10 months. There is a certain sequence and timing of the eruption of each tooth - the corresponding approximate values ​​in months are shown in the picture below:

Generally speaking, deviations from the given terms of eruption for 2-3 months are considered to be within the normal range.

Understand that the baby should soon have the first milk tooth, usually by the following signs:

• In most cases, the child has increased salivation;
• If you look closely, you can often see swelling of the gums, corresponding in shape to the teeth in soft tissues. These nodules can be palpated, that is, they feel good to the touch;
• The child during this period becomes restless and whiny more than usual;
• All that comes under the arm, the baby pulls into his mouth, thus massaging the gums and stimulating the eruption of milk teeth;
• Often (but not always), the child's temperature rises.

On a note

Previously, dentists even used the term “dental fever” to describe the symptoms of an increase in temperature when teething baby teeth in children, but today this term is outdated. Normally, the temperature of the baby can rise to 37.0-37.5 degrees. If the temperature has risen above these values, and there are symptoms such as pain and redness of the throat, runny nose, cough, then most likely these are manifestations of childhood infections, which coincided with the appearance of the first tooth.

What should parents do to help the child in this difficult period for him? It is not necessary to churn down the temperature below 38 degrees, it is enough to regularly monitor the condition of the child, making sure that the temperature does not rise further. At this time, it is especially important not to muffle a child too much (as overly caring parents often like to do), and also the baby needs to be given enough liquid to compensate for the loss of water due to increased body temperature and excessive saliva flow.

If the temperature of the child is 38 degrees or higher, then usually use antipyretic drugs in the form of suppositories and syrups (you should consult with your pediatrician in advance for choosing the appropriate medicine appropriate for the age and weight of the child).

The period of bite of primary teeth, beginning, as already noted above, approximately from the age of six months, continues until the eruption of any first permanent tooth. Dentists believe that the stage of temporary teeth lasts in children, on average, up to 3-3.5 years.

The question of parents is widespread about what teeth are not and how many teeth are in the milk bite of a child? So, all in full milk bite 20 teeth, ten in both jaws. There are no premolars in the temporary occlusion, that is, 4 and 5 teeth - their place is taken by milk molars.

Below in the photo you can see how the full set of milk teeth on the lower jaw looks like:

Normally, the child's jaw bones have a semicircular shape, the teeth are located without gaps and are in close contact with each other, the upper dentition overlaps the lower one. The back surfaces of temporary molars are located in the same plane with respect to each other.

On a note

The dental formula of the milk bite (and permanent too) is usually denoted by Roman numerals: I, II, III, IV, V, or Arabic 5, 6, 7, 8; for example, 51 tooth is the first central incisor of the upper jaw.

After the first baby tooth appears in the child, the parents are faced with a completely logical question - how to care for this first tooth and whether it is necessary to care for it at all.It is necessary to take care: today the industry makes a lot of options for silicone fingertips and toothpastes that are appropriate for the age of the baby.

An example is shown in the photo below:

As practice shows, silicone fingertip is not suitable for everyone and not immediately, because the child may not like the material itself and the appearance of this product. In this case, you can try to wrap a piece of gauze on your finger or buy a ready-made fabric version of the fingertip at the pharmacy and gently, in circular movements, clean the tooth (at first you can do this even without a paste).

Gradually, when the baby gets used to the cleaning procedure, you can go to the silicone fingertip with toothpaste. Do not be afraid that children's paste will harm the immature tooth or the baby’s body as a whole - for very small parts of the toothpaste abrasives and some chemically active substances that are part of many toothpastes for adults are specifically excluded. High-quality children's toothpastes were originally made taking into account the fact that babies, according to the results of research, can swallow up to 40% of the paste while brushing their teeth.

On a note

Sometimes there is an absolutely incorrect idea of ​​parents that once baby teeth are temporary, then there is no need to take care of them. They say they will fall out anyway, and only then it will be possible to do hygiene more thoroughly. With this approach, the condition of baby teeth in a baby can be truly catastrophic:

It is important to understand that problems in the milk bite inevitably have a detrimental effect on the permanent bite, and sometimes (with strong inflammatory processes) even the very beginnings of future permanent teeth can be damaged.

 

Anomalies of teething and changing milk teeth

Let us examine the situation when time passes, and the teeth, which, it would seem, should have appeared a long time ago, do not want to erupt.

The reasons for this can be several - both of a general nature, when a malfunction in the body leads to a delay in the normal development processes of the child, and local - in this case, the cause of the delay can be trauma or another specific effect, leading to non-treatment of individual milk teeth.

On a note

Heredity plays an important role among the general causes: if the genus of one of the parents is characterized by a prolonged absence of certain teeth in childhood, then there is a high probability thatthat this feature can be passed on through generations to a child.

Among the causes of a systemic nature can distinguish such diseases as:

• Down syndrome is a specific genetic mutation of chromosomes, which results in an additional 47 chromosomes in a cell set. Down syndrome is manifested by the presence of certain signs in a child, such as the atypical shape of the skull, a flattened face and the child’s lagging in mental and physical development. Also, normal periods of development of the milk bite are violated;
• Clavicular-cranial dysostosis (clavicular-cranial dysplasia) is a rather rare genetic disease characterized by underdevelopment of the clavicles and bones of the skull, which is manifested by prolonged closing of the spring of the infant, an altered form of the skull and, in particular, a lag in the development of the maxillofacial region in general;
• Congenital cleft lip and palate is a congenital malformation in which the oral cavity and the nasal cavity are not completely separated from each other in the process of prenatal development, as a result of which an open anastomosis remains between them. It interferes with the normal feeding, growth and development of the child,the dental system cannot be formed to the proper extent - all this requires the intervention of the orthodontist together with the maxillofacial surgeon for the necessary correction;
• Rickets - the development of this condition is determined by metabolic disorders due to a lack of vitamin D in the body. The disease is manifested by bone deformities of the entire skeleton, fragility and fragility of bones. In children with rickets, there are certain changes in the shape of the jaw bones, as well as serious deviations from the normal development of the milk bite.

As for the causes of a local nature that can lead to anomalies of eruption and change of milk teeth, the following can be identified here:

• Congenital adentia (due to the absence of the rudiments of individual teeth) - this feature can be hereditary, or cause intrauterine trauma to the fetus, or any effect on the mother's body during pregnancy. Dental budding starts at 6-7 weeks of intrauterine development of the fetus, and the formation of the maxillofacial area and the skeleton begins with 1-2 months of pregnancy.Accordingly, any serious adverse effect on the body of a pregnant woman during this period (taking certain medications, especially antibiotics, past infectious diseases, excessive alcohol intake, smoking) can cause irreparable harm to the future state of the child’s teeth and skeleton;
• Dilaceration - this term refers to the anomalous structure of the tooth root, at which the root begins to grow at an angle to the crown. Most often, this condition develops after the injury of an already erupted tooth, or its rudiment. In most cases, the teeth with dilaceration must be removed;
• Abnormal position of the tooth germ. Sometimes the cause of the pathologies of the milk bite and the so-called "crooked teeth" lies in the fact that the tooth germ was originally formed out of place. This may occur at the stage of prenatal development, and may also result from trauma during obstetric aid and forceps on the head of the child. In addition, tumor and tumor-like jaw formations can displace the rudiments of teeth. This deviation may be suspected by a specialist during the examination and palpation of the child’s dentition, or, more likely, this pathology can be established on a radiograph;
• The primary violation of teething - this pathology is characterized by the absence of the process of eruption, as such, in teeth that are not fused with the underlying bone. That is, a milk (or permanent) tooth located in the bone cannot overcome the obstacle in the form of bone tissue, because the necessary mechanism for softening the bone tissue of the gum does not occur. Such an anomaly can be, for example, a consequence of improper filling of milk teeth, after which the temporary tooth root does not resolve, being an obstacle for the eruption of a permanent tooth.

In addition, with a certain caution, doctors refer to such anomalies as:

• The birth of a child with natal teeth - that is, a child is born already with separate teeth in the oral cavity. As a rule, these are the lower incisors. Such cases require careful observation - usually the natal teeth quickly become stable and do not pose a threat to the further normal development of the milk bite. If the tooth staggers (can fall out and get into the respiratory tract) or significantly interferes with feeding (scratches the mother's nipple), then it should be removed;
• A teething cyst (cavity filled with fluid) - when a baby tooth is erupting, sometimes the underlying gum layer is peeled off, resulting in a space that is filled with blood, lymph or, in severe cases, decay products, that is, pus. The decision whether or not to go to the doctor in this situation is made depending on the general condition of the child. Basically, the cyst passes without consequences, but sometimes requires the intervention of a specialist;
• Dystopia - teething out of place. Dystopia may be due to lack of space in the dentition, or it is formed due to improper placement of the tooth germs, or due to genetic predisposition;
• Macro- and microdentia are an anomaly in the size of teeth, when they are either too small or too large, thereby causing a discrepancy in the size of the jaw bones and dentition. As a rule, it is hereditary.

If the timing of teething of individual teeth has already come, you can use a kind of teething stimulants. For example, in pharmacies and children's stores, various toys made of thick rubber or silicone are sold, playing with which the baby massages the gums and stimulates dentition.

On a note

To facilitate the eruption of milk teeth, orthodontists use special separation rings, which are installed in the gap between existing teeth. Thus, the pressure exerted on the tooth causes it to completely cut through. This method can be used when the crown is already half out of the bone.

If there is a suspicion of a delay, or the pathology of the eruption of temporary teeth, you should contact a pediatric dentist, or directly to the orthodontist.

To clarify the reasons, the doctor may send the child to x-rays (the study is done strictly according to the indications, so as not to harm the children's body with excessive radiation). Orthodontists, as a rule, send children to X-rays for the first time at the age of 4-5 years, to see how the dental system is formed and what actions can be taken now.

The doctor, first of all, wonders if there are all the rudiments of milk and permanent teeth, whether they are located in their anatomical places, what obstacles in the way of the tooth prevent it from leaving the bone. At the same time, attention is paid to the structure of the maxillary sinus, mandibular canal, and other important structures of the maxillofacial region.

 

Premature loss of milk teeth and what problems this may incur in the future

According to many parents, the loss of milk teeth is not a problem, because all the same, then they will be replaced by permanent ones. In fact, the premature loss of even one baby tooth can carry serious consequences and cause an abnormal bite in the child.

It is interesting

As they say, nature does not tolerate emptiness, and according to this law, the teeth often move toward the free space: for example, permanent upper teeth can change from the bone not strictly downwards, but slightly sideways, trying to fill the existing emptiness.

Now let's analyze in detail what can be threatened by premature loss of individual milk teeth.

Dairy incisors: loss of incisors can cause displacement of the canines towards the defect, as well as rotation and inclination of the remaining teeth.

Milk fangs: generally speaking, fangs are very important teeth. First, they carry an important functional load, they have a massive root and a crown with a pointed end, the canines are designed to tear off pieces of food. Secondly, in addition to the important functional role, the fangs are important from the point of view of aesthetics, because they are in the smile zone.

From the point of view of orthodontics, the loss of the milk canine is a rather serious problem, as it always leads to a displacement of the incisors relative to the midline of the face.

On a note

The midline of the face, or cosmetic center, is a conventionally drawn line that divides a person’s face into two halves. Ideally, it should pass between two central incisors.

Offset cosmetic center is associated with pathological contacts between the teeth, their overload, as well as premature abrasion.

Dairy first molars (chewing teeth): the loss of a temporary molar on one side of the dentition can cause a shift in the cosmetic center of the face. To prevent this complication, some orthodontists suggest the so-called balancing removal, that is, the extraction of the tooth of the same name on the other side of the dentition (but, by the way, many parents refuse to remove a healthy tooth from a child).

Children with the loss of the first milk molar should be under the supervision of a physician, and if the mixture of the midline of the face did occur, it is better to settle the first molar from the other side.

Dairy second molars: when a second milk molar is removed, there is a chance that a permanent tooth will move forward during eruption, thereby forming a pathological bite.

If, however, the removal of any baby tooth for one reason or another could not be avoided, then it is better to immediately turn to an orthodontist and assess the need for additional treatment. The task of the doctor in this case will be to save space in the dentition for the normal eruption of permanent teeth. To this end, for the formation of a normal bite, various removable and non-removable devices are used, which allow new teeth to take their rightful place.

 

Lactating milk teeth

If the schedule for changing temporary teeth to permanent ones deviates for six months or more, then this, as a rule, is a sign of the presence of some kind of hidden reason that impedes the natural process of changing milk teeth. In this case, it is recommended to always consult a doctor and carry out an X-ray examination to make sure that the germs of permanent teeth are present.

If there are rudiments, then the question arises of removing the milk precursor, which prevents the exit of a permanent tooth.

In some cases, the removal must be made as soon as possible, for example:

• Milk molars immersed in the gum are a phenomenon when the tooth does not reach the tooth on the opposite jaw while remaining imprisoned in the gum. Basically, these molars are first in the milk bite with all the teeth, and then gradually sink into the gums. If the molar is below the gum level at the completion of the terms of the formation of the root of a permanent tooth, then such a molar should be removed (as otherwise it will not allow a permanent tooth to cut through normally). In other cases, doctors leave such molars under supervision;
• Impaction of permanent molars is a phenomenon in which a permanent molar cannot erupt, as it is blocked by adjacent temporary or permanent teeth. You can try to help the tooth cut through the use of rubber separation rings, mentioned earlier, or with the help of a metal ligature, which the doctor places in the gum gap between the teeth. The pressure exerted in this way contributes to the exit of the tooth from the gums (to create the necessary space, one of the teeth blocking the causative must be removed);
• Complementary teeth - in most cases they cause bite problems (crowding, diastema, that is, the gap between the central incisors, as well as the tilt and rotation of the teeth in the dental arch).Sometimes, complementary teeth can be detected by chance after receiving an x-ray. Often, when teething, complementary teeth have an abnormal shape and are almost always to be removed.

The photo below shows an example of the presence of a supernumerary tooth in the jaw:

On a note

Also, the so-called additional teeth are found - in their form they resemble teeth of a certain group and, as a rule, stand at the end of the corresponding group.

If there are no rudiments of permanent teeth, then the milk teeth should be kept in place. In this case, after the preparatory stage of wearing the bracket system and creating a place, the patient is replaced with an existing anomaly with a dental implant.

 

Principles of treatment in the milk bite

Already at the stage of the formation of a milk bite, it may become obvious that it needs to be corrected, since otherwise it may lead to the abnormal development of the entire dental-maxillary system, not to mention the obvious aesthetic shortcomings.

In particular, it is necessary to correct the milk bite in the following cases:

• with severe crowding of the teeth (when they do not have enough space in the jaw, they begin to grow “at random”);
• in case of delay or absence of eruption of individual teeth;
• in situations where you see that the baby’s teeth just grow crooked;
• after the forced removal of milk molars or other temporary teeth due to caries and its complications;

…And etc.

In all these cases, you need to consult a doctor, he will assess the state of the bite and, if necessary, send the child to the picture, and then decide whether to intervene at this stage, or it will be better to take the child under observation in order not to miss right time to start treatment.

For very young children, an orthodontist may suggest wearing orthodontic transparent caps (trainers) - to preserve the available space in the dentition after losing a tooth or teeth.

Then the cap is replaced by a plate-type apparatus with an expanding screw and artificial teeth replacing the defect of the row. An example is shown in the photo below:

On a note

To improve the fixation of devices on small, not fully erupted teeth or in toothless mouth, orthodontists recommend using special means - gels, creams. They are spotted on the part of the apparatus adjacent to the sky, after which they are pressed against the sky, then they wait about 30 seconds.

Some parents come with complaints that the devices do not help fix the milk bite. And during questioning, it turns out that the child refused to wear a plate or a mouthpiece, crying, and parents, at best, put the device on the child for an hour or only for a few dozen minutes a day. Meanwhile, the more the device is used, the faster the child will get used, and in the future it will even feel more comfortable while wearing a plate in its mouth than without it.

At an older age (3.4, 5 years), you can teach a child in a playful way to a special set of exercises that contribute to the correction of bite, the so-called myogymnastics.

For example, to normalize the work of the circular muscles of the mouth with the emerging open bite, you can perform the following exercises:

• Pull lips, collecting them with a tube, and how to blow out the candle;
• Inflate the cheeks, and then pressing on them with hands and pulling the lips, blow them off.

The doctor selects a set of exercises individually for each patient taking into account the specific bite anomaly.

Sometimes in the milk bite it is necessary to use non-removable equipment, that is, fixing the bracket system, or various frame arc devices on the rings, which are made individually.

The use of fixed devices is necessary, for example, in congenital malformations, in the case of turns and tilts of the teeth, which can not be fixed with the help of removable devices. And also for the correction of replaceable bite, when the child wears removable devices irregularly, or refuses to use plates at all.

In conclusion, it is worth noting that this moment. Since orthodontic treatment is quite expensive today, many parents prefer not to do anything, hoping that the problem with the teeth of the growing child will “resolve” by itself. So - such a decision of parents can cause serious problems for a child in more adulthood, ranging from problems with chewing and speaking, and ending with reduced self-esteem, isolation and depression (when a child walks with crooked teeth for years and hesitates to even smile - it leaves its mark sometimes for the rest of his life).

At the same time, even very serious problems of bite can be quickly and efficiently corrected in the milk bite, but only if the parents (and the child himself) are seriously interested in the treatment.And it is better to give this issue due attention at the initial stage, during the bite of temporary teeth, so that in the future the child will not have unnecessary problems in this regard.

Health to you and your children!

 

Interesting video: how to prepare a child to visit the dentist

 

On the timing of teething in babies