Harbor Kids' Teeth
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Frequently Asked Questions (FAQ)

About Teeth

  • 1. The Basics

    Everyone will have two sets of teeth: the baby teeth or primary teeth and the permanent teeth also called the secondary teeth. Around the age of 6-8 months, the baby teeth will begin to appear; usually by the age of 3, 20 teeth have erupted.

    Around the age 6 the permanent teeth will develop and begin to erupt. Most secondary teeth are present between the ages of 12 and 14 except for the wisdom teeth. The next teeth to develop are the 12 year molars followed by the wisdom teeth. Wisdom teeth usually begin erupting after the age of 17. There are 32 permanent or secondary teeth, but most people don’t have room for all 32. The wisdom teeth are usually removed to leave room for the other teeth.

    The incisors are the front teeth. Next to them are the canines, followed by the bicuspids or pre-molars. The back teeth are the molars. You keep your permanent teeth for life. Brushing and flossing regularly with periodic check-ups and cleanings by a dentist makes an importance difference in your dental health.

  • 2. Why Primary Teeth are Important

    Primary or baby teeth are extremely important as strong, healthy teeth make it possible for a child to eat well and to develop proper pronunciation and good speech habits. Healthy baby teeth will guide the eruption of the adult or secondary teeth as well.

  • 3. Wisdom Teeth

    The third permanent molars, commonly called wisdom teeth, are usually the last teeth to erupt into the mouth. For many teens, this occurs between 14 and 18 years of age. In some cases, the wisdom teeth may not erupt until after age 20. The location of the wisdom teeth should be evaluated when the teenager is between 16 and 19. If removal is recommended, the procedure is best completed before age 20. Removal of wisdom teeth is not always recommended. However, many teens need to have their wisdom teeth removed for a variety of reasons.

    Unerupted wisdom teeth can affect the surrounding bone, gums, and neighboring teeth unless there is enough space for the wisdom teeth.

    Impacted wisdom teeth are not able to move into their proper position. In these instances the teeth may remain in the bone, come in sideways, or only partially erupt.

    Complaints of jaw pain often arise from impacted wisdom teeth. Gum infections and the infection of the surrounding bone may result. In severe cases the infection can damage surrounding teeth.

    Copyright © 2002-2010 American Academy of Pediatric Dentistry. All Rights Reserved.

  • 4. Good Diet and Healthy Teeth

    It is important to have a healthy diet which helps teeth and bones develop properly. It is good to have a variety of nutritious foods which will also help in the growth of strong teeth while helping to avoid decay and cavities. Many snacks can cause cavities in children, so children it is recommended that they eat healthy snacks like low-fat (low sugar) yogurts, cheeses, and vegetables which will help promote strong teeth.

Early Dental Care

  • 1. Teething

    Generally a child’s first tooth erupts around the age of 6 to 12 months. Sometimes the gums are tender and the baby is irritable which can last for several months. Using a clean finger or a cold washcloth to rub the gums gently will give some relief and soothe the child. Cold teething rings are helpful, but stay away from teething biscuits as they have added sugar and are not so good for the baby’s teeth.

    Monitor your baby’s teeth for signs of dark spots or decay often called baby bottle decay. Check the teeth every week or two, particularly on the inside surfaces of the teeth where the tongue is in contact with the teeth. Watch for spots (either whiter than the tooth, darker spots or lines). When put to sleep, babies should have bottles with water only as other liquids – whether it is milk or juice – contain sugars which can harm the teeth if left to coat the teeth while sleeping. The sugar in the juices and milk combine with bacteria and form acids which attack the tooth enamel. During the day when the child is awake, saliva helps carries away the liquid in the mouth. While the child sleeps, there is a decrease in saliva so the liquids stay around the baby’s teeth for longer periods which cover them in harmful acids.

  • 2. Infant's New Teeth

    The baby teeth (primary teeth) have an important place in dental development. Children need those baby teeth to chew food properly and to speak. Baby teeth are critical for jaw development and for guiding permanent teeth (also called secondary teeth) into correct placement when they start to replace the primary teeth when the child is around 6.

    Primary teeth help guide permanent teeth into place, so babies who are missing primary teeth or who lose their primary teeth too early may need a space maintainer which is e used to hold space open for erupting teeth. Caring for your child’s baby teeth plays an important role in how your child treats the permanent or primary teeth. Regular care and dental checkups are critical to maintaining a healthy mouth.

  • 3. The First Dental Visit

    A child should have the first dental visit around the first birthday or soon after the first tooth erupts, which ever happens sooner. A very important part of that first dental office visit is getting to know the dentist and becoming comfortable with the dental staff. A pleasant, comfortable and happy first visit builds a strong relationship and trust. It sets the foundation for future dental visits and will help put your child at ease.

  • 4. Why Primary Teeth are important

    Primary or baby teeth are extremely important as strong, healthy teeth make it possible for a child to eat well and to develop proper pronunciation and good speech habits. Healthy baby teeth will guide the eruption of the adult or secondary teeth as well.

  • 5. Good Diet and Healthy Teeth

    It is important to have a healthy diet which helps teeth and bones develop properly. It is good to have a variety of nutritious foods which will also help in the growth of strong teeth while helping to avoid decay and cavities. Many snacks can cause cavities in children, so children it is recommended that they eat healthy snacks like low-fat (low sugar) yogurts, cheeses, and vegetables which will help promote strong teeth.

  • 6. Infant Tooth Eruption

    A baby’s teeth start forming before birth. Around the age of 4 months, the primary or teeth erupt and break through the gums—the bottom two teeth called the incisors come first, followed by the upper teeth. The rest of the 20 baby teeth generally are in place by the age of 3.

    The permanent teeth begin erupting when the child is around school age or 6 years old, the first molars coming in followed by the lower central incisors. Tooth eruption continues until around age 21. Adults have 32 secondary (permanent) teeth which includes the 4 third molars (commonly known as the wisdom teeth).

  • 7. Preventing Baby Bottle Tooth Decay

    Tooth decay in babies can be kept to a minimum by never allowing a baby to go to sleep with milk in the mouth whether it is from a bottle or breast milk. If your child needs a bottle to help fall asleep it should be water-filled bottle or a pacifier, never a bottle with milk or juice. Dr. Block’s office is dedicated to keeping your babies and children deay free. If you notice signs of decay or spots on the teeth or gums, let us know right away.

Dental Health

  • 1. Oral Hygiene

    Starting at birth, clean your child’s gums with a soft infant toothbrush and water. Remember that most small children do not have the dexterity to brush their teeth effectively. Unless it is advised by your child’s pediatric dentist, do not use fluoridated toothpaste until age 2-3. *

    Use a toothbrush with soft bristles and a pea-sized amount of fluoride toothpaste. Fluoride toothpaste should only be used when the child is old enough to have the ability to spit, otherwise water or non-fluoridated toothpaste can be used. When you brush your child's teeth, move the brush in small circular motions to reach food particles that may be under the gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth and the surface of each tooth. It will take you several minutes to thoroughly brush your child’s teeth. Brush up on the lower teeth, down on the upper teeth and the outside, inside and chewing surface of all front and back teeth. Brush the tongue and the roof of the mouth before you have your child rinse and spit.

    Brush your child’s teeth four times daily to avoid the accumulation of food particles and plaque: In the morning after breakfast; After lunch or right after school; After dinner; At bedtime

    As soon as the bristles start to wear down or fray, replace the toothbrush with a new one. Do not let your child swallow any toothpaste; have your child rinse thoroughly with water and spit after brushing.

  • 2. Flossing

    We will talk to you and your child about the importance of flossing and will recommend flossing your child’s teeth as soon as it is age appropriate. Dental floss is used to remove food particles and plaque. Dental floss is a thin thread of waxed nylon that is used to reach below the gum line and clean between teeth. It is very important to floss between your child’s teeth every day.

    Pull a small length of floss from the dispenser. Wrap the ends of the floss tightly around your middle fingers. Guide the floss between all teeth to the gum line, pulling out any food particles or plaque. Unwrap clean floss from around your fingers as you go, so that you have used the floss from beginning to end when you finish. Floss behind all of your child’s back teeth.

    Floss at night to make sure your child’s teeth are squeaky clean before your child goes to bed. When you first begin flossing, your child's gums may bleed a little. If the bleeding does not go away after the first week, let a staff member know at your next appointment.

    *"Copyright © The American Academy of Pediatric Dentistry"

  • 3. Flouride

    When the element fluoride is used in small amounts on a routine basis it helps to prevent tooth decay. It encourages "remineralization," a strengthening of weak areas on the teeth. These spots are the beginning of cavity formation. Fluoride occurs naturally in water and in many different foods, as well as in dental products such as toothpaste, mouth rinses, gels, varnish and supplements. Fluoride is effective when combined with a healthy diet and good oral hygiene.

    Fluoride is documented to be safe and highly effective. Research indicates water fluoridation, the most cost effective method, has decreased the decay rate by over 50 percent. Only small amounts of fluoride are necessary for the maximum benefit. Proper toothpaste amount must be supervised, and other forms of fluoride supplementations must be carefully monitored in order to prevent a potential overdose and unsightly spots on the developing permanent teeth. Do not leave toothpaste tubes where young children can reach them. The flavors that help encourage them to brush may also encourage them to eat toothpaste.

  • 4. Space Maintenance

    A baby tooth usually stays in until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon. A tooth might be knocked out accidentally or removed because of dental disease. When a tooth is lost too early, your pediatric dentist may recommend a space maintainer to prevent future space loss and dental problems.

  • 5. Tooth Colored Fillings

    Because composite resins are tooth-colored, they look more natural than other filling materials. Your child can smile, talk, and eat with confidence. In addition, tooth-colored fillings are compatible with dental sealants. A tooth can be filled and sealed at the same time to prevent further decay.

  • 6. Malocclusion

    Malocclusion is the improper positioning of the teeth and jaws. It is a variation of normal growth and development which can affect the bite, the ability to clean teeth properly, gum tissue health, jaw growth, speech development and appearance.

    Both heredity and environmental factors can play a role in developing malocclusions. The shape and size of the face, jaws and teeth are determined mostly by inheritance. Environmental factors can also have a large impact and these are the types of problems which the pediatric dentist is well trained to manage.

  • 7. Sealants

    Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.

  • 8. Silver Diamine Flouride (SDF)

    Silver Diamine Flouride is a FDA-approved topical solution that treats and prevents dental caries and reduces tooth sensitivity. It is made with two acting ingredients: the silver component is an anti-microbial agent that kills bacteria and prevents the formation of new biofilm, and the fluoride prevents further demineralization (softening) of the tooth structure. Using SDF provides immediate relief from tooth hypersensitivity, kills the organisms that cause cavities, hardens softened dentin making it more acid and abrasion resistant and does not stain sound dentin or enamel.

Emergencies - What to do?

  • 1. Toothache

    Clean the area around the sore tooth thoroughly. Rinse the mouth vigorously with warm saltwater to dislodge trapped food or debris. DO NOT place aspirin on the gum or on the aching tooth. If face is swollen, apply a cold compress. Take acetaminophen for pain and see a dentist as soon as possible.

  • 2. Cut or Bitten Tongue, Lip or Cheek

    Apply ice to bruised areas. If there is bleeding, apply firm but gentle pressure with a clean gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to a hospital emergency room.

  • 3. Broken Braces and Wires

    If a broken appliance can be removed easily, take it out. If it cannot, cover the sharp or protruding portion with cotton balls, gauze or chewing gum. If a wire is stuck in the gums, cheek or tongue, DO NOT remove it. Take the child to a dentist immediately. Loose or broken appliances which do not bother the child do not usually require emergency attention.

  • 4. Broken Tooth

    Rinse dirt from injured area with warm water. Place a cold compress over the face in the area of the injury. Locate and save any broken tooth fragments. Immediate dental attention is necessary.

  • 5. Knocked Out Permanent Tooth

    Find the tooth. Handle the tooth by the top (crown), not the root portion. You may rinse the tooth but DO NOT clean or handle the tooth unnecessarily. Try to reinsert the tooth in its socket. Have the child hold the tooth in place by biting on a clean gauze or cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing milk or water. See a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

  • 6. Other Emergency Conditions

    Possible Broken Jaw: If a fractured jaw is suspected, try to keep the jaws from moving by using a towel, tie or handkerchief. Take the child to the nearest hospital emergency room.

    Bleeding After Baby Tooth Falls Out: Fold and pack a clean gauze or cloth over the bleeding area. Have the child bite on the gauze for 15 minutes. This may be repeated once; if bleeding persists, see a dentist.

    Cold / Canker Sores: Many children occasionally suffer from cold or canker sores. Usually over-the-counter preparations give some relief. Because some serious diseases may begin as sores, it is important to have a dental evaluation if these sores persist.

If you have any issues accessing these frequently asked questions, please contact us at 253-858-8581 for more information or a paper copy.

We are here to serve you, answer questions or schedule an appointment during the following hours:

Monday 8 a.m. - 5 p.m.
Tuesday 8 a.m. - 5 p.m.
Wednesday 8 a.m. - 5 p.m.
Thursday 9 a.m. - 5 p.m.
Friday 9 a.m. - 2 p.m.

Call us at (253) 858-8581 to schedule an appointment for your child. Please contact our office 24 hours in advance if you need to reschedule or cancel an appointment.

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Lisa A. Block, DMD, MS

Doctor block is the best Dentist ever

- Charlotte, Age 7

  • Washington University, Doctor of Dental Medicine
  • University of Missouri, Masters in Oral Biology
  • Board certified by American Board of Pediatric Dentistry
  • Diplomate, American Board of Pediatric Dentistry
  • Fellow, American Academy of Pediatric Dentistry
  • Member of the American Dental Association and the Washington State Dental Association
  • Former Board Member of the Washington State Oral Health Foundation
  • Board member of Mary Bridge Children's Hospital Foundation
  • Past President of Washington State Academy of Pediatric Dentistry
  • Champion of Pierce County ABCD (Access to Baby and Child Dentistry) program

3519 56th Street NW, Suite 140,
Gig Harbor, Washington 98335
Phone: (253) 858-8581
Fax: (253) 858-2189