Dental Concerns in Children

Many young children suck on their thumbs or fingers, or use a pacifier. Thumb sucking and using a pacifier are normal habits, and most children stop on their own before any harm is done (usually by the age of two). In general, it is easier to wean a child off a pacifier than to stop him or her from sucking his or her thumb or finger.

After four years of age, let your child's dentist know if he or she is still sucking his or her thumb or using a pacifier. However, there usually is no reason to worry too much until around age six, when the permanent front teeth are beginning to come in and could be affected. If thumb sucking continues, dental problems (e.g., overbite) and thumb infections may develop, and the child may be teased by friends and classmates.

Many local communities now require that tap water be treated with fluoride, and others do not. The fluoride in toothpaste is not enough to harden the tooth enamel and defend against cavities. If you live in a community that does not have fluoridated water, get your water from a private well, or use purified water, you may wish to ask your child's dentist or pediatrician about fluoride tablets. However, too much fluoride can discolor teeth. Your child's dentist can recommend the proper fluoride supplement based on your child’s age and situation.

Dental injuries are common in children of all ages. Injuries often are caused by participation in sports, fighting, falls inside the home, and other accidents. School-aged boys suffer almost twice as many dental injuries as girls. The peak period for mouth injuries is between the ages of 18 months and 3 1/2 years, because children are learning to walk and run and are more prone to falls and collisions.

Typical dental injuries include damage to the teeth, such as broken (chipped or fractured) or displaced (loosened or pushed out of alignment) teeth, and teeth knocked out of the mouth and damage to tissues in the mouth (e.g., gums, tongue). In some cases, root fracture and dental bone fracture can also occur.

Prompt treatment, preferably within 30 minutes, is necessary following any dental injury and is critical to saving the tooth in many cases. If a child's permanent tooth has been knocked out of the mouth, do not touch the root of the tooth. Carefully rinse any dirt off the tooth, gently try to put it back into the socket, using light pressure to keep it in place, and take the child to the dentist.

If you cannot re-implant the tooth, place it in milk or a sterile saline solution and bring it with you and your child to the dentist. Do not wrap the tooth in a cloth or let it get dry. Primary teeth are usually not re-implanted, to avoid harming the developing permanent tooth.

For other types of dental injuries, apply an ice pack to the mouth to reduce swelling, give the child a pain reliever if necessary, and seek dental care as quickly as possible.

In many cases, sports-related dental injuries can be prevented by using a mouth guard, also called a mouth protector. These devices usually cover the upper teeth. A child with braces or another type of fixed dental appliance may benefit from wearing a mouth protector for the lower teeth as well.

To reduce the risk for cuts, abrasions, and infections in the mouth, guards should be washed and sanitized daily and should be replaced after about 2 weeks or if they become misshapen or damaged.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 27 Aug 2008

Last Modified: 10 Sep 2015