As your child nears age 6, the jaws grow, making room for the permanent teeth. At the same time, the roots of the primary teeth begin to be absorbed by the tissue around them, and the permanent teeth under them prepare to erupt. The first permanent molars usually erupt between ages five and six, so they are sometimes called the six-year molars. Because the six-year molars do not replace any primary teeth they are often mistaken for primary teeth. You should remember that they are permanent teeth and must be cared for properly if they are to last throughout your child's lifetime. These molars are especially important because they determine the shape of the lower part of the face. They also affect the position and health of the other permanent teeth. Sometimes a primary tooth is lost before a permanent tooth beneath it is ready to erupt. If primary teeth are lost too early, nearby teeth can tip or move into the vacant space. When the permanent teeth are ready to come into the mouth, there will not be enough room. As a result, they may erupt out of their proper position, leading to malocclusion.

To avoid such future problems, your dentist may recommend using a space maintainer to reserve space for the permanent tooth. If a primary tooth does not fall out when it should, your dentist may recommend that it be removed to prevent the irregular eruption of the permanent tooth.

Your dentist may recommend that your child use an over-the-counter fluoride mouth rinse daily after age six. Be sure to instruct and, if necessary, supervise your child in the use of these mouth rinses. By age 7, your child should be able to brush alone. Flossing, however, is a more difficult skill to master. At about age 8, the child should be able to floss his or her own teeth under supervision.

Dental X-Rays are extremely valuable for helping to detect oral diseases of the teeth and surrounding tissues. An X-Ray exam may reveal small cavities that can't be seen by a visual exam, infections in the bone, abscesses, cysts, developmental abnormalities, such as extra or impacted teeth and some types of tumors. Just because such diseases, including early tooth decay, can't be seen by a visual exam does not mean that treatment isn't required.

Is it safe to have dental X-Rays?

Yes. Numerous precautions and advances in X-Ray equipment help protect patients from receiving unnecessary radiation. The amount of radiation received from a dental exam is extremely small compared to other naturally occurring sources of radiation, including minerals in the soil, radon, and cosmic radiation from outer space. A full-mouth series of films, using start-of-the-art technology, will deliver an effective dose that is equivalent to about 19 days of exposure to naturally occurring environmental radiation.

How often are they necessary?

This depends upon the patient's individual health needs. If you are a new patient, the dentist may recommend X-Rays to determine the current status of your mouth and to check for hidden problems. The need for radiographs varies according to your age risk for disease, and your past dental history.

Children may need X-Rays more often than adults because their teeth and jaws are still developing and they are more prone to tooth decay. X-Rays help the dentist discover developmental problems as early as possible so preventive or treatment measures can be started.

When teeth are developing, depressions and groves form in the chewing surfaces of the enamel. These features are called “pits and fissures”. They are impossible to keep clean, because the bristles of the toothbrush cannot reach into them. Therefore, pits and fissures are ideal places for plaque and bits of food to become lodged. Placing a thin covering ( a sealant ) over the pits and fissures can reduce the risk of decay.

Fluoride is one of the most effective elements for preventing tooth decay. This mineral combines with tooth enamel to strengthen it against decay. Fluoride may also actually reverse microscopic cavities by enhancing the process by which minerals, including calcium, are incorporated into the teeth.

The most effective way for your child to get fluoride's protection is by drinking water containing the right amount of the mineral… about one part fluoride per million parts water. This is of special benefit to children, because fluoride is incorporated into enamel as teeth form. Children who, from birth, drink water-containing fluoride have up to 40% fewer cavities. Many of them remain cavity-free through their teens.

Even though your regular water supply may be fluoridated, it is still important to use ADA accepted fluoride products such as toothpaste, and in some cases, mouth rinses. You may want to discuss with your dentist any special fluoride needs your child may have. Fluoride toothpastes and over-the-counter fluoride mouth rinses that carry the ADA seal have proven safe and effective.

Your dentist may recommend various ways to get fluoride protection, including:

· Drinking fluoridated water at school.

· Taking prescribed fluoride tablets or drops

· Brushing with a pea-sized amount of fluoride toothpaste.

· Using a fluoride mouth rinse for children over age six.

It's not difficult to help your child maintain a healthy smile. Here are a few tips for good oral health:

· Make sure your child gets the fluoride needed for decay-resistant teeth. Ask your dentist how this should be done.

· Brush and floss your child's teeth daily until the child can be taught to do this alone. Then encourage him or her to brush and floss.

· Take you child to see the dentist regularly, beginning at six months of age.

· Put only water in your child's naptime or bedtime bottle.

· Start cleaning your child's mouth daily.

· Start brushing as soon as the first tooth erupts.

With your help, in combination with their own efforts and regular professional care, your daughters and sons can grow up cavity-free and keep their teeth all their lives.

Malocclusion is a condition in which the teeth are crowded, crooked, and out of alignment with each other. Malocclusion can occur at any age, but they become particularly noticeable between the ages of 6 and 12, when the permanent teeth are coming in. In some cases, malocclusion is inherited – for example; the jaw may be too small for the teeth. Malocclusion may result from factors in the child's life, such as thumb sucking, dental injures, or the early loss of primary teeth.

Whatever the cause teeth that are crowded or out of position may be more difficult to clean. As a result, they are more likely to decay and the gums more likely to become inflamed. This can affect the child's appearance. General dentists and pediatric dentists try to prevent malocclusion. When necessary, they will refer your child to an orthodontist, a dentist who specializes in the treatment of such problems. Some preventive orthodontic treatments start as early as age 3 or 4.

Injuries to teeth occur easily, especially during childhood. But may injuries can be avoided by using mouth protectors. Mouth protectors guard against injuries to the entire mouth area, especially the teeth, lips, cheeks, and tongue. These resilient shields can also protect against other injuries by cushioning the blows that might otherwise cause concussions or lead to jaw fractures.

Have your child wear a mouth protector, especially if he or she is participating in any activity which may involve falls, head contact, tooth clenching or flying equipment – sports such as basketball, skateboarding, gymnastics & soccer!

There are three types of mouth protectors: ready-made, mouth-formed and custom-made. Ask your dentist for advice on the selection and use of protectors. If, despite precautions, your child sustains a facial or jaw injury, see your dentist immediately. If your child's tooth is knocked out, rinse it in cool water. Do not scrub it! If possible, put the tooth back in its socket and hold it in place for five minutes. If this cannot be done, put the tooth in a cup of milk or water, or wrap it in a wet cloth. Take the child and the tooth to the dentist at once. Your dentist may be able to replant the tooth. In may cases, teeth that are replaced in the mouth within 20 minutes reattach themselves to the jaw and function normally.

Smokeless tobacco is a dangerous addiction that more and more children are engaging in. The use of snuff and chewing tobacco carries multiple dangers, including greatly increased risk of oral cancer and heart disease. As little as three or four months of smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias . Abrasive and sugars in smokeless tobaccos also lead to greater tooth abrasion and decay.

Tobacco in any form can jeopardize your child's health and cause incurable damage Teach you child about the dangers of tobacco.

Don't let a dangerous habit start!!