Common Dental Concerns

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When a child eats foods containing carbohydrates, the sugars and starches are left on the teeth. Bacteria that normally live in the mouth change these foods into acids. The combination of bacteria, food, acid, and saliva form a substance called plaque that sticks to the teeth. Over time, the acids made by the bacteria eat away at the tooth enamel, causing cavities.

The good news is that tooth decay is preventable! You’ll want to make sure your child brushes their teeth 2 times a day for 2 minutes each time with fluoridated toothpaste and floss once a day. Maintain 6 month dental checkups to be sure the plaque is removed from those hard to reach areas.

Another reason to maintain 6 month dental checkups is for the dentist to detect possible decay in a timely manner. Tooth decay will need to be treated, as it will not correct itself, and only worsen with time.

Permanent Tooth Coming in Before Primary Tooth is Lost
Primary teeth, or baby teeth, usually start to fall out around age 6, but sometimes permanent teeth can grow in front or behind baby teeth. This condition is fairly common and is typically not painful for the child.

Normally, permanent teeth push against the roots of the baby teeth and make them dissolve. When the root has dissolved, the baby teeth become loose and falls out. Sometimes, the permanent teeth don’t line up with the baby teeth and push through the gums in front or behind them. With nothing pushing and dissolving their roots, the baby teeth stay put. In this case, a pediatric dentist may need to help out the baby tooth. Often when the baby tooth has been removed, the permanent tooth will gradually move into its appropriate placement.

Space Between Teeth
It is normal to have some space between a child’s primary teeth. This spacing does not cause a problem, and in fact, these spaces can be a good thing. They give the permanent adult teeth room to grow in. However, a space due to a missing tooth may be cause for concern. If your child has lost a tooth early due to decay or an accident, you will want to speak with your pediatric dentist. In these cases we will need to maintain that space until the permanent teeth are ready to come in. If this space is not maintained, the primary teeth will gradually move into that space, causing problems when the permanent tooth starts to erupt in that area.

If your child has excess space between their permanent teeth, we may recommend consulting one of our orthodontists.

Sucking is a natural reflex for infants and young children. They may suck on thumbs, fingers or pacifiers. If this habit continues after the permanent teeth have come in, it can create problems with tooth alignment and your child’s bite. If you are worried about your child’s sucking habits, please talk to your dentist at your child’s next appointment.
Misalignment, or malocclusion, is a condition in which the teeth are crowded, crooked or out of alignment, or the jaws don’t meet properly. This may become more noticeable when a child’s permanent teeth are coming in. This is a common concern, with some cases being mild and others having more of an impact on the child’s dental health. A bad bite can make it difficult to keep teeth and gums clean, increasing the risk for cavities and gum disease. It can also affect the development of the jaws, affect eating and speaking, put protruding teeth at a high risk for chips and fractures and cause abnormal wear on the teeth. We will monitor these concerns at your child’s dental checkups and may recommend consulting one of our orthodontists.

Grinding, also known as bruxism, naturally occurs at night and may wear down the primary teeth. Grinding in children is rarely treated since it typically goes away when the permanent teeth erupt. Primary teeth that are ground down to the nerve will become painful and need to be removed.  Night guards are not recommended for young children since the guard will act as a retainer stunting growth, are expensive to fabricate and become ill-fitting as growth occurs and the permanent teeth erupt.  Grinding that continues when the permanent teeth erupt causing dental or muscular pain is often cured with a night guard.

Sensitive Teeth

There are many possibilities for the cause of sensitive teeth.  Teeth expand and contract in reaction to changes in temperature and flex when grinding or clenching. Hot and cold foods and beverages can cause pain or irritation to people with sensitive teeth by over-stimulation of dentin.  Over time, tooth enamel can be worn down, gums may recede or teeth may develop microscopic cracks, exposing the interior of the tooth and irritating nerve endings.  Breathing cold air might even be painful for those with extremely sensitive teeth.  Sensitivity toothpaste, restorations or night guards are common solutions to sensitive teeth although disease should always be ruled out first.


Gingivitis (gum disease) is inflammation of the gum tissue which is often caused by plaque accumulation. Gingivitis begins when the sticky film of bacteria (plaque) irritates the gum tissue at the margin of the tooth. Irritated gums in the early stage of disease bleed easily and become red and swollen. As the disease progresses to periodontitis (inflammation around the tooth), the ligament and bone that support the teeth become diseased and tooth loss will eventually follow. Gum disease is highly preventable and can usually be avoided by daily brushing, flossing and use of an antibacterial mouth rinse.  Regular dental cleanings will also remove any excess plaque buildup.

Bad Breath

Food residue that is not cleaned from the mouth deteriorates, creating an environment that supports the colonization of bacteria.  Certain bacteria release sulfur compounds that smell unpleasant (halitosis).  While certain foods, such as onions or garlic, may create temporary bad breath, consistent bad breath may be a sign of gum or oral disease.  Bad breath can also be more common in mouth breathers.  This can be reduced by brushing your teeth regularly, brushing the tongue and keeping the mouth moist with water.

Canker Sores

Canker sores (aphthous ulcers) are small to large painful sores inside the mouth with a white or gray base surrounded by a red border. Most sores last one to two weeks and are a benign autoimmune response that has no cure. Pain medication and topical ointments will usually provide enough comfort until the body can naturally heal the sore.  These sores may be mistaken for cold sores which is a virus, but also has no cure.  Unlike canker sores, cold sores can be transmitted in the early stages.