Primi Dentini by G.Bertelli

Generality

The first teeth begin to appear towards the fourth-sixth month of life. Their eruption is accompanied by rather annoying symptoms, such as swollen gums and abundant salivation .

In addition, the child may show lack of appetite, restless sleep and a tendency to nibble on anything that comes into his hand.

The eruption of the first teeth can have a different rhythm, independent of development. Usually, however, the sequence with which they sprout is the same for all children: first the incisors, then the first molars (around the first year of age), the canines and, finally, the last molars (towards 2-3 years). In total, the milk teeth are twenty: ten higher and ten lower.

Usually, to relieve the pain associated with the eruption of the first teeth, small precautions are enough, such as, for example, massaging the reddened and painful part with clean fingers or with sterile gauze soaked in cold water.

If the appearance of the first teeth was cause for concern or doubt for the parents, it is good to rely on the indications of the pediatrician, who will also be able to advise the best strategies to prevent "bottle caries".

What are

The first teeth are the first teeth to develop and grow during the life of every human being.

In the newborn, they begin to appear around the 4th-6th month of life; within two years of age, the teeth will be complete.

Synonyms

The first teeth are also called:

Deciduous teeth (that is "destined to fall");
Milk teeth;
Primary teeth;
Temporary teeth.

Primi Dentini: how many are there?

The first teeth are twenty in total.

In detail, for each dental semi-enclosure, there are five milk teeth, which can be divided as follows:

2 incisors (1 central + 1 lateral);
1 canine;
2 molars (called respectively "first" and "second" molar).

In the deciduous dentition, however, the premolars and wisdom teeth are absent.

To remember

The first dentition consists of 20 milk teeth, while the final one is characterized by 32 teeth. All the first teeth will fall between 6 and 14 years, when they will be replaced by permanent teeth and completed by the four molars (premolars and wisdom teeth).

When they come up

Primi Dentini: eruption times and procedures

The first teeth appear, generally, between the fourth and sixth month of life, when the lower central incisors begin to appear, followed, in the following four months, by the upper central incisors .
Within the first year of life, the lower lateral incisors emerge, so that the child will have eight teeth: four below and four above.
In the following months, other first teeth erupt: the four milk molars, which can often create some discomfort, because, being bigger than the incisors, they make their way with a little more difficulty. These first teeth are separated from the lower lateral incisors by a space, which will be occupied, between the sixteenth and twenty-fourth month, by the lower and upper canines .
Finally, within the two and a half years, the last four molars appear. At this point, the deciduous dentition is completed: the child has all twenty first teeth, ten for each arch.

After some time, around 6 years, the first teeth will begin to fall spontaneously to make way for the permanent ones.

As far as the time of the dental eruption is concerned, it should be emphasized that every child has his own personal rhythms and there are no rules that apply to everyone: it can happen to see infants with an early and other later teething, while maintaining the described sequence.

Delays in the eruption of Primi Dentini

As anticipated, it is possible to observe a five-month-old baby already with the first tooth or a child of fourteen months without even a tooth. This last situation sometimes worries parents.

Any physiological "delays" in the eruption of the first teeth in a healthy child often have a hereditary basis (if even in the parents the dentition occurred late, it is likely also to the children). The reasons are almost always unknown and do not depend, as many mistakenly think, on a failure to take fluoride, vitamins or calcium. Sometimes, just be patient - sometimes even up to 16-17 months - that the first tooth peeps out.

Symptoms

The symptoms associated with the eruption of the first teeth are quite evident and include:

Abundant salivation : it is a typical signal, caused by the itching and the uncomfortable sensations caused by the stretching of the gingival mucous membranes . Excessive salivation can induce facial dermatitis .
Swollen gums : under the pressure of the first teeth that are coming out, the gum tissues become inflamed and are more sensitive; this irritation can make the child agitated;
Loss of appetite (refusal of food);
Sleep reduction and difficulty falling asleep .

First signs

Near the eruption of the first teeth, one or more white spots appear on the gum, which tends to redden and swell.

Primi Dentini: child behavior

The first teeth can cause discomfort and sometimes pain: in the newborn, this leads to crying, as well as bringing about a certain restlessness .

Rather commonly the child is observed grasping everything he finds under his hand (a toy or a finger of the parent), nibbling him tenaciously and thus realizing a sort of spontaneous massage for the irritated gums.

First teeth: fever and diarrhea

In the 24-48 hours after the eruption of the first teeth, it is not uncommon to observe the appearance of some lines of fever, diarrhea (in the form of liquid discharges, rather acidic, capable of irritating the diaper area) or other kinds of disorders .

These phenomena, however, do not depend directly on the dentition, but on the fact that, at this stage of development, the child's natural defenses are lowered, as the protection of maternal antibodies ceases.

The child is thus vulnerable to attacks by bacteria and viruses. In this sense, fever is not given by the first teeth, but by exposure or contact with infectious agents.

Carie dei Primi Dentini

The first teeth should be regularly cleaned to prevent dental diseases, such as tooth decay .

Even if the baby is still feeding mainly with milk or with semi-liquid baby foods, in fact, the teeth should always be clean : after meals, food residues adhere to the enamel and penetrate the gum collar, altering the pH of the mouth and promoting plaque formation .

It should also be considered that milk teeth are more fragile than permanent ones, therefore easily attacked ; for this reason, they are more exposed to the risk of infection and pain.

Furthermore, if they are affected by cariogenic processes, the first teeth fall faster than healthy ones. This can have negative repercussions in the long term, causing problems of alignment and occlusion in the adult's mouth: the presence of all the first teeth ensures, in fact, the correct chewing and each "holds the place" for the permanents that will emerge later. Extracting them or losing them prematurely exposes them to the risk of future teeth growing crooked or poorly spaced.

For the same reason, in the case of trauma it is good to immediately take the child to the dentist to check that a shift or hematoma has not compromised the bud of the permanent tooth.

Treatment and Remedies

To alleviate the discomfort associated with the eruption of the first teeth it is possible to resort to some simple methods without side effects.

First of all, it can be useful to massage the red and painful part of the gum with a sterile gauze soaked in cold water. Furthermore, it is possible to give the baby special toys to chew on or to spread on the gum of creams with a slightly anesthetic action.

In any case, it is always good to consult the pediatrician, who will be able to provide the most appropriate advice and prescribe, if necessary, some drugs to reduce pain.

Primi Dentini: how to relieve pain

Teething toys and devices. To alleviate disorders related to the eruption of the first teeth it is possible to use toys, specially designed for teething . These usually have a ring shape and are made of soft rubber, but slightly rough and, inside, contain a coolant . Therefore, teething toys must be placed in the refrigerator a few hours before use, so that they cool off and the cold and slightly inflammatory action can be exploited. An alternative to rings can be handkerchiefs or cotton towels (better if white), to wet and store in the fridge for an hour. These let themselves be sucked, then, by the child.
Massages . A simple massage with the fingers (well washed) on the gums can give relief to the child during the dentition phase. Alternatively, parents can place a cold sterile garzina on the reddened area, often drying the mouth with a soft sponge, to avoid stagnation of saliva.
Drugs. To alleviate the disorders associated with the eruption of the first teeth there are creams designed specifically to appease swellings, which are distributed in a modest quantity on the gum with a light massage. In the pharmacy and parapharmacy, there are also specific products for teething, such as anti-inflammatory, soothing and refreshing gels to be applied before sleep and after meals, or gum paste with low doses of amylocaine with an anesthetic effect. In some cases, the pediatrician may indicate the use of paracetamol and ibuprofen, two active ingredients useful against pain and also suggested in other contexts.
Natural remedies. During teething, it is possible to use specific products, to be purchased in pharmacies, based on chamomile, mallow, calendula and hyaluronic acid, to be applied several times a day on the gums. Their calming properties will help the child withstand the discomfort associated with the first teeth. It is not advisable, on the other hand, to dip the pacifier or the teat of the bottle in honey or other sweet substances: similar habits - although extremely appreciated by the child - are the main culprits of early and / or multiple caries on the first teeth.

Oral hygiene

How to wash the First Teeth

The care of oral hygiene starts from the first months of life of the baby. The cleaning of the first teeth, especially when performed before the night rest, minimizes the risk of so-called "baby bottle caries". It should be emphasized that when they are very small, children are unable to brush their teeth alone; therefore, it is the duty of parents to take care of their children's oral cavity.

When to clean the First Teeth

The first teeth should be cleaned after each feeding or meal and before going to bed, while the child is lying down (for example, when the diaper is changed).
Before the appearance of the first teeth begins, it is good to begin to take care of cleaning the oral cavity, if you want to ensure the maximum well-being of the child and prevent inflammation and discomfort.
When the first tooth is erupting, it is sufficient to clean and gently rub a clean and soaked garzina with physiological solution, at least twice a day.
Later, around 8-10 months, when the first teeth have emerged, you should start using a toothbrush suitable for the newborn. Obviously, you have to opt for a small head, with soft bristles, which will be moistened with water. Small amounts of toothpaste, specific for children, can be used from 16-18 months of age. The toothbrush should be replaced every 2-3 months.
After the teething, the child is accustomed to washing his first teeth by himself (ideally at the beginning of the third year of age), teaching him to correctly use a toothbrush and toothpaste (which now must contain fluoride) and supervising his gestures.

Other tips and useful tips

Maintain satisfactory oral hygiene by using appropriate toothbrushes (diversified according to the age of the child). The first teeth should be brushed, taking care to clean all surfaces.
If possible, breastfeed the baby : in addition to preventing tooth decay, breast milk strengthens the first teeth, favoring the re-mineralization of calcium and phosphorus. In addition, breast milk - unlike the vaccine (ie cow) - helps protect the enamel of the first teeth.
Guarantee the child a healthy and regular diet, limiting the intake of sugary substances as much as possible; this attitude is also useful for preventing overweight, obesity and related metabolic diseases.
Avoid food out of main meals and try not to use sweets as a reward or consolation. Furthermore, do not give the child fruit juices or other sugary drinks during the night: this behavior increases the risk of tooth decay. The general rule should be: "you go to bed with clean teeth".
The first dental visit should be scheduled around the 12 months of the child's life: during this appointment, the dentist defines an accurate dental hygiene plan, useful for making parents understand how to intervene on the first teeth of their children.
Caries must be treated in a timely manner: not only are they painful, but they can damage the permanent teeth of adulthood.
If the pediatrician and the dentist deem it appropriate, the feeding of the child should be supplemented with a fluoride supplementation, to make the first teeth stronger and, at the same time, less susceptible to caries.