This is a common concern among parents and has a fairly simple response. In general, your pediatrician will recommend that you plan on discontinuing the use of a bottle by age one. There is, of course, a little flexibility with this so that the child can undergo a relatively smooth transition to the use of a sippy-cup.

Every child is different in their need for that warm bottle of instant comfort. It is indeed an amazing cure-all for infant displeasure, but like all addictions, it isn’t easy to stop. Other children will give it up easily, gladly welcoming the new benefits of becoming a toddler. Most child-rearing books, like the “What to Expect” series, will give you tips and tricks of how to wean both the bottle and the pacifier. My biggest advice would be to start sooner rather than later, especially if you have a strong-willed child.

If you are successful in weaning both the pacifier and the bottle around 12 months, then you have no concern that either one will affect the orthodontic relationship of your child’s teeth. If you go much beyond this time frame, then it is possible that you may have some future orthodontic problems. Again, there is leeway with this, and in general we say that most of the permanent effects occur if the child has not completely stopped by age four. Of course I assume that your four year old is not drinking out of a bottle anymore, so I am speaking particularly about the use of a pacifier. If your four year old is still drinking from a bottle, you are way overdue for a crisis intervention!

The other big concern to be aware of is that, the pacifier can also cause trauma to the child’s gums. This can cause painful ulcers but can also cause the gums to recede from the tooth. This can cause many problems including gum damage for the soon erupting permanent tooth, tooth decay of the baby-tooth or painful root exposure. Your child may experience mild to severe sensitivity to hot and cold foods or even just when the air from speaking passes by the area where the gums have receded. Adults experience this too, but generally it is not caused by the use of a pacifier! There are many causes for adults, but the end result is the same resulting in sensitivity, pain or possible loss of the tooth from becoming loose. So again, stop the habit early, as it will be better for everyone!

This is perhaps the most commonly asked questions about children’s teeth. In fact, parents who have children in the 0-6 year old range often wonder if they even need to worry about their kid’s teeth at all. I would like to stress that this age range is one of THE MOST IMPORTANT times in the care and maintenance of your child’s teeth. Repeat after me: “This age range is one of THE MOST IMPORTANT times in the care and maintenance of my child’s teeth.” You are officially now more informed than 98% of the world.

I want to first dispel a major dental myth that we touched on briefly in the general questions section. You know, the one that says, “They’re just baby teeth, they are going to fall out anyway.” WRONG. Those cute, milk-white, little-bitty, ankle-biting pearly whites are the foundation that will determine whether or not you may have to pony-up $5000 for braces several years from now. Baby teeth are crucial in holding the space in the dental arch for the future permanent teeth. They predict and help guide the underlying permanent teeth into their future locations and thus will have a huge impact on both the appearance and functionality of adult teeth. Extracting them rather than filling them in many cases can cause mild to severe crowding, spacing and asymmetry of adult teeth that may not have otherwise occurred.

Without those baby teeth, we lose many opportunities to prevent later orthodontic problems. Not to mention when you extract teeth, adult or otherwise, you greatly affect the ability to chew. I think it is only fair that we allow our children to experience the delight of eating as we do, but children need to eat for nourishment to allow for proper growth. The ability to chew can limit what a child is able to eat and thus have effects on both their mental and physical development. So, we can see that in most cases it is better to try to save a baby tooth rather than extract it.

Too often parents consider baby teeth “disposable,” since they will fall out anyway. They are far from disposable and almost always benefit the child most by doing what it takes to save them. There are exceptions to this rule. For example, if a baby tooth has a cavity but no infection present, and the tooth is within 6 months of falling out, your dentist will probably recommend the baby tooth not be treated. This makes sense as it would be pointless to waste money on a tooth that will very soon come out on its own. In addition, removal of baby teeth can sometimes actually help prevent braces altogether. While braces may be unavoidable whether you maintain baby teeth or not, you’ll see that there are other extremely important reasons to keep baby teeth healthy. So, with this new paradigm shift in thought of caring for your child’s baby teeth, let’s go into more detail about these curious topics!

The body is truly amazing in so many ways (and just plain frustrating in others).  While a visit from the tooth fairy can be exciting for some kids, others are left frustrated that she may never pay a visit.  There are so many variations in how/when/where teeth become loose and actually fall out, that it can be stressful for both parents and kids.  Most kids will go along simply following the “normal” pattern and have regular visits from that darn fairy.  Some parents don’t ever have to lay a hand on those slippery little rascals while others are wondering if they need string or pliers.

In most cases, even if a tooth is loose for awhile, it will come out on its own or with the help of the child wiggling it.  If you are unsure, you really should make a visit to your dentist for an evaluation.  There are times when we elect to extract a baby tooth.  Some teeth are stubborn and when they don’t come out on their own, the permanent one tries to come in around it.  This can create orthodontic problems in the future, so in this instance it is generally recommended to remove the baby tooth.  This is usually only done when the tooth is evaluated and determined that it just isn’t going to come out on its own.

Also, on occasion, we will “help” the little guy out of there if we feel there is a choking hazard.  This is rare, but is done  if the tooth is extremely loose and the child or parent just can’t get it out. It is generally very easy to get out without upsetting the child.  If half of the tooth is broken out and the other half is stuck and not loose, it is wise to bring the child to the dentist for an x-ray.  Your dentist may or may not choose to extract the remnant, depending on what the x-ray reveals and other considerations which  they will discuss with you.

I personally do not recommend string tied to doors (OUCH!) or pliers from the garage.  The one tool I do recommend is patience.  Challenging, I know but it will eventually come out with a little twisting and wiggling and a positive attitude!