The Importance Of Baby Teeth

Overview

What are baby teeth?

Baby teeth, also known as primary teeth, are the first set of teeth that develop in a baby. Primary teeth are 20 in number and erupt between the ages of 1 to 3. The primary teeth then start falling (lost) between the ages of 6 and 12 which is replaced by the second set of teeth, known as the permanent teeth.¹

Why are your baby teeth important?

Baby teeth are crucial for development in children, they help them with chewing, development of speech, as well as maintaining space in their mouth for their permanent teeth. Neglecting the oral health of your child can result in pain and swelling in your child. This causes distress to them and sadly hinders their ability to speak and eat.²

Development of baby teeth

What is the timeline of baby teeth eruption?

• At 5-7 months, the first teeth to come through are the mandibular incisors (the baby’s bottom front teeth)
• At 6-8 months, the baby’s top front teeth start to erupt, also known as the maxillary incisors
• At 9-11 months, accompanying the top front teeth, lateral top incisors start to erupt on either side of the maxillary (top) front teeth
• At 10-12 months, accompanying the baby’s bottom front teeth, the lateral bottom incisors emerge on either side of the mandibular (bottom) front teeth
• At 12-16 months, the first molars start to erupt (which are their back teeth on the bottom and top jaw)
• At 16-20 months, the toddler’s canines start to emerge on the bottom and top jaw. The infant’s canines fit in between their lateral incisors (which accompany their front teeth), and the back teeth (their first molars)
• At 20-30 months, the second molars start to erupt (NHS)

Which factors can affect the emergence of baby teeth

The eruption of baby teeth has been known to be affected by the following factors: ^3,4

Low birth weight

It has been found in a study conducted solely on infants located in Pune in India that infants that were born with a low birth weight, of less than 2500 g, suffered from a significant delay in the eruption of their first tooth. However, more studies are needed to support this finding, which represents the whole population.³

Malnutrition

Another study’s results have suggested that children who receive better nutrition have earlier tooth eruption and more teeth. Children who were malnourished were found to have a later eruption of their primary teeth. Malnutrition is when the body does not receive enough carbohydrates, proteins and fats. Proteins are particularly important for tooth eruption, as proteins are needed to facilitate the growth and development of teeth.⁴

Genetics

In addition, several genes have been associated with the timing of eruption of the primary teeth. Two genes that have been shown to have an association with primary tooth eruption, both in humans and animals, include the BMP4 and EDA genes.⁵

Gender

For those assigned male at birth, the average time for the first primary tooth to erupt is about 8.5 months, whereas for those assigned female at birth, the average time is earlier, about 7 months.⁶

Race

Furthermore, race is also a factor in determining the eruption of primary teeth. A study investigating tooth eruption in the U.S. population found that American Indian children had an earlier primary tooth emergence than those who were white or black living in the U.S.⁷

Hormonal changes

Hormonal changes include a mutation in the parathyroid hormone 1 receptor gene, which encodes for the parathyroid hormone (PTH) receptor. The PTH receptor binds to the PTH . They act as a lock and key model, where PTH is the key to the lock ( receptor), allowing PTH to exert its effect on the body, including a cascade of events that lead to the eruption of primary teeth. However, a mutation in the PTH 1 receptor genes, means that the shape of the receptor changes, and it can no longer bind PTH. This results in primary failure of eruption, which means that the baby teeth do not erupt.⁸

Height and weight

Both an increase in height and weight can result in earlier primary tooth eruption, However, the association between early primary tooth emergence is greater for height than weight.⁹

Importance of baby teeth

Facilitating proper chewing and digestion

Baby teeth start to erupt at approximately 6 months and serve a vital purpose by ensuring that their teeth allow them to safely chew solids. Baby teeth aid in the first step of digestion with molars used for chewing food and the incisors used for cutting the food down to smaller pieces. The broken food pieces are then reconstituted to a bolus of food and then safely swallowed. ^1,10,11,12

Preventing orthodontic issues later in life

If a child prematurely loses their baby teeth it can result in an array of orthodontic issues, including malocclusion and crowded teeth. These issues can affect how the child speaks and their pronunciation of words.¹³

Aiding in speech

Your teeth play an important role in the articulation of phonetic sounds, all of the below sounds are achieved with the help of your front teeth:

• Labiodental sounds ([f] and [v])
• Alveolar sounds ([t], [n], [dh], [s] and [z])
• Dental sounds ([θ] and [d]

If your child under the age of 4 loses their front teeth, this can impair their ability to speak and pronounce different words and sounds such as: s, z, th, zh and f. This highlights the importance of baby teeth in articulating sounds and words while speaking, which is vital for a child’s development.¹⁴

Maintaining space for permanent teeth

Baby teeth are the best space maintainers for when the second set of teeth erupts i.e., permanent teeth. If the baby's teeth are lost prematurely, it is better to get a space maintainer to maintain space in the child’s dental arch for their permanent teeth to erupt.¹⁵ Sadly premature loss of baby teeth can result in the following:¹⁵

• Dental crowding (where there is not enough room in the dental arch to house all the teeth, resulting in teeth overlapping)
• Tooth impaction of permanent teeth: where the teeth move off their course and do not erupt in the desired position
• A bad bite (malocclusion)¹⁵

Impact on facial structure and aesthetics

A nice smile can determine how one feels about themselves and provides a confidence boost with an overall sense of contentment with one’s appearance. To achieve an aesthetically pleasing smile there must be a harmonious balance of dental and facial components in both children and adults. Especially since the dawn of social media, the aesthetic appearance of a child’s smile has become more important for parents, with discolouration of front teeth and the loss of the front teeth in toddlers no longer acceptable in today’s society.¹⁶

Common issues and solutions

Dental decay and cavities

It is a sad, but common thought among parents in regard to their child’s baby teeth as ‘just’ baby teeth. However, a shift is needed in this narrative as poor oral health in children is sadly resulting in dental caries and dental decay. If dental caries are left untreated this can cause pain and can cause swelling. Often dental caries impact other areas of the child’s life, with them missing out on school and education due to dental pain, and keeping their families up at night due to dental pain. In addition, dental pain can result in them avoiding brushing their teeth, which in turn leads to worsening of oral and general health.¹⁷

Early loss

Premature loss of baby teeth can affect speech and pronunciation. In addition, this can lead to other dental issues including tooth impaction, dental crowding and a bad bite (malocclusion).¹³

Importance of proper oral hygiene and regular dental check-ups

Tooth decay is the most common disease in childhood, which is why it is important to ensure good oral hygiene. You should ensure that you wipe your baby’s gums after every meal before their primary teeth emerge, and avoid putting them to bed with a bottle. In addition, when your child’s first baby tooth erupts you should brush your child’s teeth twice daily. If your child is younger than 2 years you should consult with your dentist about which toothpaste is appropriate for their age group and when a fluoride-based toothpaste should be used. (CDC)

You should ensure that your child avoids foods with high sugar content, and encourage them to eat fruits and vegetables as snacks as an alternative to sweets. When you eat foods high in sugar, the bacteria in the mouth produce acid, which erodes away the enamel on the surface of the tooth and initiates tooth decay. This is why it is important to limit foods high in sugar and ensure that the teeth are being regularly cleaned to prevent tooth decay. (CDC)

Your child’s first dental appointment should be when their first baby tooth erupts. This helps your child to get used to going to the dentist, and regular dental check-ups allow the dentist to advise on how to prevent tooth decay. (NHS)

Summary

• You have 20 baby teeth, which first start erupting at approximately 6 months
• Your baby teeth are later replaced by a second set of teeth known as your permanent teeth, however, the health of your baby teeth is equally as important as the health of your permanent teeth
• Baby teeth have a role in allowing your child to speak, facilitating chewing and digestion, maintaining space for permanent teeth, and improving your child’s aesthetic appearance
• Lack of care for baby teeth can result in tooth decay and the formation of cavities
• Early loss of baby teeth can lead to an array of issues including a bad bite, crowding of the teeth and tooth impaction
• It is important to brush your child’s teeth twice a day and avoid sending them to bed with a bottle
• You should book your child’s first dental appointment when their first baby tooth erupts, as this gets them used to the dentist, and the dentist can advise on how to avoid cavities