Losing a baby tooth is an important milestone in a child's life. Be sure to take a photo of that toothless smile — it will be something you treasure as your child grows up.

You may be wondering what is really happening when a baby tooth becomes loose and eventually falls or is pulled out. Read on for some answers.

What are baby teeth?
An infant's teeth begin to form before birth, by the fifth to sixth week after conception. When the baby is born, 20 primary (baby) teeth are almost completely formed inside the jaws. These first teeth, also called deciduous teeth, begin to erupt through the gums at about the time the baby begins to eat solid food. The front teeth (incisors) are usually the first to come in, at age six months to a year.

Why are they called deciduous teeth?
Deciduous means “falling off at maturity.” The same term refers to trees that lose their leaves every fall. In many mammals, including humans, it refers to the first teeth, which need to come out to make room for the larger permanent teeth to come in.

What causes the deciduous teeth to become loose?
While your child is using his primary teeth to bite and chew, his adult (permanent) teeth are quietly growing inside his jawbone. Starting with tooth “germs” (the word comes from germination, meaning the start of growth), the top part of each tooth, called the crown, grows first. Then the bottom part, or root, begins to grow and elongate. As the roots develop and the permanent teeth take up more room in the child's jaw, they begin to push against the baby teeth. This causes the roots of the baby teeth to melt away or resorb. Eventually little or nothing is left to hold the baby teeth inside the child's gums, they become wiggly, and finally they can easily be pulled out. This may leave a little bleeding gum tissue that quickly heals.

What should you watch for in the transition from primary to permanent teeth?
As the permanent teeth erupt (push through the gums and become visible), you may notice that they are too crowded, have too much space between them, or are crooked. It's a good idea to have an orthodontic (from ortho, meaning straight and dont, meaning tooth) evaluation at age five to seven. Watch to see that the baby teeth are lost in the right sequence. If one is lost prematurely, for example from decay, make sure that the space that it occupied is maintained to make room for the adult tooth that will replace it. We can help you with this.

Contact us today to schedule an appointment to discuss whether your child's baby teeth are being lost in the right sequence and if the adult teeth are coming in correctly. For more information see the Dear Doctor magazine article “Losing a Baby Tooth.”

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn't worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. See us as soon as possible to assess the extent of injury, so that proper and appropriate action can be taken.

An additional reason why bonding with composite resin may be the ideal choice for repairing a child's chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer.

An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor's Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.

Wouldn't it be wonderful if you could put up a protective shield to guard your children's teeth from decay? Think of the time and money you would save, not to mention the pain your children would avoid. Well, it turns out that you can put up such a protective shield — or at least, we, your dental professionals, can.

The natural protective mineral coating (the enamel) of a child's new teeth is more permeable to the acids that dissolve minerals and cause decay, so the new teeth are more vulnerable to tooth decay than mature teeth are. As a tooth's enamel matures it becomes more resistant and stronger. Thus it is important to protect the surfaces of the new teeth when they erupt (grow up through the child's gums).

The back teeth, particularly, often erupt with deep grooves in them. The backs of the top front teeth may also have such grooves, which dentists call “pits and fissures.” When the grooves are deep, they are hard to keep clean. Toothbrush bristles may not be able to reach to the bottoms of the grooves; and bacteria may gather in them, releasing acid byproducts that dissolve tooth enamel and start forming decay.

Dental sealants are among the preventive options we have in the war against decay in your child's new teeth. Regular tooth brushing and flossing, regular dental visits, application of fluoride, and low sugar consumption are also important in decay prevention techniques.

Sealants are protective coatings placed in the tiny pits and fissures to seal them off from bacterial attack. Some dentists routinely seal all permanent molar teeth and many primary (baby) molar teeth soon after they erupt.

Some dentists use sealants only when an examination shows that decay is just starting or very likely to start in a particular tooth. In such cases a minimal amount of tooth enamel is removed to eliminate any decay, and a mini-resin, invisible filling is applied.

Contact us today to schedule an appointment to discuss your questions about dental sealants for your children. You can learn more about them by reading the Dear Doctor magazine article “Sealants for Children.”