Caring for toddler's teeth

My son is 19 months and has had all of his front teeth and four of his molars since he was about 13 or 14 months. Any reason why his teeth came in so soon? Should I be worried about anything? I brush his teeth morning and evening and floss occasionally - is that enough? Should I be concerned with him swallowing the paste? He's been brushing since he was 12 months. I use very little paste on his brush. Please let me know. We haven't been to the dentist's office yet. Should we go now since he has so many teeth?


Dear Daphne,

Your son is not too early in his tooth development. The primary incisors and molars are usually present in the mouth by about the age of 15 months. The primary cuspids or canines may be slightly later, about 16 months for the lower and about 18 months for the upper. These are all average ages for tooth eruption. Accordingly, some children will develop their teeth sooner and some later. Generally, children who develop their primary teeth at an earlier age tend to develop their permanent teeth earlier as well.

You should be brushing his teeth at least twice daily, more often if he ingests a lot of sugars and/or carbohydrates. Flossing at least once daily, even if there are slight spaces between his primary teeth, is a good idea. Not only does this remove any food particles and plaque not removed by brushing, but this practice also allows a child to get used to flossing daily. In addition, as his second primary molars erupt, they will most likely be in very close proximity to his primary first molars. The area in between the first and second primary molars is one of the most common areas for cavity formation. Daily flossing, especially in this area, will help prevent these interproximal cavities from forming.

Children do swallow toothpaste; this is why it is very important to place only a matchhead size portion on their toothbrushes. Fluoride is not one of those substances that if a little is good, more must be better. Given in very small dosages, it has dental benefits, but overdoses can cause dental and systemic problems.

I have been advising parents to take their children for their first dental visit at about 1 year old. Some pedodontists advise that the first visit should occur when the first tooth is erupted into the oral cavity. Even at 1 year old, some children will cooperate quite well; others may only see the office and "go for a ride" in the chair. I do not push children to let me see their teeth at the first visit. Usually, if they get to know me and the office in a non-threatening manner, they will be more cooperative in the future. I definitely advise you to take your son to the dentist for a check-up now. If the dentist can look in his mouth, you will learn of any potential problems. If the dentist is unable to look in his mouth, at least he will have been introduced to the dental office environment. The most important thing is to make the experience a positive one for your son so he will not dislike going to the dentist.

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