The American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) recommend that a child see a dentist when their first tooth appears and no later than their first birthday. 

Its recommended to start brushing your child’s teeth as soon as the first tooth erupts with a smear of fluoride toothpaste and a soft bristle toothbrush. 

A soft bristle toothbrush with a small head designed for the appropriate age is recommended. 

Young children may grind their teeth together when they first come in because they are new in the mouth and they are getting used to them. It is common and will stop as child gets used to their new teeth and as they get older. 

Some older children also grind their teeth at night and can be due to stress due to a new environment, changes within the family, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

All children should have an orthodontic evaluation by age 7 to look out for orthodontic problems that might arise such as crowding, crossbite, open bite, etc. A pediatric dentist  and orthodontist can evaluate the need for early orthodontic treatment if necessary. 

This is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth is coming in.  In most cases if the child starts wiggling the baby tooth, it will usually fall out on its own within two months. If it doesn’t, then contact your pediatric dentist, where they can easily remove the tooth.  The permanent tooth should then slide into the proper place.

Many parents struggle with brushing their children’s teeth. Its best to establish a routine so they know what to expect. To be able to brush adequately, the child should be in a comfortable position where the parent has control. Examples are laying down and in a knee to knee position with another adult. 

Gently brush all teeth and all surfaces in soft circles with smear of fluoride toothpaste if child is less than 3 years old and a pea size amount if they are older and can spit excess out. 

If your child is having tooth pain, rinse mouth with warm salt water, apply a cold compress if there is swelling, administer an analgesic if necessary and visit a dentist as soon as possible.