Kids 6-13 Years
Eruption of Permanent Teeth
Shedding of Primary Teeth
Teeth will start loosening, as the permanent teeth push them out. It is not necessary to see a dentist when this happens. Shedding primary teeth is much less traumatic at home!
The child can wiggle the tooth until it comes out or you can assist him/her in taking it out.
A few good tips: Give your child ice-cream before taking it out – the coldness numbs the
gum slightly. Give apples, meat or biltong – the tooth sometimes comes out with a bite.
If you are taking the tooth out, make sure you have a good grip because you probably will only have one chance. Use a tissue for a good grip. Apply downward (toward the gum) and outward pressure for easy shedding.
Remind your child of the tooth fairy bringing a reward. Don’t worry if there is some bleeding.
Have a piece of moist, clean cotton wool handy for the child to bite on for a few minutes.
Don’t worry if the tooth appears to be without roots or is broken. The roots are usually resorbed by the permanent tooth. If an abcess has formed or the child is in extreme pain and/or you are not able to shed it – the dentist will be happy to assist.
All shedding should be finished by ±12 years. (see illustration on below)
Prevention of dental problems
By the age of six, the child should have sufficient fine-motor co-ordination to be brushing on his/her own. Flossing should also be started. Flossing cleans in-between the teeth where brushing can’t and it is essential that children floss! This is a habit they will not regret learning.
At this age parents usually leave the children to brush unsupervised. However, it is very important to still monitor the brushing and to check the status of the mouth once in a while. This is the most important stage where all permanent teeth start erupting and the time in which most teeth get rotten.
Children at this age seldom understand the consequences of not brushing and flossing. Place fissure sealants at age 6/7yrs (see CHILDREN 0-5 years: Dental terms and procedures). Go for regular check-ups and cleaning; once a year if your child has no caries and good oral hygiene, and every six months if your child is prone to caries and calculus build-up.
A mouth guard is very important as soon as the child starts with sport that requires protection of the teeth. Do not wait until an accident happen! The dentist will take an impression and make the mouth guard, and there are different materials and colours from which you and your child can choose.
All dental procedures discussed under CHILDREN 0-5 years apply to CHILDREN 6-13 years, except for pulpotomy (partial removal of the nerve) and stainless steel crowns. These procedures are only done on primary teeth.
A root canal (called ‘pulpectomy’ on primary teeth) is done on permanent teeth when the nerve is infected with bacteria. It may take one to three visits to prepare the nerve canals, fill them and restore the tooth. If you don’t want a root canal to be done, the tooth can be extracted, but remember there are no new teeth that will fill that gap! This treatment can be done with or without antibiotics.
A crown is placed if lots of tooth structure is lost or a root canal is done. This is to prevent further breaking of the tooth or to improve aesthetics and function.
Is grinding of teeth at night normal? Some children grind their teeth at night up to the age of 13 years; this assists with the resorption of primary teeth roots and to get the teeth in a stable position. If this continues after the age of 13 or the child complains of joint pain or headaches in the morning, consult your dentist. If it is necessary, the dentist will make a biteplate to protect the teeth and tempero-mandibular joint (the joint that connects the upper and lower jaws).
Does my child need braces?
Irregularities of teeth, the jaws or the face can be corrected with orthodontic intervention. Treatment is needed when the position of the teeth prevents normal function like eating, when the child has pain or discomfort, or if the child’s self-esteem and emotional well being are affected.
Orthodontics can also be done purely for aesthetic reasons, where one or two teeth may be little skew without causing real problems. In suitable cases in the primary dentition, a removable appliance can be made to correct the occlusion. This is a plate that the child can remove and clean and the success of treatment is based on the compliance of the patient.
When all the permanent teeth have erupted, the child will have to visit an orthodontist who will place fixed braces. The treatment-time varies according to the severity of the case. It is important to prepare your child emotionally for the braces and that he/she understands the goal and outcome of wearing braces. Regular cleaning and good oral hygiene is essential during orthodontic treatment! It is difficult to clean teeth with braces, but negligence leads to gum infections and caries.
The period between approximately 10-12 years is known as the Ugly Duckling-stage and it is normal for upper-front teeth to be spaced. These spaces usually close with the eruption of the canines. If spaces persist after the eruption of the canines, consult your dentist.
Warning signs when to see a dentist regarding orthodontic intervention:
– irregular or no shedding of primary teeth;
– early loss of primary teeth without space maintainers;
– habits such as thumb sucking and mouth breathing;
– if your child constantly bites his/her cheeks or lips.
Every child is different and it is important to take the child’s needs into consideration. Discuss all options with your dentist and never be afraid to ask!
Wisdom teeth erupt between ages 18-25, but there are exceptions where they can erupt either earlier or much later. If there is enough space in the jaw, the wisdom teeth can erupt fully without any complications. The only danger in this case is that they are sometimes difficult to clean, which leads to caries, pain and extraction.
If there isn’t enough space, the teeth can erupt partially and be slightly visible in the mouth. The gum over a partially erupted tooth often gets bitten, which leads to pain, swelling, infection and difficulty opening the jaw. In such a case the child will probably need antibiotics and the wisdom teeth will need to be removed.
The teeth may not yet be visible in the mouth, but signs such as headaches, movement of teeth, pain in the jaws or difficulty opening the mouth may indicate wisdom teeth that do not have enough space to erupt, and are causing pressure on the other teeth. Make sure that your child sees a dentist. The dentist will
take x-rays to determine the position of the wisdom teeth. Depending on the position, options for removal of wisdom teeth are the following: in the chair with a normal injection, conscious sedation in a dental chair, general anaesthesia in theatre or in complicated cases, referral to a maxillo-facial surgeon for removal. If your child has had orthodontic treatment (braces), it is always advisable
to remove wisdom teeth, in case they cause movement of teeth when they start erupting.
Do not worry if wisdom teeth don’t appear or don’t bother your child – many people go through a lifetime without even knowing about their wisdom teeth.