Ugly Ducklings and anxiety about your children's teeth

Many parents get anxious about their children’s teeth.

One of the most common concerns I see is nothing to do with any toothache issue, but is to do with front teeth starting to come through.

What ideally happens at about the age of 6 is that the front baby teeth, one by one, become loose, fall out and are replaced with new adult teeth.

However, in real life this process isn’t always quite so smooth.

Sometimes the adult teeth come through before the baby teeth have been shed. When this happens, they usually come through on the inside of the baby teeth and so little Johnnie seems to have too many teeth and they look wrong.

Sometimes the adult teeth take ages to come through and so little Sophie has missing teeth at the front for quite some time.

And sometimes, the baby teeth are very late in being lost and so the child is the only one in the class who still has baby teeth.

When they do finally arrive, they usually come through as crooked teeth. The reason for this is that they are full sized teeth, trying to fit into a child-sized mouth. The good news is that this usually corrects itself as the child’s mouth grows and things get better without any kind of intervention.

So don’t panic when your child who always had beautiful little baby teeth suddenly looks like Dracula. In dental terms, we call this the “Ugly Duckling” stage, and they usually end up as beautiful swans.

Do all missing teeth need to be replaced?

Absolutely no!

Teeth are optional. There’s no law saying that everyone has to have 32 teeth.


It’s not like running a car where getting an annual MOT is a legal requirement. As far as I am aware, it’s not illegal to be missing some teeth.


Lots of people have various missing teeth and it does them no harm at all.


So how do dentists work out which ones need replacing and which ones don’t.


Well, here’s my feelings on the matter.


Does it show? 
Most people don’t want to have gaps in their smile. However, many people are just unaware of how they look when they smile and just how many teeth they show, because they only see themselves in a mirror front view only. If they could see themselves from the side, especially when they are smiling widely or laughing, they could really see what shows and what doesn’t. So if you’re not sure, ask someone else if they can see the gaps.


Can I chew OK?
The more spaces there are, the harder it is to chew your food properly. This can have effects on food digestion as well as being embarrassing socially. Amazingly, there are people who manage to eat loads of things without any teeth at all, just by using their gums! You’ll know if you are missing out on the pleasures of being able to eat whatever you want. The people you eat with will know if you’re taking twice as long to chew as everyone else.


Is it causing any harm?
Although it can be hard to notice it because it happens slowly, teeth will often move around if there are gaps. Missing teeth can lead to the neighbouring teeth tilting and the opposing teeth (that’s the teeth in the opposite jaw to the gaps) moving drastically out of position. This, in turn, can lead to the other teeth decaying, which can cause big problems. You may not notice this movement, but your dentist will be aware of it.


Is it right at the back?
Generally, I don’t advise replacing missing teeth that are right at the back of the mouth, provided that people have enough other teeth elsewhere. The benefits of having them are often outweighed by the difficulties, costs and risks of replacing them.


I hope this helps, do let me know your own thoughts

Cleaning Children’s Teeth

I’m often asked questions about how to look after children’s teeth, how to brush them, when to brush them, what toothpaste to use etc, etc.

Children need to have their teeth brushed as soon as they get them. At first you can just use either a very small baby-sized toothbrush or a cotton bud. As the baby grows and gets more teeth use a very small toothbrush.

The teeth need brushing twice a day: every morning and every evening. As well as keeping the teeth clean for the baby/ infant, this is a great way of making sure that good habits are instilled

Use Children's Tooth Paste

I recommend using a child’s toothpaste for the first few years, before changing to a regular adult toothpaste. It’s a good idea to just use a very small amount of paste on the brush – about the same size as the child’s little finger nail so that they don’t get too much as it can have a strong taste.  I also recommend that after brushing the child should spit out but not to rinse – that way the fluoride from the toothpaste will be in contact with the teeth for longer and will do more good.

How often to brush

The teeth need to be brushed twice daily by an adult until the child is 9 or 10. This is because the child won’t have the manual dexterity to use the brush properly until they’re about this age, although they may look like they’re doing a good job.

Some children really don’t like having their teeth brushed and it can be a real struggle with some of them. I would encourage parents to try and make the whole process fun. Sometimes the parent is using too much strongly flavoured toothpaste so remember just to use a pea-size amount.

But sometimes there is no solution other than a wrestling match on the bathroom floor. Being the father of three children myself, I know that this is sometimes the only way. The important thing is that the parent looks after the child’s teeth and takes responsibility for getting the job done – the parent must be in control, not the child. Believe me, they will thank you for it in the end.

I’ll be posting a video demonstrating how to do the brushing so keep in touch.