• When teeth first appear
• Caring for first teeth
• Pacifiers and buckteeth
• Preventing tooth decay
• Causes of dental erosion

When teeth first appear

Infants are born with twenty teeth growing just under the gums. These "baby" or "milk" teeth help your child to eat, talk and smile. Although they will eventually be replaced, milk teeth are very important as they guide the development of your child's adult teeth.

It is an exciting time when your baby's front tooth grows through the gum. This usually happens between the age of six and twelve months. Over the next two years, more milk teeth will appear so that by the time your child is three-years-old, he or she will have all twenty. After the age of six, permanent molars begin to appear at the back of your child's mouth and the milk teeth are gradually replaced, so that your child will eventually have 32 permanent teeth.

Caring for first teeth

Well cared for milk teeth play an important role in determining the health of your child's permanent teeth, so it is vital to look after that first set of twenty. Begin to clean your baby's mouth as soon as the first tooth breaks through. Simply wipe the tooth with a soft, clean, damp cloth every day. When the molar teeth appear, place a smear of low-fluoride toothpaste onto a specially designed children's toothbrush and carefully brush your child's teeth. Your baby may resist at first, so try to make the routine as playful as possible until your child becomes used to having their mouth cleaned. The following tips might help:

• Try holding your child on your lap while you brush;
• Choose a colourful brand of children's toothpaste;
• Let your child watch you as you clean your teeth;
• As she gets older, encourage your child to hold up a mirror to see what you are doing - a useful technique for distracting them and helping them to learn something.

And remember

• Do not to let your baby eat the paste from the tube.
• Never let a child wander around with a toothbrush held in their mouth.

Continue to help your child to brush their teeth until they reach age seven or eight years. By this time, your child should be brushing their teeth twice a day. Your dentist or hygienist will advise you if they think your child needs to floss their teeth and will give you and your child instruction in how to do so. Flossing is the only way to remove the plaque that builds up between the teeth and just below the gum line - places where decay usually begins and that a toothbrush cannot reach.

Also, get into the habit of taking your child in for regular dental check-ups as soon as their first tooth appears. Your dentist will be able to advise you on how to prevent any dental disease and to monitor the development of your child's teeth.

Pacifiers and buckteeth

Many parents worry about the effect of pacifiers and thumb-sucking on the shape of their children's teeth. In terms of preventing your child's front teeth from sticking out, the shape and type of pacifier is less critical than the age at which the habit ceases. Try to get your child out of the habit as early as possible. However, bear in mind that a pacifier is preferable to thumb or finger sucking, since a pacifier is easy to throw away. If your child simply won't settle without a pacifier, choosing a square, orthodontic one as opposed to one that resembles a nipple will help prevent buckteeth.

Other steps you can take to help keep your child's teeth properly aligned include encouraging them to drink from a feeder cup instead of a bottle from age one onwards.

If your child's teeth are not aligned or sticking out, your dentist will advise you on whether your child needs to visit an orthodontist. Where required, an orthodontist can assess the position of your child's teeth when they are about ten years of age.

Preventing tooth decay

From the moment the first tooth emerges, your child runs the risk of tooth decay. To prevent this, avoid giving your child sugary foods and drinks, including fruit juice and fizzy drinks. Even sugar-free fizzy drinks should be limited as they can erode the tooth's surface.

Remember that children are not born with a sweet tooth; their tastes are influenced by the food you prepare for them so if you begin by banning sugar your child will not miss it.

Bear in mind also that the frequency with which sweetened foods and drinks are taken is more important than the actual amounts. Therefore:

• Do not give your child sweets and chocolate every day - save them as a treat
• you want to give your child a sugary treat it is best to include it as part of mealtimes - as a dessert - rather than as a snack.
• Offer your child dental-friendly snacks such as fruit, raw vegetables, cheese, small sandwiches, nuts in older children, milk*, water, well diluted sugar-free squashes and unsweetened tea and coffee, in-between meals if necessary.
• Never give your baby a bottle of milk, juice or sweetened liquid to help them get to sleep.
• Do not dip your child's pacifier into honey, sugar or other sweet substances to encourage your child to take it.
• As foods usually contain hidden sugars, carefully check food labels and select the brand with the lowest amount. Sucrose, glucose, fructose, maltose and syrup are all different types of sugars.
• Cow's milk should only be given to children as a main drink after the age of 12 months.

Causes of dental erosion

Dental erosion occurs when teeth are worn away by acidic foods and drinks, such as fruit juices and fizzy drinks. As the teeth wear, the outer enamel is lost first and eventually the next layer, the dentine, is involved. The teeth become thin and extremely sensitive to hot and cold. If nothing is done to prevent the erosion, the teeth eventually chip and break. The enamel and dentine will not grow back and if your child's adult teeth become eroded, the child will need fillings and crowns on these teeth for the rest of their life.

Initial findings from a tooth erosion study carried out on five-year-old children in County Cork, and reported in 2002, showed that 45% of them suffered from erosion. Among those affected, 19% had severe erosion involving the dentine layer. When trying to determine a cause, the research pointed to the consumption of carbonated (fizzy) drinks. Children who drank fizzy drinks at least once a day were more than twice as likely to experience tooth erosion than children who did not. The study also identified a bigger culprit than fizzy drinks - fruit squashes - children who drank them at least once a day were three and a half times more likely to experience tooth erosion than those who did not. When preparing fruit squashes for your child, it is important to follow the manufacturer's diluting instructions correctly and do not allow your child to consume them frequently throughout the day.

As well as helping us to eat and speak, teeth make all the difference to a smile. When well looked after, there is no reason why teeth should not last a lifetime. If you follow the advice above, you will give your child a pleasant and inexpensive experience of dentistry rather than a lifetime of dental repair.