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Pediatric Dental Stages

Birth to 1st Birthday

Our office is equipped to manage the most common reasons for an early life assessment. Some children are referred by their pediatrician or lactation consultant for the assessment and management of natal/neonatal teeth. Some babies are born with their lower central baby teeth — often not fully formed or stable. These are known as natal teeth. If these baby teeth erupt within the first year of life, they are termed neonatal teeth. A relationship with a Pediatric Dentist allows you access to care during this unexpected experience to keep both mom and baby happy in their new endeavor of feeding.

A common reason for an early life relationship with our office may be related to nursing challenges. Your pediatrician, lactation consultant or infant feeding specialist may recommend our consultation as your baby may have been born with a shortened lingual frenum. This frenum presentation may cause difficulties in nursing during these challenging early times. Our office is prepared to manage infant frenectomy procedure using a CO2 laser in conjunction with a relationship with your additional specialists in early feeding concerns.


Our most common relationship with families before your baby’s 1st birthday is to manage early oral hygiene and teeth eruption patterns. Some children may be assessed and managed for signs of early childhood cavities. 

  • Discuss your baby’s tooth eruption sequence

  • Discuss various options and approaches to brushing your baby’s teeth

  • Evaluate and discuss cavity prevention, development and/or management

  • Discuss injury prevention and management


1st Birthday to 3 Years

This is a time of many changes. Babies are erupting numerous baby teeth and parents are learning how to manage teething pains and brushing wriggly littles with chomper reflexes. We are always so glad parents come in so we can be a part of your support group during these changes. Our exams generally begin by your 1st birthday (or within six months of your first tooth coming in). These early visits provide a tremendous amount of guidance in cavity prevention and management. We guide parents as to our best recommendations surrounding fluoridated toothpaste use and how exactly to brush! During these years, we keep parents abreast of how many of the 20 baby teeth have come through and when to expect next eruptions between our six month visits. These early years of mobility can cause some injuries to baby teeth. In having already established this relationship, we are only a quick phone call away to guide you on next steps!

3 to 6 Years

By the time your toddler is three years old, they have more than likely completed the eruption of all 20 baby teeth! I advise their parents to help encourage good oral hygiene (including flossing) to prevent cavities. Approaching age six, many parents can expect the transition of baby teeth to permanent teeth to begin. During this time, parents will see the emergence of their child’s first permanent molar. A good rule of thumb is that you “exchange” your baby teeth in the front at a similar time as you “gain” your permanent tooth in the far back. Often parents will call about a double row of teeth in the lower front — we refer to this as “baby shark teeth”. The lower permanent incisors come in behind the baby teeth and can cause the baby teeth to get a bit stuck. On occasion, you need your dentist to remove the baby teeth, allowing the natural forward drift of your new permanent teeth. Space management concerns may be indicated during this early transition and questions surrounding an orthodontic assessment start to come up.


6 to 13 Years

These are the years of enormous facial skeletal changes and the commonly expected “tooth fairy visits”. Yes, your children really gear up for the gradual process of exchanging their baby teeth for permanent ones and it is an exciting time. 


These are common discussion topics during this age group: shark teeth, crowding, premature loss of neighboring teeth because of crowding or narrowly tapered arches, a developmental Panoramic x-ray to determine development of all permanent teeth and their angulation, an orthodontic assessment by age seven, injuries to the newly erupted permanent teeth, kids brushing and flossing on their own, sports mouth guards and cavity management.

Tooth Fairy Visit 

Many parents and kiddos are excited about losing their first tooth. The anticipation of your little's first Tooth Fairy Visit is an exciting time and generally is experienced around age 6 years. Some kiddos are ahead and some are a little behind this age. Often at our dental visits approaching Kindergarten, we start searching for these little wiggly teeth on the bottom. Keep in mind that if your child feels a funny feeling around this age and area, they really may be starting to feel their baby teeth getting loose before even we do!


Whatever your family tradition is, enjoy the experience and the magic of this time. It changes your child's appearance and suddenly you realize your baby is really growing up!

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13 to 18 Years

At this age, your child is usually in full permanent dentition. They have likely already completed an initial Phase 1 orthodontic phase and are gearing up for a possible Phase 2 comprehensive orthodontic management phase. My goal during this time is to support parents in permanent teeth oral hygiene, diet, cavity and injury prevention that is most needed during this time. Your children are learning real responsibilities as these are now what I refer to as your “forever ever teeth”. I ask that parents and I work cohesively to support our young adolescents in their autonomy over dietary choices and oral hygiene practices lending to optimal health. 

Graduation to General Dentistry

Families often ask me when they move on to a General Dentist during their child’s high school years. I think most of this is initially decided by your child. Some late adolescents are ready to move on to a more adult scene in their healthcare, but yes, we are equipped to manage your child’s needs through to their high school graduation. Should your child need more advanced dental care management such as prosthodontic needs including crowns, implants or bridges, I suggest this transition to a General Dental practice to better meet these prosthodontic needs. It is always a privilege to be your child’s dentist and we are grateful to have met your child’s early life needs. We trust and value our colleagues in General Dentistry to provide the optimal care your child has now grown to need.

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