Teething/Dental Problems 

Evidence 

https://pubmed.ncbi.nlm.nih.gov/9153835/ 

W K Seow 

Preterm and low birthweight children comprise approximately 6 per cent of all live births. They are prone to many serious medical problems during the neonatal period which may affect the development of oral tissues. Studies have shown a high prevalence of generalized enamel hypoplasia in the primary dentition of around 40-70 per cent in preterm children which is likely to be associated with low bone mineral stores. The clinical significance of enamel defects is poor aesthetics, and predisposition of the lesions to dental caries. Other dental defects observed in preterm children are localized enamel hypoplasia, crown dilacerations, and palatal distortions which are usually associated with traumatic laryngoscopy and prolonged endotracheal intubation. 

Education 

Teething can be an uncomfortable time for your baby, but the more you know about it, the more you can help your little one get relief and practice their new smile. The teething experience can be different for every child. Your baby's first tooth may appear as early as three months or as late as a year or more. The average age is around six months. 

If your baby was born premature, their teeth will likely take longer to start coming through. An individual tooth will usually only cause discomfort for a few days at most, but it can take longer for some babies. The whole teething process is usually complete by the age of two to three. 

Teething symptoms to look out for include: 

• excessive drooling 

• red, swollen, or bulging gums 

• redness on the cheeks or chin 

• an increase in biting, chewing and sucking behaviour. 

• rejecting food 

• disturbed sleep 

• face rubbing or ear pulling. 

If your child is feeling teething pain, there are many home remedies and products you can try to relieve these symptoms and soothe their aching gums. These include: 

• Gum massage: Making sure your fingers are clean, gently rub the sore areas of your baby's gums. This counter-pressure can give them some temporary relief. 

• Teething toys: Soft plush, plastic and rubber toys are safe for your baby to chew on and could soothe their gums. 

• Cold washcloth: Chill a damp, clean washcloth in the fridge or freezer and allow your child to gnaw on it. This can relieve some of the pressure and swelling. 

• Medicine: If home remedies aren't working, ask your paediatrician, dentist or chemist about safe pain relief options. 

When should I start to brush my child's teeth? 

As soon as your baby's first tooth appears, you need to start taking care of it. Tooth decay can affect children of all ages, so it's important to keep it at bay through regular cleaning. 

Gently brush or rub their milk teeth using water. You don’t need to use toothpaste because babies tend to simply swallow it! This should be enough, especially in areas where there’s fluoride in the drinking water but consult with your dentist to be sure. By age three, your child can graduate to a small bit of fluoride toothpaste (smaller than pea-sized) twice a day. 

Dental Concerns 

Unfortunately, a premature birth can result in an increased risk of dental health concerns in both childhood and later in life. Three of the most prevalent dental issues that can occur for a premature child are:  

• Delayed Tooth Eruption is when the child begins teething at a later stage than is normal (usually between 4-7 months old). This condition is more common among premature children, in particular those who were born very tiny or very ill.

• A palatal groove is a narrow groove in the roof of the mouth, which is caused by the baby having breathing tubes in the NICU. Some premature babies have developed grooves after having breathing tubes for as few as seven days, but generally speaking, the longer the time, the more likely a palatal groove will develop. It can result in overcrowding or poor positioning of the teeth which may increase the chance for needing braces.

• Enamel hypoplasia means there is a lack of enamel on the outside of the teeth. This can lead to the thin enamel chipping away in which the teeth are more prone to fracture. Causes are when the baby has breathing tubes in NICU as well as a lack of nutrients in the NICU.   

Empowerment 

All of the above conditions result from a difficult start to your child’s life and are very treatable with current dental techniques and practices. If you are the parent of a premature child, you may have to expect a few more visits to the dentist and teeth procedures than is usual and you may also need to get your child some orthodontic treatment to correct any major problems with their smile.  

Useful Links  

Raising Children 

https://raisingchildren.net.au/babies/health-daily-care/dental-care/dental-care-babies 

Miracle Babies Foundation 

https://www.miraclebabies.org.au/content/dental-problems/gmvwmw 

Australian Dental Association  

https://www.ada.org.au/getattachment/Your-Dental-Health/Resources-for-Professionals/Resources-for-Children-0-11/When-should-my-child-first-see-the-dentist/When-should-my-child-first-see-the-dentist_.pdf.aspx 

Need support? NurtureConnect allows you to connect with our NurtureProgram support team, or call our 24 hour NurtureLine 1300 622 243 or join our Facebook community.

NurtureConnect