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Your darling three-month old is crying and fussy—can she be teething already? Or, your happy baby boy has just celebrated his first birthday—with only one tooth in that beautiful, gummy smile. Is this normal? Probably! While baby teeth do typically erupt (come in) in the same order for all babies, and around the same time, there is still a lot of flexibility in the time it takes for a full, healthy smile to develop.

Baby teeth actually form before your baby is born, and those 20 teeth are there under the gums waiting to come out and shine. And even though there are no firm and fast dates for each of these primary teeth to erupt, it’s helpful to have a general overview of typical teething patterns so you know what to look forward to.

Incisors

These little teeth create a charming baby smile, and, if your finger has been in the wrong place at the wrong time, a very sharp one as well! That is because these tiny incisors are made to bite into foods. You might notice this when you introduce solid foods, even if the majority of your child’s “chewing” is done with her back gums. These teeth are the earliest to arrive.

• Six to ten months old: The lower central incisors (bottom front teeth) are often the first to come in.
• Eight to 12 months old: The upper incisors (8-12 months) are the next to show.
• Nine to 13 months old: The upper lateral incisors on each side of the front teeth arrive.
• Ten to 16 months old: The lower lateral incisors appear.

First Molars

Because these are larger teeth, babies often experience another bout of teething pain at this time. The large flat surface of each molar helps your child to chew and grind food, so he can handle a wider variety of foods and develop his chewing skills.

• 13 to 19 months old: You can generally expect to see the upper first molars arrive.
• 14 to 18 months old: The lower first molars appear.

Canines (Cuspids)

Fitting between the first molars and the incisors, the strong, pointed shape of the canine teeth allows your child to grip food and break it apart more easily.

• 16 to 22 months old: The upper two canines make their way into the space between the incisors and the first molars.
• 17 to 23 months old: The two lower canines appear.

Second Molars

By the age of three, most children have a full set of baby teeth.

• 23 to 31 months old: The second pair of bottom molars start erupting—you are in the home stretch!
• 25 to 33 months old: The upper second molars come in—completing that beautiful set of 20 teeth!

Baby teeth are extremely important, as Drs. Peter Vogel, Vijal Vadecha will tell you when you visit our Anthem office. They help your child eat and chew, develop face and jaw muscles, assist proper speech formation, and provide space for the adult teeth to come in properly. Now that your child’s smile is complete, keep providing him with the same care and attention you have been giving those little teeth since the arrival of the very first incisor.

It seems that so much of new parenthood is scheduling—when to feed her, when to put her to bed, how many hours between naps. But we soon find out that every baby is not on the same schedule, and the same is true for the arrival of their teeth. We should see your baby when that first tooth comes in, or by his or her first birthday. And if you ever have concerns at any time about your child’s teething schedule or teething delays, always feel free to give us a call.

Gum recession, a common result of gum disease, occurs when the gum tissue that surrounds the teeth wears away or pulls back, forming pockets between the gumline and exposing more of the tooth. Gum recession occurs gradually, so you might not know that you have it. Left untreated, gum recession can result in tooth loss. In addition, there are several studies that suggest that gum disease is associated with modest increases in coronary heart disease. Here are five ways to know if your gums are receding.

1. Healthy gums are firm, light pink, and very elastic. If your gums don’t fit that description, then it’s time to visit our Anthem office. Red, swollen gums are a common symptom of gum disease, and may lead to gum recession.

2. Do your gums bleed easily when you brush or floss? If you have gum recession, even if you brush gently and with toothpaste specifically designed for sensitivity, it may still result in bleeding.

3. When you look in the mirror, do you see more of a tooth than you used to? This is one of the easiest ways to tell if you have gum recession. When gums recede, more of the tooth is visibly exposed. Look for lines or notches along the bottom of the teeth, as this typically indicates areas where the gums have receded.

4. One of the first signs of gum recession is tooth sensitivity. Does it hurt when you bite down or chew? The more gums recede, the more painful it is going to be. However, before you experience tooth sensitivity or pain, you may notice awkwardness when you bit down. When gum recession occurs, teeth can shift slightly, making it feel as if they are not properly aligned.

5. Loose teeth are a symptom of advanced gum recession and periodontal disease. In other words, the supporting bone structure of the teeth has already begun to deteriorate. If left untreated, it will result in tooth loss.

From deep cleaning (scaling) to gingival tissue grafting surgery, there are several ways to combat gum recession and periodontal disease. How gum recession is treated depends on how far advanced it is. Talk to Drs. Peter Vogel, Vijal Vadecha about what options are best for you.

A lot of patients go at their teeth like they were sanding an old floor—that is to say, way too hard! Brushing too hard is probably the most common mistake patients make in their oral care routine, and it can be detrimental to the gums and teeth.

What can brushing too hard cause?

• Receding gums
• Bone loss around teeth
• Loss of teeth
• Tooth sensitivity, especially to hot and cold
• Worn down enamel

Brushing too hard wears away at your gums, which can lead to the neck of the teeth being exposed. This part of the tooth isn't covered by hard enamel like the rest of the tooth and hence the soft inner layer, or dentin, is exposed. Dentin is very sensitive to hot and cold and much more susceptible to bacterial decay. Once the gums recede due to improper brushing, it’s usually irreversible.

How to brush your teeth properly

You know you're supposed to brush your teeth twice a day, so why not do it right? First and foremost, you should only ever brush with a soft bristled brush—not medium or hard—unless directed otherwise by Drs. Peter Vogel, Vijal Vadecha. Unless you have braces or specific oral health issues, brushing twice a day for two minutes is usually plenty.

The main purpose of brushing is to remove plaque from your teeth and gums. Plaque is actually soft and is a buildup of bacteria, saliva, and food debris. You really don't need to brush hard to remove it, just make sure you aim your toothbrush at the gum line (where plaque grows) and brush in small circular motions, never a back-and-forth motion.

It's also wise to hold your toothbrush gently. People tend to brush harder the tighter they hold their toothbrush.

Still have questions about proper tooth brushing technique or gum health? Ask any staff member or Drs. Peter Vogel, Vijal Vadecha during your next visit to our Anthem office; we'd be happy to help!

If you have never had a crown before, you might be wondering why crown treatment is best, what the procedure involves, and which type of crown to choose. Let’s get down to the basics of crowns!

A crown is the best way to treat many dental conditions, either to strengthen and save the tooth or to improve its appearance. We might suggest a crown if you have any of the following conditions:

• A filling that needs to be replaced, without enough tooth structure left to fill properly
• A tooth that is fractured or broken, or so weak that it might fracture
• A recent root canal
• An implant
• A bridge which needs a crown to serve as the base for attachment
• A tooth that is discolored or irregularly shaped

On your first visit to our Anthem office, Drs. Peter Vogel, Vijal Vadecha will prepare the tooth that will be receiving a crown. A tooth might have to be built up if there isn’t enough of the original tooth left, or the top and sides of the tooth will be shaped down so that the crown fits smoothly and evenly with your other teeth. An impression will be made and sent to a dental lab so that a crown with the perfect fit for your tooth and mouth can be created. A temporary crown will be put in place to protect your tooth while the final crown is fabricated.

 The permanent crown is a cap which covers your tooth. It can be made of various materials, which all offer different advantages:

• Metal Crowns—made of gold, platinum or base metal alloys, these are the longest lasting. Because of their metallic color, they are often chosen for back molars where they are less visible.
• Porcelain Over Metal—because the color of the porcelain is matched to your natural teeth, these crowns look very realistic. Porcelain is more fragile than metal, so there is the possibility that they won’t be as durable.
• Resin—less expensive than other options, but these crowns are more fragile and do not wear as well.
• All Porcelain/All Ceramic—the most realistic looking option, especially for front teeth, and also suitable for anyone with a metal allergy. They are, again, not as strong as metal crowns, and can be subject to damage.
• Stainless Steel—often used for baby teeth or as a temporary crown for adult teeth.

We’ll discuss your options and help you decide on the best type of crown for you. When the crown is finished at the dental lab, you will have one more visit where the crown will be secured in place. We will make sure your bite is comfortable and the color and appearance of the crown are satisfactory. We will also give you instructions for the next few days following the procedure, and can make adjustments if needed.

A crown is a perfect example of form and function working together: a crown maintains the beauty of your smile and preserves the health of your tooth. If you need a crown, we will be happy to talk to you about your best options for a strong, long-lasting, and natural smile.