Common Questions Answered: Baby Teeth, Thumb Sucking, Fruit Juice

Some of the most often asked questions of Dr. Eric Jackson are about fruit juice, baby teeth, and thumb sucking. This article will answer important questions, such as “Why are baby teeth important?”, “When should I expect my baby to start getting teeth?”, “When do adult teeth typically come in?”, “What should I do about thumb sucking?”, and “How much juice should I be giving my child?”.

Why are baby teeth important?

Baby teeth (aka deciduous/primary teeth) may only be temporary but they play an extremely important role in a child’s development. These teeth not only aid in the development of clear speech, they reserve space for a permanent teeth and give the face its normal appearance as well. Baby teeth help a child attain good nutrition and give the permanent teeth a health start. Decay, infection and missing baby teeth can make it difficult for a child to chew causing them to reject some foods and cause damage to the permanent teeth developing beneath the baby teeth.

Once a child’s first tooth erupts it is susceptible to decay and cavities, so it’s important to start good oral hygiene habits from an early age. The American Dental Association recommends that a dentist examine a child within six months after the first tooth erupts and no later than the first birthday.

At home there are few things to help parents jump start those good oral hygiene habits, such as brushing the newly erupted teeth with a child’s size toothbrush and water. Children over the age of two can use a pea size amount of toothpaste to brush their teeth. (Consult the child’s dentist on toothpaste & fluoride recommendations.) When it comes to bedtime and naptime, children should never sleep with a bottle.

When should I expect my baby to start getting teeth?

Baby teeth normally begin to erupt around 6 months of age and all twenty baby teeth have typically erupted by age 3. Remember, these teeth erupt at different speeds from child to child. A good rule of thumb is that for every 6 months of life approximately 4 teeth will erupt. The bottom two incisors are normally the first teeth to erupt.

When do adult teeth typically come in?

The graphic below gives guidelines for when permeant teeth typically erupt.

Helpful facts about teeth

  • Girls generally precede boys in tooth eruption
  • Lower teeth usually erupt before upper teeth
  • Baby teeth typically fall out in the same order that they came in
  • The average age for a child to lose his/her first baby tooth is 6 years old
  • Primary teeth are smaller in size and whiter in color than permanent teeth
  • Thumbsucking & pacifier use before the age of four can affect your child’s permanent teeth

What should I do about thumb sucking?

Why do children suck on their thumbs in the first place?

Thumb sucking is a natural reflex for all children and babies. In fact, it is quite normal for a developing fetus to suck his/her thumb in the womb. Thumb sucking provides a sense of security to the child. This is why we see most thumb sucking occur at night or during periods of separation from parents. It also soothes the child and often helps them fall asleep. Children will often suck their thumbs after being put to bed for the night as well as any other time of day when they are tired.

What problems are caused by sucking?

The most significant problems will result due to prolonged sucking when the adult teeth begin to erupt. This can often occur as early as age 5. Continued sucking can cause problems with proper growth of the mouth and alignment of teeth. It can also cause changes in shape to the roof of the mouth. The intensity and duration of the sucking is very important. These are the main two factors that determine the severity of problems.

Are pacifiers a better alternative?

Not really. Pacifiers will cause the same problems as thumb sucking. The only real difference is that breaking a pacifier habit is typically much easier since it can be taken away from the child. If you give your child a pacifier, never dip it in food or drink. This will only heighten the child’s attachment to the device. Additionally, never dip it in sugary foods like honey as prior generations did. This will cause a significant increase in cavities. When you go to the pacifier isle at the store you will likely see two primary types of pacifiers: Orthodontic and traditional. Orthodontic pacifier nipples have a rounded top and a flat bottom, and were designed to prevent tooth troubles later in baby’s life. However, if your baby prefers a rounded traditional pacifier nipple, go with what works. Both types of pacifier nipples have been found to cause dental problems. In my opinion, limiting the amount of time baby spends with the pacifier and taking the pacifier away after baby’s first year are far more predictable methods of minimizing dental damage.

When and how should I help my child stop thumb sucking?

Most children stop sucking their thumbs on their own between the ages of 2-4 years. For school age children, peer pressure comes into play and often convinces them to stop. After age four, parents should take a more active role in breaking the thumb sucking habit. Here are some suggestions:

  • Don’t scold the child for thumbsucking. Instead, use praise and positive reinforcement for not sucking. In my office we will give children “homework” to stop sucking their thumb before they have their teeth cleaned again. They’re told they’ll receive an extra special reward if they return in six months and mom/dad tells us they’ve broke the habit. This basic psychology works very well and can be reaffirmed at home.
  • Address and try to correct any sources of anxiety in the child’s life. Sometimes this is a very difficult topic for parents to address, but do everything possible to minimize these sources.
  • Involve your dentist! Often having someone other than a parent speak about the topic works wonders.
  • Place a sock or thumb sucking glove over the child’s hand at night
  • Apply non-toxic bitter nail polish to the thumb or fingers.
  • Consult an orthodontist regarding oral appliances that can assist in breaking the habit.
  • If none of the preceding suggestions work, and years pass without success, consider a consultation with a childhood psychologist to address the mental aspects of why the habit cannot be broken.

How much juice should I be giving my child?

The American Academy of Pediatrics (AAP) gives helpful recommendations on fruit juice for infants, children, and adolescents, which Dr. Jackson summarized as follows:

  • Juice should not be introduced to infants before 1 year unless clinically indicated. Daily intake should be limited to 4 ounces in toddlers ages 1-3 years, 4-6 ounces for those 4-6 years. For those 7-18 years, limit juice intake to 8 ounces or 1 cup of the recommended 2-2½ cups of fruit servings/day.
  • Toddlers should not be given juice from bottles or easily transportable covered cups that make it easy to consume throughout the day, nor should they be given juice at bedtime.
  • Children should be encouraged to eat whole fruits and educated on the benefit of fiber intake. (Remember the American Academy of Pediatrics’ sentiment – “Eat fruit…Don’t drink it.”)
  • Families should be educated that human milk and/or infant formula is sufficient to satisfy fluid requirements for infants, and low-fat/nonfat milk and water are sufficient for older children.
  • Consumption of unpasteurized juice products should be strongly discouraged.
  • Grapefruit juice should be avoided in those taking certain medications (talk to your dentist or medication instructions for details).
  • When evaluating children with malnutrition — as well as chronic diarrhea, excessive flatulence, abdominal pain and bloating — pediatricians should determine the amount of juice being consumed.
  • In evaluating risk for dental caries, discuss the relationship between fruit juice and dental decay, and inquire about the amount and means of juice consumption.
  • Routinely discuss the use of fruit juice vs. fruit drinks, and educate older children and parents about the differences.

You can also read the AAP News Bulletin about fruit juice or watch a video about 2017 AAP recommendations on fruit juice on their YouTube channel.

Contact Dr. Eric Jackson

If you would like to speak more about these topics, or any others, please feel free to call Oral Health Care Professionals and schedule a complimentary appointment with Dr. Eric Jackson. Email and Twitter are also available options. He is extremely passionate about modern dentistry and loves discussing it with patients, so don’t hesitate to contact him!

Eric G. Jackson, DDS, MAGD, FICOI, FICD, FADI
Email | Twitter

Oral Health Care Professionals
2033 Ogden Avenue
Downers Grove, IL 60515
(630) 963-6750

This article is sponsored by Dr. Eric Jackson. All facts and opinions belong to Dr. Jackson.

About the Author

Annie Tandy
Annie loves making great memories with her kids and started Kidlist so she can help others do the same! Besides finding fun and exciting things to do, Annie, her husband, and their kids enjoy caring for their chickens and hanging out with them in the backyard. Click here to read about Annie's chickens and see pictures! She also finds joy in gardening, home improvement projects, knitting, soap making, and painting along with being active in her community, church, and as a board member of the Western Springs Business Association. Click here to follow Annie on Instagram.

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