Baby Teeth: What to Worry About (and What Not To)

What's usually fine

Spaces between baby teeth

Good sign — suggests room for permanent teeth. No action needed.

Teeth that erupt slightly out of line

Baby teeth don't need to be straight. Many straighten themselves as the jaw grows.

Delayed eruption by 3–6 months

Variation is wide. Some children get their first tooth at 4 months, others at 14 months. Both are normal.

Grinding at night

Common in children up to age 6 or 7. Usually resolves without treatment. Mention at check-ups but no nightguard needed typically.

White spots after illness or antibiotics

Often fluorosis or enamel hypoplasia — cosmetic, can be bonded over later. No health impact.

What to see a dentist about

Brown, yellow, or black spots on teeth

Early decay needs prompt attention. Baby-tooth decay spreads to the adult tooth below.

Pus, swelling, or a pimple on the gum near a tooth

Sign of infection. Always needs evaluation.

Chipped front tooth after a fall

X-ray needed to check for damage to the developing permanent tooth above.

Late eruption past 14–16 months

Worth an x-ray to rule out missing or impacted teeth.

Teeth erupting very crooked with jaw asymmetry

Early orthodontic consultation (age 7 is ideal first screening).

Bleeding gums at any age

Uncommon in kids. Needs evaluation.

The myths

"Baby teeth don't matter because they fall out." False. Premature loss affects jaw development, adult tooth eruption, speech, and self-esteem.

"My child is too young for x-rays." Not necessarily. Bitewing x-rays can be taken safely from age 4–5 if clinically needed. Modern digital x-rays use ~80% less radiation than film.

"Fluoride is dangerous for children." Disproven. All major health bodies recommend age-appropriate fluoride toothpaste from first tooth.

Thumb sucking

• Normal and common until age 4
• After age 5, can start to affect jaw development
• Gentle behavioural approaches first; habit-breaking appliances reserved for persistent cases after 6

Teething

• First tooth usually around 6 months
• Can cause mild fussiness, drooling, chewing on things
• Does not typically cause high fever (over 38°C → check for other causes)
• Cold teething rings help; avoid teething gels with benzocaine in under-2s

When to start hygiene visits

• By age 1
• Every 6 months thereafter
• More often if cavity risk is high (genetics, dietary patterns)

References

• American Academy of Pediatric Dentistry
• NHS — Children's oral health