Expert: Mark Bornfeld DDS - 2/26/2009

Question
I have a couple concerns and questions about my 6yo daughter. Let me start by saying that the reason she has yet to see a dentist is that she has Autism and is terrified and has a meltdown at the mere mention of it. I realize that I am going to have to take her soon and am planning that in the near future.

Here are my questions…She has her 2 bottom permanent teeth already. They came in nicely a few months ago. She does not have any other loose ones right now although they are spacing out evenly on top to make room should she loose the baby teeth. When should they come out? I’m getting concerned. Also…those 2 permanent ones on the bottom have recently developed yellow spots on the center of each one. Is this from the fluoride in her toothpaste? It looks as if she has popcorn kernels stuck and needs to be scraped.

We brush twice a day. I’m sure not long enough though and never floss. Again…she won’t allow it. Can you advise me? Please send response to

Thank you very much. Kimberly

Answer
Dear Kimberly,

You can view a tooth eruption chart that lists the average age when the various primary and adult teeth first make their appearance at:

http://www.ada.org/public/topics/tooth_eruption.asp

As for the yellow spots-- fluoride toothpaste would not account for this discoloration. It might be anything from extrinsic stain to tooth decay. A formal diagnostic session should clear up any uncertainty.

Some dental practices have dedicated themselves to treating children with special needs. I urge you to contact your local dental society for assistance in finding one of these practices near you. To find contact information for your local dental society, see the following web page:

http://www.ada.org/ada/organizations/local.asp

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY