Expert: Rafael Mosery,D.D.S. - 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
At 6 years old, sounds like she's right on schedule as far as eruption is concerned.You could get an idea of the timing by googling: eruption schedule of human dentition.I can't say for sure what the  spots are without seeing them for myself.It may be related to how the tooth developed,may be due to nutritional contributing factors,it may be of no consequence, hard to say w/o an exam.It's not from the toothpaste.If anything, if she'd rinse and spit out I would encourage you to use an over the counter flouride rinse in addition to the flouride paste.
You might consider visiting a pedodontist.The environment is more conducive to children that are apprehensive.In addition they might give her a mild sedative to drink that will make the visit less stressful for all.