Dr. Brett DeCoursey and his daughter Alexandra.

For everything that parents obsess over in their children, care of primary teeth often isn’t one of them, said Dr. Brett DeCoursey of Northshore Family Dental Care

“One of the biggest questions I get from parents is, ‘These are just baby teeth, why do I really need to worry about it?’” he said. “The simple answer is, they're 3 or 4 years old and they're going to have these teeth until they're 10 or 11.”

“We like to say ‘first tooth, first visit.’ We want parents to come in and get educated on how to take care of their child's teeth and give them some steps they can take to start good dental habits early on.”

Your child's first visit (under age 4) is free at North Shore Family Dentistry, so there's no reason not to visit. By developing habits to maintain the health of primary teeth, kids are also impacting the permanent teeth to come.  

“With primary teeth, it's all about maintaining space for the permanent teeth to erupt later,” DeCoursey said. “If primary teeth aren’t there to do their job, we run the risk of permanent teeth erupting abnormally or in the wrong position.”

Getting to the dentist early in life can also identify genetic defects in a child’s tooth development, which can make a patient more susceptible to cavities.

“There are some genetic predispositions to decay. The main ones have to do with enamel malformation where the teeth just don't form properly,” DeCoursey said. “If mom spikes a fever during the middle of her pregnancy, you can actually see exactly when she got sick based on how the enamel formed during that time. It's almost like rings on a tree.

“There are also some congenital conditions that can affect tooth development and lead to an increased risk for cavities, which is another reason I like to see the kids early on. I can tell if there's going to be an enamel malformation pretty quickly and we can alter their treatment plan based on what I see at that first visit.”

Childhood is, of course, a contact sport providing any number of ways for youngsters to suffer trauma to their baby teeth. DeCoursey said treatment in such situations varies from patient to patient.

“The overall goal of dealing with trauma cases in baby teeth is to stabilize the situation until the permanent teeth can come in,” he said. “Sometimes if a kid falls and busts a tooth at age three, say it's their front middle tooth which is probably the most common, the treatment protocol is to do everything you can to save that tooth because we've got to hold onto it for, on average, another five years.  

“There's different schools of thought if a primary tooth gets knocked out or for trauma that’s severe enough to warrant significant work. On my end, we usually take them out and put in a space maintainer to keep it open for the permanent tooth to come in. We can even build a little flipper for kids who knock out their front teeth and don't want to be embarrassed at school.”

Accidents aside, DeCoursey said the difference between healthy teeth and a lifetime of dental problems is set early.

“It all starts at home. Kids can completely reverse what we dentists do in just a couple of months if they're not brushing and flossing,” he said. “Age six is about the mark where we really want to buckle down with kids and tell them ‘Hey, this is your last set of teeth. You only get one crack at this.’”