Dental Problems (Common Problems of Former Preemies)

Dental Problems

What are common dental problems of former preemies?

The most common dental problems are:
  • Abnormal formation of enamel (white outer covering of the tooth)
  • Slow teething, especially of the first baby teeth. As the child gets older, there is catch up to the normal teething pattern.
  • High arch or groove to the palate (roof of the mouth)
  • Abnormal bite called cross-bite

Why do preemies have more dental problems than term babies?

We do not know all of the reasons for these problems, but some common factors are:
  • Stress and severe illness delay and alter normal tooth formation.
  • Normally during the second half of pregnancy the teeth are forming enamel from calcium and phosphorus. It is not possible to deliver as much calcium and phosphorus to the preemie as s/he would get if s/he were in the womb. This is true even though formulas, breast milk and nutritional fluids by vein are fortified with added calcium and phosphorus.
  • If a baby needs to be on the breathing machine, the breathing tube that is in the mouth rubs or presses against the roof of the mouth and the gums. Over time this may make the palate high and more arched than normal. The pressure of the tube or an instrument on the gums may also change the development of the teeth under the gum.

How will I know if my child's teeth have enamel problems?

Often small abnormalities in enamel formation are not visible. More severe abnormalities are:
  • The teeth may not appear as white as other children's. They may have a gray or brownish color.
  • The teeth may have an uneven surface.
  • The teeth may have an abnormal shape.

What problems should I expect if my child's teeth have poor emamel?

When the emamel of the tooth is poorly formed, it is much easier for the tooth to develop cavities.

What can I do to prevent tooth decay?

It is very important to do the following:
  • Develop good toothbrushing habits as soon as the teeth break through the gums. The teeth should be cleaned two times a day, morning and before bedtime.
  • Avoid the habit of letting your child sleep at night or nap with a bottle. It can cause decay so severe that it destroys the teeth. Dentists refer to this as Nursing Bottle Tooth Decay.

Which teeth are most likely to be abnormal?

The baby teeth are most often affected with enamel problems. Sometimes the first permanent teeth to come in are affected also, but usually to a lesser degree. These include the front teeth (incisors) and the first permanent molars (six-year molars).

What can be done for my baby's abnormal teeth?

Often problems look worse than they actually are. Good dental care and regular teethbrushing may be all that is needed. Cavities can be filled just as for any child with a dental cavity.

What can be done for my baby's high arched palate?

The shape of the palate can effect many things, including speech and bite. As your child gets older, the shape of the palate, along with other factors, determine if your child needs braces or other orthodontics. Most children seem to adapt to the shape of their palate and will compensate if their palate is higher than normal.

Will my child need braces later on?

The need for braces is determined by many factors including the shape of the palate and the presence of a cross-bite. The chances that your preemie will need braces are probably a little higher than average.

When should my preemie first see a dentist?

Pediatric dentists prefer to see children at a very young age. The current recommendation of the American Academy of Pediatric Dentistry is for any child to see the dentist by his/ her first birthday. Since preemies are known to have more dental problems, this early exam is often beneficial. At this visit your dentist may:
  • Show you how to care for your child's teeth; give tips on brushing
  • Address diet concerns that relate to teeth
  • Find any problems that need attention
No matter what the age, if you notice any questionable areas in your child's teeth, make a dental appointment.