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Children's teeth

Milk teeth are not practice teeth.

The dental health of children in Germany has improved greatly over the past decades. Most children now reach school age free of caries. At the same time, what remains is distributed very unevenly: a small proportion of children carries most of the caries. Anyone who starts early is very unlikely to be among them.

Why milk teeth count

The idea that milk teeth fall out anyway is widespread and wrong. They have four jobs that no replacement takes on:

  • Placeholder. Every milk tooth keeps the space free for its successor. If it is lost too early, the neighbouring teeth tip into the gap and the permanent tooth has no room left. A brace later on is the consequence.
  • Chewing. Without working molars, food is less well broken up; that has an effect on nutrition.
  • Speaking. The front teeth are involved in forming sounds. If they are missing early, speech errors can arise.
  • A model for the bone. The permanent teeth develop directly beneath the milk teeth. A deep inflammation on a milk tooth can damage the germ of its successor.

There is also a structural difference: the enamel of a milk tooth is thinner and softer than that of a permanent tooth. Caries therefore reaches the nerve considerably faster — what looks small is often already deep.

Caries is transmitted

A newborn has no caries bacteria in its mouth. They come from outside, and usually from the people closest to the child: via licked dummies, shared spoons, bitten-off mouthfuls, kisses on the mouth.

What follows from this is not a rule about keeping distance but a simple order of things: whoever gets their own oral health in order transmits less. The best time for that is during Pregnancy. The obvious rules help as well — do not lick the dummy, use a separate spoon for the child, do not taste from the shared plate and give it back.

The most common avoidable damage

Early childhood caries — formerly called nursing bottle caries — arises when a child sucks for long periods on a bottle with sweetened or acidic contents, especially while falling asleep and at night. The upper incisors are affected first: brown margins that spread quickly.

This does not only mean lemonade. Juice, diluted juice, sweetened tea and even milk over hours act in the same way, because hardly any saliva flows at night. What helps: the bottle belongs with a meal, not in bed and not as a constant companion. From about one year of age the child learns to use a cup; between meals there is water or unsweetened tea.

The series of preventive appointments

Children are entitled to a close series of appointments that the statutory health insurer covers in full:

  • 6th to 33rd month of life: three early-detection examinations, plus advice and, from the first tooth, a fluoride varnish.
  • 34th to 72nd month of life: three further examinations.
  • 6th to 18th birthday: twice a year Individual prevention — staining, instruction in oral hygiene, fluoridation, findings.
  • Sealing of the permanent molars after they have come through.

These appointments are the most effective part of dental prevention as a whole. They cost nothing and are nevertheless often skipped.

The essentials at a glance

  • Milk teeth keep the space free for the permanent teeth. If one is lost too early, the neighbours move — and the successor finds no room.
  • Caries bacteria are transmitted, usually by the closest carers. Licked dummies and shared spoons are the most common routes.
  • Brushing starts with the first tooth, with a fluoride children's toothpaste.
  • Prevention is a health insurance service from the sixth month of life — six examinations up to the sixth birthday.

Answered briefly

Frequently asked questions

From the first milk tooth. Parents clean the first teeth once or twice a day with a soft children's toothbrush; a children's toothpaste is added later. It is important to let the child join in early – that way brushing becomes part of the daily routine from the outset.
No, the fine motor skills are missing for a long time. Children should brush themselves early in order to learn the routine – that does not yet make it thorough. Well into school age, parents have to help, above all by brushing again afterwards.
As early as possible, ideally with the first milk teeth. That way problems are found early, and the child experiences the visit as an ordinary appointment. If dark spots that cannot be removed appear during brushing, that belongs at the dental practice promptly.
Children are not afraid of the dentist to begin with – they are mainly curious. What matters is that parents do not pass on their own fears and treat the visit as something ordinary. An early first appointment at which things are only looked at helps with that.
By talking about what a dentist does and what the child can expect during the visit. Children's books take up the subject sensitively and in a way children understand. The visit should appear as an ordinary appointment, not as something threatening.
Yes, to a check-up – there the child sees how relaxed an appointment is. Let the practice know beforehand. For an extensive treatment or treatment of pain, however, the child should not come along.
In principle all dentists treat children too. A dentist specialising in children is useful above all when a child is very anxious or an extensive treatment is due. If in doubt, ask your dental practice for a recommendation.