Let your child wiggle it out themselves. That's the safest approach. A tooth that's ready will come out with very little effort and very little blood. Pulling one before its root has dissolved can hurt, bleed more, and occasionally leave a root fragment behind. Have them wiggle it with a clean finger or tongue throughout the day. Most teeth fall out on their own within a week or two once they get genuinely loose. See your dentist if the tooth has been loose for months without progress, if there's swelling or pus around it, or if it got loose from a fall rather than on its own schedule.

Both are completely normal. Permanent teeth are naturally darker than baby teeth. Baby teeth are unusually white, so the new ones look yellow by comparison, especially when they sit right next to each other during the years when your child has both. That contrast fades as the rest of the baby teeth are replaced. The size is normal too. Permanent teeth erupt at full adult size into a jaw that's still growing, which is why kids often go through an awkward stage before their face catches up. What I don’t want to see is a single tooth that's noticeably darker than its neighbors. That can signal trauma or a nerve issue, so let us take a look.

Sealants are a thin protective coating painted into the deep grooves of the back teeth, and they're one of the best cavity prevention tools we have for kids. Those grooves are narrower than a single toothbrush bristle, which means they collect food and bacteria that brushing simply can't reach. Sealing them off dramatically reduces decay in the teeth where kids get most of their cavities. Application takes a few minutes per tooth, requires no drilling and no numbing, and we typically place them on the permanent molars soon after they come in, usually around ages 6 and 12. We check them at each visit and can repair one if it chips.

Yes. Modern digital dental X rays use a very small amount of radiation, less than what your child receives from a day of ordinary background exposure, and we use a lead apron and thyroid collar every time. Frequency depends on the individual child. Kids with a history of cavities or crowding may need bitewing images every 6 to 12 months, while a child with low risk and well spaced teeth may go longer. Images let us see between touching teeth, watch permanent teeth develop, and catch problems while they're still small and inexpensive to fix. I'm always happy to explain why I'm recommending a particular set, so please ask.

Around age 7 for an evaluation, even though most kids won't start treatment anywhere near that early. By 7, enough permanent teeth have arrived to reveal how the bite is developing. Crossbites, severe crowding, jaw growth differences, and habit related issues all show up at that stage. Catching them early sometimes means a short, simple intervention now instead of a much longer one later. That said, an early evaluation very often ends with a plan to simply recheck next year, and that's a perfectly good outcome. I keep an eye on your child's bite at every checkup and will tell you when I think it's time.

Yes, for any sport with contact or a flying object, and that includes basketball, soccer, and skateboarding, not just football and hockey. Dental injuries in kids are common, expensive, and often permanent, since a knocked out or fractured adult tooth means a lifetime of dental work. A custom fitted mouthguard is far more comfortable and protective than a boil and bite version from the sporting goods store, and comfort matters because a guard only works when it's actually being worn. If your child has braces, a mouthguard is not optional. It protects the lips and cheeks from the brackets as much as it protects the teeth.

Not necessarily, but I would want to find out if there is a root cause for the grinding. What I look for at checkups is whether the wear is outpacing normal: flattened chewing surfaces, sensitivity, jaw soreness or headaches in the morning, or a child who complains about it. Night guards are rarely the answer for a growing child, since a guard can interfere with teeth that are still erupting. I think an airway issue is almost always the underlying cause, so I send these patients to an airway-centric orthodontist for evaluation. I work with several airway-centric orthodontists in the area who can evaluate this for us. See the next question.

The connection runs both directions, and it's worth taking seriously. Habitual snoring and daytime mouth breathing are not normal in children and they're often tied to enlarged tonsils or adenoids, allergies, or a narrow airway. The dental signs I watch for are a high narrow palate, a longer face shape, crowding, front teeth that don't meet when the back teeth are together, and chronically dry, inflamed gums. Sleep matters here beyond the teeth. Children who sleep poorly often present as irritable, hyperactive, or unfocused rather than tired. If I see these signs, I'll say so and help coordinate with your pediatrician, an ENT, or an orthodontist. Sometimes widening a narrow upper jaw during growth makes a real difference.

They're one of the worst things I see for kids' teeth, and most parents are genuinely surprised to hear it. The problem isn't the amount of sugar, it's the stickiness. A gummy packs into the grooves of the molars and stays there feeding bacteria long after the snack is over, which is the same reason fruit snacks, dried fruit, and gummy candy do more damage than a cookie. Timing makes it worse, since vitamins are usually taken at bedtime or right after a meal and then nobody brushes again. If your family relies on them, give them with a meal and brush afterward, or switch to a chewable tablet or liquid form.

I generally wait until all the permanent teeth have erupted, usually around ages 14 to 16, and until any orthodontic treatment is finished. Whitening a mouth that still has baby teeth or braces gives uneven results, because the areas under brackets stay their original shade. Teen enamel is also more prone to sensitivity, so I usually start with a lower strength professional option and take it slowly. The bigger reason to check in with us first is that not all discoloration responds to whitening. Stains from trauma, medication, or enamel defects need a different approach entirely, and drugstore kits won't touch them. I make customized trays that hold whitening gel, which allows a more personalized approach to the whitening process. The trays can be used for years and you’d only need to purchase gel when touchups are needed.

More than most parents realize, and I see it in teenage mouths regularly. Vaping dries out the mouth, and reduced saliva means less natural protection against decay. Vape aerosol is also sticky and sweet, which feeds cavity causing bacteria, and nicotine reduces blood flow to the gums. Energy drinks and sports drinks are highly acidic, and sipping one over an hour bathes the enamel in acid the entire time. Enamel doesn't grow back. Here's a practical middle ground if quitting isn't on the table: drink it in one sitting rather than sipping, rinse with water afterward, and wait 30 minutes before brushing so you're not scrubbing softened enamel.

Permanent white scars on the front teeth, and I mean permanent. When plaque sits around a bracket for months, it pulls minerals out of the enamel and leaves a chalky white square exactly where the bracket was. Nothing is more heartbreaking than the day the braces come off and a beautifully straight smile is outlined in white boxes. Those marks don't brush off and often need cosmetic treatment later. Swollen, bleeding, overgrown gums and slower tooth movement come with the territory too. What actually works with teenagers is showing rather than lecturing: disclosing tablets that dye the plaque bright pink, before and after photos of decalcification, an electric brush and a water flosser to cut the time it takes, and a fluoride rinse at night. I'm also glad to see teens in braces more often than every six months.

In children it's almost always something local and fixable, and the tongue is the usual culprit. Bacteria collect on the rough surface at the back of the tongue, so add gentle tongue brushing to the routine before you worry about anything else. Dry mouth is the next most common cause, which is why morning breath is worse and why mouth breathers and kids who don't drink enough water notice it more. Food trapped between teeth, a cavity, or inflamed gums can all contribute. One more that surprises parents: in toddlers, persistent bad breath from one side of the nose can mean a small object is lodged up there. If breath stays bad after we've ruled out dental causes, tonsil stones, allergies, sinus drainage, and reflux are worth raising with your pediatrician.

For a knocked out permanent tooth, act within 30 minutes. That's the window that matters most. Pick the tooth up by the crown, never the root, rinse it gently with milk or saline if it's dirty (don't scrub it), and try to place it back in the socket. If you can't, put it in a cup of milk and get to us immediately. Do not reimplant a knocked out baby tooth. Doing so can damage the permanent tooth developing underneath. For a chipped tooth, save the fragment in milk if you can find it, rinse the mouth with warm water, and use a cold compress for swelling. Call us either way, even if your child seems fine. Because time is of the essence, if you can’t get ahold of your dentist immediately, there are several emergency dental clinics in the area that are open late 7 days a week. My favorite clinic is Dental Emergency Care USA off Heritage Trace Pkwy (817) 440-7577.

No, and I want to take this one seriously, because I hear the guilt behind it constantly. Genetics do play a role in enamel strength, saliva composition, and tooth shape. But the largest factors are ones you can actually control: what your family eats and drinks, how often, and how consistently teeth get brushed and flossed. The biggest lever is frequency rather than quantity. Every time your child eats or drinks something other than water, their mouth stays acidic for roughly 20 minutes, so a candy bar in one sitting is gentler on teeth than a bag of crackers grazed over an afternoon. Cluster snacks into set times, keep water as the between meals drink, and stay on a regular checkup schedule. That combination beats genetics most of the time.