It is not uncommon for a permanent tooth to start to come in before the baby tooth has fallen out. If the baby tooth is not loose enough for you to remove at home, make an appointment at your dental office. The over-retained baby tooth may need to be removed to prevent problems with the position of the permanent tooth coming in.

Usually twenty baby teeth will be lost by the time the child is 13 years old.

When a child is losing baby teeth, the jaws are still growing to make room for the permanent teeth.

Crowded, crooked teeth or a "bad bite" may be more noticeable at this time. Some problems will correct themselves in time. Crooked teeth may straighten out on their own, as other teeth come in. Other problems may be inherited or a result of the insert child's oral development. If a baby tooth is lost early because of decay, a space maintainer may be placed to prevent remaining teeth from taking over the space.

A dental professional will be able to tell whether there is an orthodontic concern and may refer you to an orthodontist. Your child may need braces to straighten teeth and correct bite problems.

Remember
When there is a problem with tooth spacing, crowding or the way jaws meet:

• It is more difficult to keep teeth and gums clean. This increases the risk of tooth decay and gum disease.
• Protruding teeth are more easily chipped or fractured.
• Speech difficulties can occur.
• Teeth may show abnormal wear.
• Jaws may not develop properly.
  

Parents need to floss their child's teeth once a day until the child has the coordination to floss alone.

This happens about age nine.
While six-year-old children generally can brush on their own, parents still need to make sure they are doing a good job. The Canadian Dental Association recommends that children should brush twice daily with a pea- sized amount of fluoride toothpaste and a soft bristled toothbrush.

Most meals and snacks contain sugars or cooked starches. The more often your child eats, the more often he or she "feeds" decay-causing bacteria. Teach your child to limit snacks and choose healthy foods.

Encourage healthy choices by keeping your refrigerator stocked with fresh fruits and vegetables.

A fall or other injury may break or knock out a permanent tooth. A knocked out permanent tooth should be put back in the tooth socket immediately (or within 20 minutes of the accident). Apply a cold compress to the mouth over the injury. Contact your dental professional immediately. Fractured or chipped teeth can be restored easily with a tooth-colored bonded material.

Your local hospital emergency department may have a dentist on call if your dental office cannot be reached.

Sealants are plastic coatings that seal the pits and grooves of teeth so that plaque acids cannot start the decay process. The tiny pits and grooves in the chewing surfaces of children's back teeth are difficult to clean and therefore more likely to decay.

Sealants are quite different from fillings because sealants are applied to teeth to prevent decay. Fillings are placed in teeth after decay has been removed. Children receive the greatest benefit from having sealants placed on permanent teeth that have just come in, because this is when teeth are the most likely to decay.