Category Archives: Pediatric Dentist

Adult Teeth Behind Baby Teeth

Can you help me? I am 16 years old. I’m with a new foster family who wants to help me with my dental care and we’re trying to figure out what to do. I asked my foster mom if I could research. She agreed so I thought I’d start here. I have both baby teeth and adult teeth but my adult teeth all came in behind my baby teeth. It’s been like this for a long time and it is very embarrassing. Is there a good way to fix this?


Dear Celia,

Young woman smiling

I am glad to hear you have a foster mom that is being proactive with your oral health care. I’m sorry you had to wait this long for it to happen. Had you been under the care of a good pediatric dentist this would not have happened to you. The good news is all of this is repairable.

The first thing they’ll want to do is extract all of your baby teeth. I know you had no control over this, but for the sake of parents out there reading this, I want to discuss what to do when you have adult teeth ready to erupt when the baby teeth are not coming loose.

The best thing to do in that case is to simply extract them, as I am suggesting to you. However, sometimes you have retained baby teeth when there is no adult tooth to come in. This is called a cogenitally missing tooth. In that case, there is a different plan of attack.

In that case, there are two scenarios. If it a molar or premolar. It is helpful to maintain those as long as possible and then when they finally fall out, you can replace them with a dental implant.

If they are not molars, we usually will extract the baby teeth and separate them with orthodontics in order to make the appropriate space. Then, depending on your age, you can replace it with a dental flipper (which is removable and inexpensive). Then, when your jaw is fully developed replace those with a dental implant as well.

Once Your Baby Teeth are Extracted

Now, back to your case. Once you have your baby teeth removed you will want to straighten the adult teeth. You sound like a very responsible young woman. With teens like yourself, I tend to recommend Invisalign teen. It can straighten your teeth comfortably and invisibly. It is removable so it requires patient compliance. I don’t think that will be a problem for you.

This blog is brought to you Lafayette, LA Dentist Drs. Forman and Thimmesch.

When During Illness Do I Throw Away My Daughter’s Toothbrush?

My daughter has strep throat. Our doctor said we’ll want to get her a new toothbrush, but when I got home I realized I wasn’t clear as to when. If I throw it away now and get her a new toothbrush, she still has strep. Won’t that mean she will infect the new toothbrush? But, if I try to wait until she is better, then she could be reinfecting herself. What is the best procedure?


Dear Mary,

I can tell you are a loving mother and you are looking to do the absolute best for your children. The whole idea about a toothbrush needing to be replaced at every illness is actually something propagated by toothbrush companies more than science.

In my research, I only know of one scientific study that investigated this issue in depth. This study was done at the University of Texas in 2013. Their results showed that there was no transmission of strep throat via a toothbrush.

Honestly, I am not sure why doctors and even some pediatric dentists keep pushing this. Even if you get a new cold or another virus on the back of another one, it is a completely different strain.

How to Sterilize a Toothbrush

If you’re still worried, there is a way to sterilize your and your daughter’s toothbrush anytime you want to. Chlorine bleach has effective bactericidal properties. You just need to put enough in a cup to cover the head of your toothbrush and leave it there for about 5 mintues. Then rinse. It’s that simple.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Can tooth decay Affect the Salivary Gland?

I am trying to find a solution for my daughter. She’s had two salivary gland infections and the doctor can’t figure out why. I know the molar above the salivary gland has decay. It is a baby tooth, though, so I haven’t messed with it. It’s going to fall out anyway. Now, I am wondering if maybe that decay is causing her salivary gland problems.


Dear Andrea,

Some baby teeth have to stay for many years.

There are a couple of separate issues here. First, let’s talk about that molar with decay. While baby teeth do fall out, your daughter’s molars need to stay until she is around twelve years old. That is when her adult molars will come in. If the molars fall out pre-maturely, then the adjacent teeth will shift or tip into the open space. This will lead to crowding and expensive orthodontics later in life.

You’ll want to preserve that back molar. I would start by getting that decay looked at and filled as quickly as possible. It’s possible at this point that the molar has become infected. If that is the case, then she will need a pulpotomy to keep the tooth viable until it is safe to come out. A pulpotomy is simply a child’s version of a root canal treatment.

I’m concerned your pediatric dentist hasn’t addressed this. Additionally, she should have had her molars sealed to prevent decay to begin with.

Now, regarding her salivary gland. Tooth infections do spread to other parts of the body, which is why they are considered dental emergencies. Because of that, if her tooth is infected, it is possible that it has spread to her salivary gland. Some dental x-rays can let you know either way. You don’t want to leave this any longer because it can also spread to her heart, lungs, or brain. All of those are close to her jaw.

This blog is brought to you Lafayette, LA Dentists Drs. Foreman and Thimmesch.