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Q: I have a two year old. Her teeth are a little more crooked than I think they should be and I was wondering if she is too young to take to the dentist yet.

added on: July 22, 2011

A: Your question couldn’t have been timelier. February is National Children’s Dental Health Month and a great time to make sure that children are being properly cared for.

It is not unusual for children’s teeth to be a little crooked. However, they shouldn’t look like miniature versions of adult teeth either. As dentists, we love to see spaces between the baby (or deciduous) teeth. We call these spaces primate spaces. If there are no spaces, the child is much more likely to have crowding and crooked teeth (and need braces) when the permanent teeth come in. Crooked teeth or not, there are other reasons to have your child’s teeth checked.

As with other health care issues, it is very important to adopt good habits at an early age. Your dentist can help you to see what to look for. Generally, if you find a problem, it might have been found earlier by your dentist. We can find early decay, gum problems, growth and development problems, and sometimes even systemic diseases.

The website of the Pediatric Dental Association suggests that children be seen by a dentist when their first tooth comes in. As a general dentist, I have a tendency to see children a little older, at about 2 ½ years old. Hopefully, their first appointment won’t be an emergency. The dentist can be fun (believe it or not). We like for our first visits to be ‘play’ visits–take a ride in the chair, go to the treasure box, watch a monkey demonstrating brushing and flossing, count your teeth, and get a new toothbrush. These initial exams are great times for the dentist and dental hygienist to teach the parents what to expect. New parents need to know how to take care of their child’s teeth and what to expect in the way of growth and development over the next few years.

The crooked teeth that you mentioned could simply be from a thumb-sucking habit, but it could also be from a cyst or tumor that is pushing on a tooth. The latter problem is very rare and can quickly be ruled out. Thumb sucking, pacifiers, and abnormal swallowing patterns can also cause crooked teeth.

It would be very unusual if this was the first time that we had seen this type of problem. We love seeing families and children in the office so don’t be shy about asking questions.

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