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Delivery within 3-5 business days – Free for orders of R500 or more
By Dr Raveena Manga
A child’s smile is constantly changing. From the very first baby tooth to the eruption of the permanent dentition, every stage of development plays an important role in lifelong oral health. One of the questions I hear most often as a paediatric dentist is, “Is this normal?”
Understanding how children’s teeth develop, what to expect at different ages, and how to establish healthy habits early can help parents feel confident as they support their child’s growing smile.
Tooth development begins long before the first tooth appears. In fact, a baby’s primary (milk) teeth begin forming while they are still in the womb. Although many babies display signs of teething from around three months of age, the first teeth typically erupt between six and ten months. However, eruption anywhere between four and twelve months can be completely normal.
By approximately three years of age, most children have a full set of 20 primary teeth. These teeth are far more important than many people realise. They allow children to chew comfortably, develop clear speech, support healthy jaw growth, and maintain the space required for their future permanent teeth.
Around six years of age, two important developmental milestones usually occur:
This marks the beginning of the mixed dentition phase, during which both baby and permanent teeth are present.
Every child develops at their own pace. Tooth eruption, mobility and exfoliation may occur earlier or later than expected, which is often perfectly normal. Regular dental examinations allow us to monitor development and identify any concerns early.
Teething may cause tender gums, increased drooling, irritability, disrupted sleep, reduced appetite, increased breastfeeding, loose stools and an increased desire to chew on objects.
Unfortunately, teething is largely a waiting game. We cannot speed up tooth eruption, but we can help keep babies comfortable. Cold teething toys, chilled washcloths, skin-to-skin contact, additional breastfeeds, topical teething remedies and, when appropriate, pain relief can all help reduce discomfort as the tooth moves through the jawbone and emerges through the gum.
During the first few months of life, it is worthwhile assessing whether a baby has any oral ties, particularly if breastfeeding is challenging.
When intervention is indicated, releasing an oral tie is often simpler during early infancy and can usually be performed without general anaesthesia. Importantly, the decision to intervene should always be based on function rather than appearance alone. Assessment by an airway-informed practitioner is essential to determine whether an oral tie is contributing to feeding or oral dysfunction.
Early childhood caries remains one of the most common chronic diseases affecting children worldwide.
Dental decay is multifactorial, making it difficult to attribute it to a single cause. A child’s individual risk profile may be influenced by factors such as:
Understanding these factors allows us to provide personalised preventative strategies rather than adopting a one-size-fits-all approach.
Healthy smiles begin with healthy choices. Alongside a balanced, nutrient-dense diet, offering naturally sugar-free beverages such as the Carmién Kiddies Cold Brew Rooibos Ice Tea range can help reduce frequent sugar exposure, support hydration, and encourage healthy habits that benefit both oral and overall wellbeing.
If your baby uses a dummy, it is helpful to understand the differences between available designs. While babies often develop their own preferences, prolonged dummy use may negatively influence jaw development, tongue function and facial growth. Where possible, dummy use should be gradually discontinued by around two years of age. Weaning at the appropriate time supports healthy jaw development and allows the tongue to function optimally.
As toddlers develop independence, toothbrushing can quickly become a daily challenge. Establishing a consistent routine is key. A helpful strategy is to allow your child to brush first before an adult performs a thorough second brush. Maintaining a calm but firm routine helps reinforce healthy habits that will benefit them throughout life.
Molar incisor hypomineralisation (MIH) is a developmental condition that affects the enamel of the first permanent molars and, in many cases, the permanent incisors.
The affected enamel is weaker than normal and may break down after eruption, leading to sensitivity, rapid wear and an increased risk of decay. The severity varies considerably between children, with some requiring only monitoring while others benefit from early intervention.
Although the exact cause remains unclear, MIH affects a significant number of children worldwide.
Breathing plays a much larger role in oral health than many people realise. Chronic mouth breathing and other dysfunctional breathing patterns can significantly influence facial growth, jaw development and dental alignment. They may also contribute to poor-quality sleep, behavioural challenges, learning difficulties, orthodontic concerns and an increased risk of dental disease.
Early identification and management can positively influence both oral health and overall wellbeing.
Crowding, bite discrepancies and jaw growth concerns can often be identified long before all the permanent teeth erupt.
Early orthodontic assessment allows many developing problems to be managed conservatively while a child is still growing, potentially reducing the need for more complex treatment later.
Healthy smiles are built through small, consistent habits practised every day. Some of the most important include:
There is no single secret to raising a child with healthy teeth. Rather, lifelong oral health is built through consistent daily care, balanced nutrition, healthy breathing habits, regular dental visits and early attention to concerns as they arise. Every child is unique, and there is no cookie-cutter approach. What works well for one family may not necessarily suit another.
By partnering with families, we can support children in developing not only healthy smiles, but healthy, resilient and confident bodies that will serve them well throughout life.
