dr verwest pediatrics

When Will My Baby’s Teeth Come In?

As with most things with children (as you’ll soon learn), their teeth will start come in when they’re ready.  The age your child is when their teeth first start to come in is not indicative of whether they’re developmentally behind or ahead.  And when you’re up at 3AM with a fussy child who’s cutting his first tooth, you’ll wonder why you ever looked forward to this wonderful event.


The average time for the appearance of the first teeth is between 5 and 7 months old.  However, teeth could come in as early as one month or they might not reveal their toothy grin until 1.5 years olds.  In some extreme cases, a child can even be born with teeth!  This typically only happens in about 1 out of every 2,000 newborns, and these are often extra teeth that should be removed.

If teeth are very early or very late to appear, you should take your child to a doctor to make sure that it is not indicative of a more serious complication.  Delayed eruption could be caused by a nutritional problem, such as rickets, or a systemic condition, such a hypopituitarism or hypothyroidism.  If baby teeth appear very early, it could indicate a hormonal problem such as hyperthyroidism.

The following tables outline the normal ranges for teeth to erupt and to shed:


  Upper Lower
Central incisors 6-8 months 5-7 months
Lateral incisors 8-11 months 7-10 months
Cuspids (canines) 16-20 months 16-20 months
First molars 10-16 months 10-16 months
Second molars 20-30 months 20-30 months


  Upper Lower
Central incisors 7-8 years 6-7 years
Lateral incisors 8-9 years 7-8 years
Cuspids (canines) 11-12 years 9-11 years
First molars 10-11 years 10-12 years
Second molars 10-12 years 11-13 years


  Upper Lower
Central incisors 7-8 years 6-7 years
Lateral incisors 8-9 years 7-8 years
Cuspids (canines) 11-12 years 9-11 years
First premolars (bicuspids) 10-11 years 10-12-years
Second premolars (bicuspids) 10-12 years 11-13 years
First molars 6-7 years 6-7 years
Second molars 12-13 years 12-13 years
Third molars (wisdom teeth) 17-22 years 17-22 years


***A few facts about baby teeth:

  • A general rule of thumb is that for every 6 months of life, approximately 4 teeth will erupt.
  • Girls generally get their baby teeth before boys.
  • Lower teeth usually come in before upper teeth.
  • Teeth in both jaws usually erupt in pairs — one on the right and one on the left.
  • Primary teeth are smaller in size and whiter in color than the permanent teeth that follow.
  • By the time a child is 2 to 3 years old, all primary teeth should have come in.

Can My Child Really Need a Root Canal?

It’s a scary thought, right?  But yes, even children as young as 2 years old could need a root canal — a fact that many unassuming parents find alarming.  In fact, even with all of the advances in the healthcare industry, oral healthcare is on the decline.

The Center for Disease Control and Prevention found a significant increase in the number of preschoolers with cavities.  An interview with dental professionals confirmed that they are seeing more preschoolers with 6 to 10 cavities than ever before, many of which require treatment under general anesthesia.

What’s more? ALL children are at risk – regardless of ethnicity or income level.

So what’s at the root of all these root canals?  Many parents are not even aware that a child’s first dentist visit should be around their 1st birthday.  And even those that are don’t quite understand the importance of beginning an at-home oral care routine early.  Let’s face it – at the end of a long day, the last thing parents want to deal with is a battle over brushing teeth.

But with childhood dental disease on the rise, it’s more important than ever to put your child’s dental care first.  Here are a few steps to take to prevent a root canal in children:

Take your child to visit the dentist around their 1st birthday – even if they only have a few teeth. Just because you can’t see the teeth, doesn’t mean they aren’t there. Teeth actually begin to form in the 2nd trimester of pregnancy.
Brush the teeth of children 2 or younger with a tiny bit of fluoride 2x per day. Children don’t learn to spit until age 2.  At that point, use a pea-sized amount of toothpaste. 
Reduce snacking. Eating starchy or sugary foods causes the pH level in your mouth to drop sharply, resulting in an increase in acid for at least 20 minutes until saliva normalizes the pH. This frequent exposure deteriorates enamel. Practice good nutrition.
Do NOT share utensils with a child or clean a pacifier in your mouth. Parents with active tooth decay can pass cavity-causing bacteria via saliva.
When putting your baby to sleep with a bottle, only use tap water. Better yet, don’t leave a bottle in their crib at all. If sugars from juice or milk remain on a baby’s teeth for hours, they eat away at the enamel, creating a condition called bottle mouth (pocked or discolored front teeth).
Brush toddlers’ teeth for them. According to Dr. Tim Verwest, kids are not in a position to effectively brush their teeth until ages 7 or 9.


It’s never too early to start teaching your children good oral hygiene.  After all, good oral health is the beginning of good overall health.

But how do you get a 3-year-old to stand still long enough to learn to brush their teeth for 2 whole minutes (aka, an eternity to a toddler).

Give them a teaching tool disguised as a new toy.  A friend to share in the daily bedtime routine.

Bell Tower Shops Kidding Around Feb 15 (6)

Pediatric Dentistry of Ft. Myers sponsors Future of Art

FORT MYERS, Fla. (April 2, 2015) – Pediatric Dentistry of Ft. Myers, Dr. Tim Verwest, DMD will be the exhibit sponsor for Future of Art at the Alliance for the Arts. Works of art created by elementary and middle school students across Lee County will be on display from March 30 to April 11 with an opening reception on Tuesday, April 7 from 5-7PM. Work created by high school students will then be exhibited with a second opening reception on Wednesday, April 15 from 5-7PM

Gallery Alliance for the Arts

“Our community always has come first. Being able to support local kids is what community engagement is all about,” said Dr. Verwest.

This is the 23rd year the Alliance has partnered with the Lee Arts Educators Association (LAEA) to provide students with an opportunity to display their artwork in a formal exhibit. This annual show features more than forty schools and hundreds of pieces of art in a wide variety of mediums.  Judges will select winners in several categories and award a Best in Show.

Pediatric Dentistry of Ft Myers, Dr. Tim Verwest, DMD, continues to provide pediatric dental care to children for over 25 years. Areas of service include comprehensive dental exams, cleanings, composite fillings, dental hygiene education, extractions, fluoride treatments, sealants, sedation dentistry, space maintainers, x-rays and tooth nerve treatment. For more information, visit www.DrVerwest.com or (239) 482-2722.

Medical or Cosmetic: Are Braces Really Necessary?

Anywhere between 50% and 80% of kids in the US are flashing metal-filled, rite-of-passage-to-teenagerdom smiles. But how many of those kids absolutely needed braces for medical reasons?

It’s hard to say.  A thought-provoking article by Marc Ackerman, the Director of Orthodontics at the Boston Children’s Hospital, explained, “In simple terms, we orthodontists are able to straighten your teeth, but we really have little idea how or why they went crooked in the first place.  In fact, many of the dental traits that have been labeled orthodontic problems are merely examples of normal human variation.”

Human variation? Like how some people have bright red hair and some have blonde? Or how some people hit the gym for two hours a day to no avail and others just seem to shed pounds in their sleep?

Turns out, some people’s teeth are overcrowded simply because it’s written in their genetics. What’s more? Orthodontists haven’t been able to determine exactly what makes a “healthy bite” and who has, unfortunately, been handed down genes that require a little stainless steel intervention.

Ackerman goes on to explain that an imperfect bite cannot actually determine whether a person needs braces.  Instead, it’s the symptoms, or what results from that imperfect bite, that ultimately plays the deciding factor.

Are your child’s teeth so crowded that they can’t brush them thoroughly, and end up dealing with cavity after cavity?  Did their teeth erupt in such a way that they’re causing a speech impediment?  That’s when it’s time to step in with braces.


But what about the other kids who are walking around with a mouth full of metal?  The ones who could eat, breathe, and talk normally without braces?

Our society has become more image-centric than ever before.  Many times, parents opt for braces for their kids solely for cosmetic improvements – although this might be as good a reason as any.  A good smile goes much further than we think.  Children who grow up with crooked or buck teeth often face ridicule that leads to insecurities.

Unfortunately, the bias doesn’t seem to disappear with adolescence.  A top social scientist claims that our standing in society “is becoming increasingly dependent not on our education or our upbringing – but on the state of our gnashers.”  Malcolm Gladwell, famed author, agrees that “teeth are becoming the new benchmark of inequality.”

According to these two, people with bad teeth have less of a chance at success because they are denied certain entry-level jobs. Interestingly, a survey showed that people with whiter teeth were thought to earn over $16,000 more than they actually do. Hence, nicer smiles imply greater success.

Bottom line – it’s more difficult than you think to classify who needs braces and who doesn’t. Instead, parents have to consider a multitude of factors: their preference, their child’s preference, their child’s medical history, the long-term effects of NOT fixing their smile, timing, and cost.  Either way – whether braces are medically necessary or cosmetically necessary – both are good reasons to give your child braces.

Ackerman offers his decision-making guidelines: “When a parent thinks their kid needs braces then they probably do, and when a parent doesn’t think their kid needs braces then they probably don’t, it’s as simple as that.”

So where do you stand? Are you willing to shell out a few thousand dollars for your child’s perfect smile? Or are braces an unnecessary expense that’s become a quick and easy way for orthodontist’s to keep their practice up and running?

Pediatric Dentistry of Ft. Myers Ante’s Up For Autism

FORT MYERS, Fla. (March 11, 2015) – Pediatric Dentistry of Ft. Myers, Dr. Tim Verwest, DMD will be the wild card sponsor at the 4th annual Ante Up for Autism Casino Night on Friday, April 10, 2015 at the Crowne Plaza Hotel. All proceeds collected will benefit Peace by Piece Center for Children with Autism in Ft. Myers.

peace by piece

“After visiting with the children from Peace by Piece for a dental presentation we were made aware of how autism effects our community. We knew right away that we wanted to help support this wonderful cause,” said Dr. Tim Verwest, DMD of Pediatric Dentistry of Ft. Myers.

The mission of Peace by Piece is to provide research based behavior analytic and educational services to children with autism and other developmental disabilities, in an environment that is surrounded with unconditional love, patience, support, and respect. For more information on sponsorship opportunities, please call Peace by Piece Center for Children with Autism at (239) 245-8301 or (239) 850-0802.

Pediatric Dentistry of Ft Myers, Dr. Tim Verwest, DMD, continues to provide pediatric dental care to children for over 25 years. Areas of service include comprehensive dental exams, cleanings, composite fillings, dental hygiene education, extractions, fluoride treatments, sealants, sedation dentistry, space maintainers, x-rays and tooth nerve treatment. For more information, visit www.DrVerwest.com or (239) 482-2722.

Teaching Your Child To Floss

Let’s face it – as adults, we generally don’t floss, despite the constant nagging from our dentists and the guilt-ridden, embarrassed responses we’re forced to give twice a year when the hygienist asks us how often we floss.  And if we don’t floss, how can we possibly expect our children to pick up the habit?

We know, we know. It’s just another thing to add to your never-ending to-do list.  Getting kids to brush their teeth is hard enough; let alone asking them to add another 2 minutes onto their bedtime routine.

According to dentists, flossing is even MORE important than brushing when it comes to preventing periodontal disease and tooth decay.  Brushing covers the surface of the tooth, but your tongue and saliva help to reduce plaque in those areas as well.  Between your teeth is a whole other story.  Food particles (yes, even if you can’t see them) get stuck between your teeth, attracting cavity-causing bacteria.  If you aren’t flossing, you’re missing out on cleaning up to 40% of your tooth.

As soon as your child has two teeth that are touching, it’s time to start the flossing routine.  As with brushing, they’ll require supervision until they’re about 7 or 8 years old.  To make it more enjoyable, let your child pick their favorite flavored floss.  To make it easier, let your child use a pre-threaded flosser of floss holder to maneuver around all of their teeth.


Step One. To begin flossing, have your child cut off a piece of floss approximately 18 inches long.

Step Two. Have them wrap the ends around their middle or index fingers on both hands.

Step Three. Next, have them gently guide the floss between their teeth, carefully moving the floss around the tooth and under the gum line. Make sure they floss between the gum line and the side of each tooth.

The 5 Subconscious Habits You’re Doing that Damage Your Teeth

We all have times when we’re running on autopilot, and we’re pulled in a million different directions. At these times, you might not even realize the wear & tear you’re doing to your teeth. Beware of these 5 habits you probably do subconsciously that could wind you up at the dentist’s office.

1. Crunching on ice

This one is a tough habit to break because most people either never eat ice or eat ice all of the time. Your teeth are designed to crush THROUGH things, not AGAINST them, so the hardness of ice cubes can cause serious damage to your teeth. One dentist reminds use that even “your blender needs special blades to crush ice.”

2. Using your teeth as tools

We’ve all done it. Don’t see the tool you need laying close by hand? Plan B: Use your teeth – whether it’s breaking off a clothing tag, opening a bag of chips, or unscrewing that impossible soda top. But remember, your teeth are meant for 3 things: to chew food, to speak properly, and to look better when smiling. If you’re not using your teeth for any of those 3 things, don’t use them at all.

3. Absentmindedly chewing on whatever you have in your hand

You might not even realize how often you do this. (You might not even realize you’re doing it right now!) Some people have a habit of holding whatever object they have in their hand – pens, pencils, eyeglasses, etc. – between their teeth when they’re concentrating. Again, your teeth are designed to crush through things, so even though it might not seem like a big deal, you’re most likely putting more pressure on your teeth than you even realize.

4. Sipping on soda

We all know soda is bad for us — too much sugar, too many calories, leads to serious health conditions (really, is there anything good about soda?) — but sipping on soda over a long period of time can be detrimental to your teeth.  By casually drinking a soda at your desk, you’re literally washing your teeth in acid for an hour.  In the long term, this leads to decay and loss of enamel.

5. Excessive snacking

It’s true that snacking throughout the day kickstarts your metabolism, but it also raises the acidity level in your mouth for a prolonged period of time. When you snack, it takes your saliva about an hour to return the acidity level in your mouth back to normal, but if you’re snacking every hour or every two hours, the acidity level will be high many times throughout the day, which causes decay and enamel erosion.