社團法人中華民國兒童牙科醫學會

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0~3歲 Ages 0-3 牙齒生長發育 ODONTOGENESIS

0至三歲 Between 0 to 3 years

牙齒的生長與發育 0至三歲

嬰兒在出生時是沒有牙齒的,大約在6至8個月時開始長牙,此時長的牙齒是乳齒。

乳齒有20顆,平均約在兩歲半時全部萌出。有一些異常是在出生時就有牙齒叫做出生牙(Natal Tooth),有些是在出生後一個月內萌發,叫做新生牙(Neonatal Tooth),大多出現在下顎前牙區。

這新長的牙齒有些只是口腔內的鈣化組織,並非是完整的牙齒結構;有些則是提早萌發的乳齒。這類異常可能會影響哺乳,如果有這種情況,是否應該拔除請找兒童牙科醫師進一步診斷與治療。

嬰兒剛出生時為了滿足口慾,我們會使用安撫奶嘴。但是隨著小朋友慢慢長大、長牙、吃副食品,父母建立小朋友的安全感後,可以找適當時機將安撫奶嘴戒掉。

臨床上,和父母討論界奶嘴問題時,時常聽到:「沒有奶嘴睡不著!」、「請醫師跟小朋友講,他最聽醫師的話了!」等等回答。這其實是父母不願面對問題、推卸責任的話,是父母本身對安撫奶嘴的依賴,請不要把安撫奶嘴當成讓小朋友停止哭鬧的萬靈丹。

過度使用安撫奶嘴會影響牙齒位置與顎骨發育,影響程度與使用時間長短與頻率有關,可能會造成前牙開咬、暴牙,這問題大多會隨著奶嘴的戒除而慢慢自動改善,建議在兩歲前將安撫奶嘴戒除。

舌繫帶為舌頭底下連接口底的一片薄膜,太緊或太厚的舌繫帶會限制舌頭的活動範圍,嚴重的話可能會影響嬰兒哺乳、學習發音、吞嚥時舌頂上顎等等動作,嚴重的舌繫帶粘連可以施予舌繫帶切除手術改善。如果家長懷疑小朋友有舌繫帶問題,請找牙醫師進一步診斷。

Babies are born without teeth and they begin teething when they are between 6 to 8 months old. These baby teeth are twenty in total and on average, become fully erupted by the time children turn 2 and half years old.
Some exceptions include natal tooth, meaning a tooth appeared at birth or neonatal tooth, that is a tooth erupted within the first month after a baby is born, mostly found in the anterior segment of the mandible.
Some of these teeth are only calcified issues in the mouth, and do not have a complete tooth structure. Others are baby teeth prematurely erupted. These abnormalities can affect breastfeeding and parents should consult a pediatric dentist to determine if further intervention or treatment is required. When babies are young, parents can use a pacifier to satisfy their need for sucking. As children grow up, start teething and eat solid food, parents can build up their sense of security and find an appropriate timing to wean them off the pacifier.
It's common for pediatric dentists to hear parents saying, “my baby can't sleep without a pacifier.” “please talk to my kid because he'll only listen to a doctor.” These comments, in fact, reflect parents' own dependence on pacifiers and reluctance to face the problem. Please do not treat pacifiers as the miracle cure to stop children from crying.
Prolonged use of pacifiers can harm the growth and development of mouth and teeth. Its level of impact depends on the length and frequency of the use. It may cause open bite and protrusion, both of which can improve by itself as the habit discontinues. It's recommended to stop using pacifiers before children turn two years old.
Tongue-tie is a thin tissue underneath the tongue connecting the bottom of the mouth. A tongue-tie too tight or thick will limit tongue's movement and affect feeding, pronunciation and swallowing. Surgical correction can significantly improve the situation. If parents suspect their children may have this issue, please consult a pediatric dentist for further assessment.

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