What is teething?
Teething is when your baby's first set of teeth (“baby teeth”) start to appear. Caring for your baby’s teeth begins as soon as the first tooth peeks through your child’s gums. Healthy teeth are an integral part of your baby’s overall health.
Teething can be a tough period both for babies, who feel the pain, and parents, who witness it. They may cry and drool more than usual, may be agitated and cranky. They may sleep poorly while teething. However, most babies seem to get through teething without any symptoms whatsoever. Still, for those who don’t, there are steps you can take that will help both you and your child can get through this stage in good health and spirits.
What you can expect
The first tooth usually appears at about 6 months. Every child develops at a different pace, however, so do not worry if your child’s teeth appear as early as 3 months or as late as 12 months.
The two bottom front teeth (lower central incisors) are usually the first teeth to appear. These are followed by the two top front teeth (upper central incisors). Most children will have all 20 primary (or “baby teeth”) by 3 years of age. Between the ages of 5 and 13, your child will lose the primary teeth to make room for the permanent teeth.
Signs and symptoms
You may not be able to see your baby’s incoming teeth, but your infant will probably feel them and show signs of teething. Signs and symptoms of teething may include:
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swollen or red gums
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a desire to chew on solid objects
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drooling, which may begin about 2 months before the first tooth appears
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crankiness, irritability, or bad temper
Teething does not cause fever or diarrhea. If you notice your baby showing these symptoms, contact your doctor right away. In addition, do not assume that crankiness, irritability or bad temper are due to teething.
Causes
Teeth pushing through the gums cause discomfort. Since your baby cannot express her soreness and tenderness in words, she may be more irritable and cranky as the teeth emerge.
Tips on how you can help soothe your baby’s gums
When your baby seems uncomfortable, consider helping her with some of these simple tips:
Rub your baby’s gums
Using a clean finger or a damp washcloth, massage her gums. The cold sensation and pressure will help ease the discomfort.
Offer your baby a teething ring
A teething ring made of firm rubber will allow your baby to put pressure on her gums. Liquid-filled rings are not recommended, as they could break or hurt your baby under the pressure of her chewing.
Your child may also like chewing on a bottle, which also puts pressure on the gums. Make sure to fill the bottle with water, not formula or juice, as prolonged contact with the sugar in those liquids can lead to tooth decay.
Keep it chilled, not frozen
A cold washcloth or chilled teething ring will likely relieve your baby. If your baby is eating solid foods, she will also enjoy chilled foods like applesauce or yogurt. However, frozen teething rings are not recommended, as the extreme cold could hurt rather than soothe your baby.
Wipe the drool
Constant drooling is a part of the teething process. It keeps your baby’s mouth hydrated and lets the teeth break through without gum damage. However, too much drool can irritate your baby’s skin. Keep your baby’s chin dry by wiping the drool with a clean cloth.
Monitor the pain
If your baby is especially irritated or cranky, you may offer acetaminophen (Tylenol or Tempra) or ibuprofen (Advice or Motrin) to ease the pain. Always check with your physician before you give your child ASA (acetylsalicylic acid or Aspirin).
Avoid over-the-counter teething creams
Unless your doctor recommends a certain type of lotion, avoid teething medications that can be rubbed directly on the baby’s gums. The medication could be swallowed by your child and numb your baby’s throat. This could interfere with the normal gag reflex. More likely, the lotion will be washed away by your baby's saliva and have no effect at all.
Mouth care and cleaning
Start cleaning with the first tooth
Start taking care of your baby's teeth as soon as they emerge. Clean the teeth at least once a day as soon as the first tooth appears. Bedtime is usually a good time to start the routine. Use a soft bristle toothbrush designed for babies.
Avoid juices and sugary drinks
Limit the amount of sugary beverages your baby drinks. Do not allow her to go to bed with a bottle. Natural sugars in juice, formula, or breast milk will cause serious tooth decay, especially if these liquids pool in your baby’s mouth while she is sleeping. Bottle with bed use is also associated with iron deficiency anemia.
Brush twice a day when ready
When your child is 3 or 4 years of age, you can teach her to brush her teeth for at least 2 minutes twice a day. Use a pea-sized amount of toothpaste, and encourage her to spit out the toothpaste rather than swallow it. Use fluoride containing toothpaste when your child is old enough to spit.
When to seek medical assistance
Contact your baby’s doctor if you notice a persistent fever. Teething does not cause fever.
Your child should have her first visit to a dentist at 12 months of age.
Key points
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Caring for your baby's teeth begins when the first tooth peeks through her gums.
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Healthy teeth are an important part of your baby's health.
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Treat your baby's pain with acetaminophen or ibuprofen. Never give ASA without first checking with a physician.
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You can help soothe your baby's gums with a chilled washcloth or teething ring made of rubber.
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Sugary drinks such as juice and soda contribute to tooth decay. Limit your baby's intake of these drinks and never allow her to sleep with a bottle.