Teething

What is teething?

Teething is when your baby's first set of teeth (“baby teeth” or primary 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. They will help your baby chew and eat properly, learn how to speak and they hold place for the future permanent teeth.​

Teething can be a tough period both for babies, who feel the pain, and parents, who witness it. Your baby 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. If your baby experience symptoms, 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, 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 primaryteeth 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.

Primary Teeth
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The first set of teeth that babies develop is called primary teeth. The teeth erupt in a specific order as numbered above. They last until permatnent (adult) teeth come in.

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:   

  • swollen or red gums
  • a desire to chew on solid objects
  • drooling, which may begin about two months before the first tooth appears
  • 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 their soreness and tenderness in words, they 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 your baby's  gums. The cold sensation and pressure will help ease the discomfort.

Child chewing on teething toy 

Offer your baby a teething ring

A teething ring made of firm rubber will allow your baby to put pressure on their gums. Liquid-filled rings are not recommended, as they could break or hurt your baby under the chewing pressure.

Your child may also like chewing on a pacifier or a bottle, which also puts pressure on the gums. Make sure to fill the bottle with water, not milk or juice, as prolonged contact with the sugar in those liquids can lead to tooth decay called early childhood carries.

Keep it chilled, not frozen

A cold washcloth or chilled teething ring will likely relieve your baby. If your baby is eating solid foods, they 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. Do not 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. your baby may swallow the medication that could numb their throat. This could interfere with the normal gag reflex. The lotion will more likely 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 come out. 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. For more information, see our page on dental care.​

Avoid juices and sugary drinks

Limit the amount of sugary beverages your baby drinks. Do not allow your baby to go to bed with a bottle filled with anything else but plain water​. Natural sugars in juice, formula, or breast milk will cause serious tooth decay, especially if these liquids pool in your baby’s mouth while they are sleeping. Early childhood carries are 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 them to brush their teeth for at least two minutes twice a day. Use a green pea-sized amount of toothpaste, and encourage your child to spit out the toothpaste rather than swallow it. Use fluoride containing toothpaste when your child is old enough to spit.

When to see a doctor

Contact your baby’s doctor if you notice a persistent fever. Teething does not cause fever.  

Your child should have their first visit to a dentist at 12 months of age or when they get their first tooth.

Key points

  • Caring for your baby's teeth begins when the first tooth peeks through their gums.
  • Healthy teeth are an important part of your baby's health.
  • Treat your baby's pain with acetaminophen or ibuprofen. Never give ASA​ without first checking with your baby's doctor.
  • You can help soothe your baby's gums with a chilled (but not frozen) washcloth or teething ring made of rubber.
  • Sugary drinks such as juice and soda contribute to tooth decay. Limit your baby's intake of these drinks and never allow them  to sleep with a bottle.

Reviewed by:

Michael J. Casas, DDS, MSc, FRCD(C)

1/7/2014




Notes: