Teething

Teething is the normal process of new teeth working their way through the gums. Your baby's first tooth may appear any time between the time she is 3 months to 1 year old. Most children have completely painless teething. The only symptoms are increased saliva, drooling, and a desire to chew on things. Teething occasionally causes some mild gum pain, but it doesn't interfere with sleep. The degree of discomfort varies from child to child. Your child won't be miserable. When the back teeth (molars) come through (age 6 to 12 years), the overlying gum may become bruised and swollen. This is harmless and temporary.

Because teeth erupt almost continuously from 6 months to 2 years of age, many unrelated illnesses are blamed on teething. Fevers are also common during this time because after the age of 6 months, infants lose the natural protection provided by their mothers' antibodies.

Which baby teeth come in first?

Your baby's teeth will usually erupt in the following order:

• 2 lower incisors
• 4 upper incisors
• 2 lower incisors and all 4 first molars
• 4 canines
• 4 second molars

How can you take care of your child?

• Gum massage

  Find the irritated or swollen gum. Massage it with your finger for 2 minutes. Do this as often as necessary. You may also massage the gum with a piece of ice.

• Teething rings

  Your baby's way of massaging her gums is to chew on a smooth, hard object. Solid teething rings and ones with liquid in the centre (as long as it's purified water) are fine. Most children like them cold. A wet washcloth or banana chilled in the freezer for 10 minutes will please many infants. Avoid ice, popsicles, or other frozen objects that could cause frostbite of the gums. Also avoid hard foods that she might choke on (like raw carrots). Teething biscuits are fine.

• Diet

  Avoid salty or acid foods. Your baby probably will enjoy sucking on a nipple, but if she complains, use a cup for fluids temporarily.

• Acetaminophen

  If the pain increases, give acetaminophen (Tylenol) orally for 1 day. Special teething gels are unnecessary. Many teething gels contain benzocaine, which can cause an allergic reaction. If you want to use a gel, do not apply it more than 4 times a day.

• Common myths about teething
  Teething does not cause fever, sleep problems, diarrhea, diaper rash, or lowered resistance to any infection. It probably doesn't cause crying. If your baby develops fever while teething, the fever is caused by something else. Don't tie a teething ring around your baby's neck. It could catch on something and strangle your child. Attach it to your baby's clothing with a "catch-it-clip."

Call during office hours if:

• your child develops a fever over 38.3°C (101°F)
• your child develops crying that doesn't have a cause
• you have other questions or concerns

	TEETHING The initial appearance of "baby" or milk teeth in infants. As the teeth break through the skin, infants can suffer discomfort. Symptoms include excessive drooling, the desire to bite down hard on objects, and irritability. Generally, teething begins at about six months of age and lasts until about 30 months of age when all 20 teeth have emerged.

	FEVER A rise in body temperature above normal. "Normal" depends on how you measure your child's body temperature. If you measure by rectum (bum) or by ear, fever means a temperature over 38°C (100.4°F). If you measure by mouth, fever means a temperature over 37.5°C (99.5°F). If you measure in the armpit, fever means a temperature over 37.3°C (99.1°F).