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.
Primary teeth
What you can expect
The first tooth usually appears at about six months. Every child develops at a different pace, so do not worry if your child's teeth appear as early as three 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 teeth by three years of age. Between the ages of five 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:
- 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 them 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.
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 cavities.
Keep it chilled, not frozen
A cold washcloth or chilled teething ring will likely relieve your baby’s discomfort. 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 or ibuprofen to ease the pain.
Avoid over-the-counter teething creams or gels
Unless your doctor recommends a certain type of teething medication, avoid those 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. Often, the medication cream or gel 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 their 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, and any type of milk including cow’s milk, formula and breast milk, will cause serious tooth decay, especially if these liquids pool in your baby's mouth while they are sleeping. Early childhood cavities are also associated with iron deficiency anemia.
Brush twice a day when ready
When your child is three or four 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 health-care provider
Contact your baby's health-care provider 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.