Teething

What Is Teething?

Teething is when your baby’s teeth start to come through their gum line. Another word for it is odontiasis.

When Do Babies Start Teething?

Most babies begin to teethe between 4 and 7 months old, but some start much later. There’s no need to worry if your baby’s teeth come in on another timetable -- it can be different for every baby.

Signs and Symptoms of Teething

The symptoms aren’t the same for every baby, but they may include:

  • Swollen, tender gums
  • Fussiness and crying
  • A slightly raised temperature (less than 101 F)
  • Gnawing or wanting to chew on hard things
  • Lots of drool, which can cause a rash on their face
  • Coughing
  • Rubbing their cheek or pulling their ear
  • Bringing their hands to their mouth
  • Changes in eating or sleeping patterns

Teething can be painful, but it doesn’t usually make babies sick. Call your doctor if your baby has diarrhea, vomiting, rashes on the body, a higher fever, or cough and congestion. These aren’t normal signs of teething.

You also should call the pediatrician if your baby’s gums are bleeding or you see any pus or swelling of their face.

Order of Tooth Eruption

When and how teeth come in can be different for every baby and may be based on family history. But most of the time, the lower front two teeth come in first, followed by the opposite top two teeth and the two on either side of those. Next come the two on either side of the bottom front teeth, then the first molars appear. The teeth in front of the first molars are next, and the back molars are the last ones to come in.

In all, 20 “baby teeth” will eventually be in place, usually by age 3.

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Soothe a Teething Baby

What works to soothe a friend’s baby might not work for yours. You may need to try different things to help your little one feel better:

  • Something cold in your baby’s mouth, like a cold pacifier, spoon, clean wet washcloth, or a solid (not liquid) refrigerated teething toy or ring. Some experts say frozen teething toys are too cold and may hurt your baby’s mouth. Make sure to clean teething toys, washcloths, and other items after the baby uses them.
  • Try offering a hard, unsweetened teething cracker.
  • If your baby is older than 6-9 months, you can offer cool water from a sippy cup, too.
  • Massage the gums by gently rubbing them with your clean finger. If the teeth haven’t come in yet, you can let your baby gnaw on your finger. If you’re nursing your baby, try dipping your fingers in cool water and massaging their gums before each feeding. That may keep them from biting your nipple while nursing.

Treatments to Avoid

Never put anything in your baby’s mouth that isn’t specifically approved to help soothe teething. Even some products described as teethers or teething aids aren’t safe choices, including ones:

  • Filled with liquid that can tear and spill
  • Made of breakable material, like plastic, that can possibly lead to choking
  • That are frozen solid -- these can be too hard on a baby’s mouth

Another reason to be aware of the material used to make the teethers: Some can be made from harmful substances, like lead. Look for ones made of rubber.

Teething Necklaces

Child health experts don’t recommend teething necklaces. They’re dangerous: They can strangle the baby. They also can choke if the necklace breaks and they swallow the beads.

If you do choose to use one, make sure to:

  • Put it on a wrist or ankle, not around the baby’s neck.
  • Always watch your baby when they wear it.
  • Take it away when you aren’t watching your baby, even for a very short time.

You may have heard that amber teething necklaces release a pain reliever when heated. That’s not proven, and doctors say using one is not a good idea.

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Teething Medicine

Medicine that you rub on your baby’s gums to stop the pain of teething may not help. It quickly washes away in the mouth and may numb the back of their throat and make it hard for them to swallow.

Stay away from over-the-counter teething gels and liquids that have the ingredient benzocaine. The FDA says this ingredient shouldn’t be given to children under 2. It can cause rare but serious side effects.

A small dose of a children’s pain reliever, such as acetaminophen, may help your baby. Don’t use ibuprofen for an infant under 6 months old, and ask your doctor before giving your baby any medication. Use it exactly as the doctor says.

Teething can be rough for you and your baby at first. But it’ll get easier as you both learn how to soothe each new tooth that pops out.

How to Care for Baby’s New Teeth

Good oral hygiene is important, even before your baby has teeth:

  • Until teeth start to come in, clean your baby’s gums with a wet washcloth or piece of gauze at least once a day.
  • Once they have teeth, clean your baby’s mouth the same way at least twice a day. After feedings is a good time for this.
  • After their first birthday, you can start to use a soft-bristled baby toothbrush with water and a small amount of toothpaste that doesn’t have fluoride in it. You can also start flossing between their teeth.

The pediatrician will monitor your baby's teeth for decay and will decide if a referral to a dentist is needed prior to age 1. For most kids, the pediatrician can continue to screen teeth until age 3.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on August 12, 2020

Sources

SOURCES:

American Academy of Pediatrics: “Teething: 4 to 7 Months,” “Teething Pain," “Children’s Oral Health," “Amber Teething Necklaces: A Caution for Parents."

American Dental Association/Mouth Healthy: “Teething.”

Massignan, C. Pediatrics, published online March 2016.

FDA: “FDA Drug Safety Communication: Reports of a rare, but serious and potentially fatal adverse effect with the use of OTC benzocaine gels and liquids applied to the gums or mouth.”

American Academy of Pediatric Dentistry: “Frequently Asked Questions.”

American Academy of Family Physicians: “Dental Hygiene: How To Care For Your Baby’s Teeth.”

© 2020 WebMD, LLC. All rights reserved.

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