Drool everywhere, chewing on everything, and a baby who's suddenly fussy and up at night. For many families, teething is the first big milestone of their child's smile. Here's what to expect, what's normal, and what really helps.
When does teething start?
Most babies get their first tooth at around 6 months, but anywhere from about 4 to 12 months is normal. Some babies are even born with a tooth, and others don't get one until after their first birthday.
The usual order is:
Bottom front teeth (lower central incisors), often first, around 6 to 10 months
Top front teeth, a little later
Side front teeth (lateral incisors)
First molars, usually somewhere around the first birthday
Canines (eye teeth)
Second molars, often between 2 and 3 years
By about age 3, most children have all 20 baby teeth.
Common signs of teething
Extra drooling, sometimes with a drool rash on the chin
Chewing or gnawing on fingers, toys and anything nearby
Swollen or tender gums
Fussiness and irritability
Changes in sleep
Rubbing the ears or cheeks
Symptoms often show up a few days before a tooth breaks through and ease once it's in.
What teething doesn't cause
Teething may cause a slightly raised temperature, but it doesn't cause a high fever, diarrhea, vomiting or a runny nose. If your baby has a fever of 100.4°F (38°C) or higher, or seems unwell, call your pediatrician. It's easy to blame teething for an illness that needs attention.
Safe ways to soothe sore gums
Gentle gum massage. Rub your baby's gums with a clean finger for a minute or two.
Chilled (not frozen) teething rings. Solid rubber or silicone rings cooled in the fridge work well. Frozen ones can be too hard on gums.
A cold, damp washcloth to chew on.
Chilled foods, if your baby has started solids, such as cold purées, with supervision.
Pain relief, if your pediatrician recommends it. Ask them about the right medicine and dose for your baby's age and weight.
Lots of cuddles. Sometimes comfort is the best medicine.
What to avoid
Numbing gels and teething medicines with benzocaine or lidocaine. The FDA warns against using them for children under 2 because of rare but serious side effects.
Homeopathic teething tablets. The FDA has warned against these too.
Amber teething necklaces and bracelets. They carry a risk of choking and strangulation, and there's no evidence they help.
Anything small or breakable that could be a choking hazard.
Sweetened teething biscuits, or dipping anything in juice or honey. Honey is never safe for babies under 1.
Start caring for teeth right away
As soon as that first tooth appears, it can get a cavity. Start good habits early:
Brush twice a day with a soft, baby-sized toothbrush.
Use a smear of fluoride toothpaste about the size of a grain of rice.
Wipe gums with a clean, damp cloth where teeth haven't come in yet.
Don't put your baby to bed with a bottle of milk, formula or juice.
Book your baby's first dental visit
The American Academy of Pediatric Dentistry recommends a first dental visit by age 1, or within six months of the first tooth. It's a gentle, quick visit where we check how teeth are coming in and answer your teething questions. Read more about your child's first visit, or request an appointment at our Middletown or West Dover office.