Information about Teething
When an infant or child's new teeth push through the gums, the process is called teething (also known as tooth eruption). The primary teeth, also known as the milk teeth, baby teeth, temporary teeth, or deciduous teeth (meaning "subject to being shed") usually begin coming in between the ages of four to eight months until around the third birthday.
Of the 20 primary teeth, the 8 incisors (sharp front teeth) come in first and are typically all in place at 12 to 14 months. These are followed by molars (back teeth used for chewing) and canines (pointed teeth located between molars and incisors).
As the teeth work their way through the gum tissue, the gums can become swollen and tender. A teething child may fret, cry, be unwilling to eat, and have trouble sleeping.
It is not clear, however, whether these and other symptoms associated with teething are due to tooth eruption. For example, most teething infants drool frequently, but the drooling may be caused by the normal development of the salivary glands. Teething has also been blamed for causing infections and high fevers, but these are most likely separate problems that occur simultaneously with the emergence of new teeth.
Symptoms of Teething
Signs of teething may include:
- Drooling increases
- Fingers are put in the mouth more often
- Gums can become red and/or swollen
- Annoyance and irritability may increase
- Loss of appetite
- Fever and rashes
Teething is a normal part of development in infants and toddlers and can be treated without prescription or over-the-counter (OTC) medications.
The U.S. Food and Drug Administration (FDA) warns against using viscous lidocaine and products that contain benzocaine (e.g., Anbesol, Baby Orajel, etc.) to treat teething pain. These products can cause a rare, but serious and potentially fatal, condition called methemoglobinemia (greatly reduced blood oxygen levels).
What If You Do Nothing about Teething?
Any teething-related discomfort, which varies in intensity from child to child, is almost always harmless and temporary.
Home Remedies for Teething Pain
Because stimulating the gums helps alleviate any discomfort, a baby who is teething will often chew on fingers and other hard objects. Here are several ways that a parent can help.
- Give your child an object to teethe on. Make sure that the object is large enough that your child can’t swallow it or choke on it. Usually, a hard rubber pacifier is the best choice. Avoid plastic objects because they can splinter and harm the child. A chilled teething ring or a metal spoon can help numb irritated gums. (But don’t use a frozen object; a baby’s mouth can get frostbite.) Do not tie a teething ring around your child’s neckit can become a strangulation hazardand make sure to supervise your baby.
- Massage the gums. Rub the child’s gums gently with your little finger for a minute or two. Make sure your finger is clean. Don’t rub aspirin on the gums; not only can it cause irritation, but it also may be dangerous if swallowed.
- Ask your pediatrician about medicating. If teething pain is especially distressing, acetaminophen or ibuprofen can be used to relieve pain. Follow dosage instructions on the label for your child’s age and weight. Do not apply a teething gel or other topical anesthetic used to numb the gums. They can cause serious reactions.
- Skip the bottle at bedtime. Do not lull a baby to sleep with a bottle of milk, either at nap time or at night. If milk stays in constant contact with the teeth, tooth decay can result. Milk should be used for feeding, not for teething or to quiet your child.
- Keep your child’s face from chapping. To prevent chapping on the cheeks and around the mouth caused by excessive drooling, rub a thin layer of petroleum jelly on troublesome areas of the child’s face.
- Clean gums and new teeth regularly. Gently clean your child’s gums and new teeth twice daily (especially after bedtime feedings) with a clean washcloth, a soft toothbrush, or a piece of gauze. This reduces the amount of bacteria present on the gums, decreasing the risk of infection and irritation.
Beyond Home Remedies: When To Call Your Doctor
Generally, teething does not warrant calling your pediatrician. But if your child develops a fever, particularly a fever over 101°F, call your doctor, since any fever will probably have a cause other than teething. Likewise, diarrhea, vomiting, or loss of appetite suggest an underlying health problem and can be signs to call your physician.
Occasionally, bluish bruises (blood blisters) will form on the gum opposite the one where a tooth is starting to push through.
What Your Doctor Will Do
Your doctor will determine whether any pain, discomfort, or fever is due to something other than teething.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media