Teething

Timeline

There is no correct time for your baby to cut his/her first tooth. Some babies are born with a tooth (although this is rare) while others may still have none at 12 months old. As a general rule, however, teething starts at about 6 months and ends between 2 and 3 years.

You will notice the teeth break through the gum tissue one at a time over a period of months, and often – but not always – in this order: First the bottom two middle teeth, then the top two middle ones, then the ones along the sides and back. They may not all come in straight, but don't worry – they usually straighten out over time.

Symptoms

As your baby's first tooth starts to push its way through the gum, you may notice a small, pale bump. Your baby may also show signs of the following:

• Excessive drooling, which can lead to a facial rash
• Irritability or fussiness
• Gum swelling and sensitivity
• Biting behavior
• Refusal of food
• Difficulty sleeping

You should never blame any other symptoms on cutting a tooth; it is a myth that teething can cause fever, diarrhea, vomiting, convulsions, rashes, or loss of appetite. If you are at all worried, call our office or get medical advice immediately.

Helpful Tips

No parent likes to see their child in discomfort, so we suggest doing the following to help relieve any pain or discomfort:

• Offer your baby something firm to chew on like a cooled teething ring. Your baby may find sucking painful, so give drinks from a cup instead.
• Try just gently rubbing your child's gums with your own little finger – this can help as much as anything. Your attention and concern about your baby's pain will bring him/her comfort.
• Avoid taking your child out in a cold wind, which always seems to make the pain of teething worse. When you go out in the winter, try to cover most of your child's face and head with a warm hat or a hood and put a scarf around his neck and chin.
• Don't put teething gels containing local anesthetics on his gums. They only have a transient effect, and local anesthetics can cause allergies.
• Don't use over-the-counter teething remedies. Your baby has many teeth to cut, and if you use anything regularly you will be exposing your baby to a large amount of medication, much of which may be unnecessary and all of which may be accompanied by side effects.
• Be careful if you use the water-filled teething rings that can be frozen by placing them in the freezer. Careless use of these teething rings has been known to cause frostbite in babies. To avoid this problem, place them in the refrigerator instead of the freezer.
• Avoid the frequent use of acetaminophen, which is found in Tylenol. It is useful, but should not be given with any regularity except under a doctor's order. If you need it to soothe your fretful baby for more than 2 doses, then you should consult your pediatrician.