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Teething

(Cutting Teeth)

Definition

Teething begins before a child's first tooth breaks through the gums. It is a natural process, but causes sore gums. Teething can make your child uncomfortable and cranky. Teething lasts from 6 months to 3 years.

Primary Teeth

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Causes    TOP

The first teeth start to come in when your baby is 6-12 months old. The first teeth are most often the two bottom front teeth. Other teeth will quickly follow. The pressure on the gums can make them swollen and tender.

Risk Factors    TOP

Teething is a natural process. No factors increase the chance of teething.

Symptoms    TOP

Many babies do not experience any problems or pain. When symptoms do occur, they generally last for several days before and a few days after the tooth comes through the gums.

Symptoms include:

  • Drooling
  • Wanting to chew on fingers or hard materials
  • Rubbing the gums or ears
  • Restlessness
  • Irritability
  • Increased sucking
  • Reduced interest in solid foods
  • Slight rise in body temperature
  • Swollen gums
  • Sensitive gums
  • Rash on face, resulting from drooling

If the baby is feverish and acts sick or very upset, seek medical care. Something else may be causing the symptoms.

Diagnosis    TOP

A doctor will diagnose teething by the baby's age, symptoms, and appearance of the gums. A teething baby's gums appear swollen and are tender. Sometimes small, white spots appear on the gums just before a tooth comes through. There may be some bruising or bleeding.

Treatment    TOP

Most children will only need basic comfort measures. Your doctor may recommend pain-numbing gels and medications, but they are rarely needed.

Bring your child to a dentist when the first tooth comes in. Make sure to visit the dentist by one year of age. The dentist will perform an exam. You will be shown how to care for your child's teeth.

Cleaning

  • After each feeding, wash your baby's gums with a soft, damp cloth or gauze.
  • When teeth come in, brush them daily. Use a small, soft-bristled toothbrush or a damp gauze pad.
  • For a child's first teeth, use an amount of fluoride toothpaste that is about the size of a grain of rice. Progress to an amount that is about the size of a pea by the time your child is 3 years of age. This will reduce the risk of the child swallowing it.
  • Remove any drool. Keep the baby's face clean and dry. This will prevent a rash.

Comfort Measures

Teething babies usually like to chew on a wet washcloth or teething ring. Guidelines for teething rings include:

  • Make sure anything given to your baby is clean and too big to swallow.
  • The teething ring should be made of firm rubber. It should be just one piece.
  • Do not freeze a teething ring. It will become too hard, which could damage new teeth. In addition, the cold could hurt tissue in the mouth.
  • Avoid teething rings with liquid inside. They could break open, exposing your baby to the contents.
  • Do not tie a teething ring or anything else around your baby's neck. If the ring or cord were to catch on something, the cord could choke your baby.

Note : Avoid using amber teething necklaces. Current evidence does not show that they help relieve pain. They are also a strangulation and choking hazard.

Other general tips include:

  • Rub the gum with a clean finger or wet gauze to help reduce discomfort.
  • Cool fluids may offer some relief.
  • If crackers or teething biscuits are given, watch your baby carefully to prevent choking.
  • Do not use alcohol.

Prevention    TOP

Teething is a normal part of child development. Prevention methods are not needed.

RESOURCES:

Healthy Smiles, Healthy Children—American Academy of Pediatric Dentistry
http://www.aapd.org/foundation
Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca
The Canadian Dental Hygienists Association
http://www.cdha.ca

References:

Amber teething necklaces: a caution for parents. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Amber-Teething-Necklaces.aspx. Updated October 19, 2016. Accessed December 8, 2016.
Teething: 4 to 7 months. American Academy of Pediatrics Healthy Children website. Available at:
...(Click grey area to select URL)
Updated December 3, 2013. Accessed February 17, 2014.
Teeth and teething. American Academy of Family Physicians Family Doctor website. Available at:
...(Click grey area to select URL)
Accessed February 17, 2014.
Teething tots. Nemours Kid's Health website. Available at:
...(Click grey area to select URL)
Updated November 2011. Accessed February 17, 2014.
2/17/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014;145(2):190-191.
Last reviewed March 2017 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 5/5/2014

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