What to Do When Your Child Starts Teething
by Christine Hansen
All primary teeth should be in by the time your child turns 3 years old. The process of getting those 20 little pearly whites, though, can be quite an ordeal. Some children get all their teeth without batting an eye, while others (and their families) agonize over every tooth.
The Teething Process
The primary teeth begin to form in the uterus when the fetus is developing. The actual eruption of teeth through the gums, called teething, begins when a baby is 4-9 months old. Sometimes teething can occur earlier or later than this and still be normal. Your doctor may want to do more testing if teething happens too far outside of this range.
The first teeth to show are typically the incisors: first the lower front ones, followed by the upper front ones. Although some books and charts may give you an idea of how teething progresses, each child is different. Don't be alarmed if your child's teeth aren't erupting in this order.
When your child is teething, They may be more irritable than usual or might chew on everything within reach. These are all normal teething symptoms. However, if your child has a fever and diarrhea, call the pediatrician. A common myth about teething is that it causes a fever. This is not true. If your child has a fever, there is a reason for it, and it is unrelated to their newly erupting teeth.
Tips and Techniques for Coping
Provide your child with safe things to chew on. Favorite items are a one-piece teething ring (smooth or with bumps), teething biscuits, or a pacifier.
You should avoid using fluid-filled teething rings because they can break open or leak. Other options include letting your child gnaw on a big tablespoon chilled in the refrigerator, or rubbing your baby's gums with a clean finger. Do not using frozen teething items because they may cause injury when put in the mouth.
It's not advisable to use topical anesthetics. Some can numb your child's throat and interfere with swallowing. The US Food and Drug Administration (FDA) also recommends that teething medications containing benzocaine should not be used in children under 2 years old.
Rubbing whiskey or other alcohol on the gums is an old remedy, but pediatric dentists do not recommend it. Consider using non-aspirin type of analgesic, such as acetaminophen for infants. Check the label carefully, as dosages may differ between drops and elixir.
Care of Baby Teeth
Though your child will eventually replace their primary teeth with permanent teeth, they are still essential right now, and not just for appearance. Primary teeth enable children to chew and speak properly, and these baby teeth reserve space in the jaw for permanent teeth.
To properly care for primary teeth, wipe your child's gums and teeth with a damp gauze pad or washcloth after every feeding, beginning a few days after birth.
For older children, use a small, soft toothbrush, and brush very gently. Avoid scrubbing your child's teeth too hard or you may remove gum tissue.
You can start using toothpaste for children who are 1 year old. It is important to use a very small amount of toothpaste. This is because young children have not mastered the art of spitting it out, and strongly flavored toothpastes may induce an irritating burning sensation. Be careful not to let your child swallow the toothpaste or eat it out of the tube. This puts them in danger of ingesting too much fluoride.
Fluoride is essential for the development of strong and healthy teeth. Many communities have added fluoride to their water supplies. Have your drinking water tested before you give your children fluoride supplements.
Baby Bottle Tooth Decay
Whether a baby is bottle-fed or nursed, they are vulnerable to baby bottle tooth decay, one of the most common and serious dental problems associated with young children. Such decay occurs when little teeth are exposed to liquids containing sugars (basically, anything other than water) for long periods of time. Bacteria in the mouth thrive on these sugars and produce acids, which attack the tooth enamel.
The result is damage to the teeth, which is evident by black or brown spots. It can result in your child losing primary teeth before they are ready to fall out naturally, extensive dental work, or damage to adult teeth.
The best treatment for baby bottle tooth decay is prevention. Do not let your child use a bottle or spill-proof cup as a pacifier, or fall asleep with a bottle or spill-proof cup containing anything but water. And be sure to gently clean their teeth and gums after each feeding.
Your Child's First Dentist Appointment
The American Academy of Pediatric Dentistry recommends that kids see a dentist as soon as their first tooth appears, usually before their first birthday. The dentist will check your child's teeth and gums for healthy development, and will show you how best to clean them.
Healthy Smiles Healthy Children—American Academy of Pediatric Dentistry
Mouth Healthy—American Dental Association
Canadian Dental Association
Caring for Kids—Canadian Paediatric Society
How to prevent tooth decay in your baby. American Academy of Pediatrics Healthy Children website. Available at: https://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/How-to-Prevent-Tooth-Decay-in-Your-Baby.aspx. Updated May 15, 2015. Accessed July 31, 2017.
Teething. American Academy of Pediatrics Healthy Children website. Available at:
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Updated August 1, 2011. Accessed July 31, 2017.
Teething pain. American Academy of Pediatrics Healthy Children website. Available at: https://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Teething-Pain.aspx. Updated November 28, 2015. Accessed July 31, 2017.
Teething tots. Nemours Kids Health website. Available at:
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Updated August 2014. Accessed July 31, 2017.
Last reviewed July 2017 by Michael Woods, MD, FAAP
Last Updated: 8/5/2015
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