Topic Overview

What is teething?

Your baby is teething when his
or her first set of teeth, called primary teeth, break through the gums.

When does teething typically start?

Teething
usually begins around 6 months of age. But it is normal for teething to start
at any time between 3 months and 12 months of age. By the time your child is
about 3 years old, he or she will have all 20 primary teeth.

The
lower front teeth usually come in first. Upper front teeth usually come in 1 to
2 months after the lower front teeth. See a picture that shows
when the primary teeth come in.

What are the symptoms?

Some babies are fussier
than usual when they are teething. This may be because of soreness and swelling
in the gums before a tooth comes through. These symptoms usually begin about 3
to 5 days before the tooth shows, and they disappear as soon as the tooth
breaks the skin. Many babies don’t seem to be affected by teething.

Babies may bite on their fingers or toys to help relieve the pressure in
their gums. They may also refuse to eat and drink because their mouths hurt.

Many babies drool during teething, which can cause a rash on the
chin, face, or chest.

Mild symptoms that get better usually are
nothing to worry about. Call your doctor if your baby’s symptoms are severe or
don’t get better.

How can you help your baby be more comfortable while teething?

Here are some tips to help your baby feel better while
teething:

  • Use a clean finger (or
    cold teething ring) to gently rub your baby’s gum for about 2 minutes at a
    time. Many babies find this soothing, although they may protest at first.
  • Provide safe objects for your baby to chew on, such as teething
    rings.
  • If needed, give your baby an over-the-counter pain reliever that is labeled
    for his or her specific age. Read and follow all instructions. Do not give aspirin to anyone younger than 20, because it has been linked to
    Reye syndrome, a rare but serious disease.

Do not use teething gels for children younger than 2. The U.S. Food and Drug Administration (FDA) warns against using teething gels that contain the medicine benzocaine because it can harm your child.

Do not use teething tablets. The FDA warns against using teething tablets. They may contain belladonna, a toxic substance that can harm your child.

Frequently Asked Questions

Learning about teething:

Knowing what to expect:

Getting treatment:

Ongoing concerns:

What to Expect

Tooth development

Primary teeth are usually known
as “baby teeth.” Usually, the first primary tooth comes in (erupts) at about 6
months of age, although it can be as early as 3 months or as late as 1 year of
age. In rare cases, a baby gets a first tooth after his or her first birthday.
By age 3, most children have all 20 of their primary teeth.

Primary teeth usually erupt in a
certain order:

  1. The two bottom front teeth (central
    incisors)
  2. The four upper front teeth (central and lateral
    incisors)
  3. The two lower lateral incisors
  4. The first
    molars
  5. The four canines (located on either side next to the upper
    and lower lateral incisors)
  6. The remaining molars on either side of
    the existing line of teeth

Secondary, or permanent, teeth usually begin replacing
primary teeth around 6 years of age. Permanent teeth erupt in roughly the same
sequence as primary teeth. Usually, a permanent tooth pushes the primary tooth
out as it erupts.

Symptoms of teething

Many times you might not know
that your baby has a new tooth coming in until you see it or hear it click
against an object, such as a spoon. Some babies may show signs of discomfort
from sore and sensitive gums, be cranky, drool, and have other mild symptoms.
These symptoms usually begin about 3 to 5 days before a tooth erupts and go
away as soon as the tooth breaks through the gum.

Teething may cause a mild increase in your child’s temperature. But if the temperature is higher
than 100.4°F (38°C), look for symptoms that may be related to an infection or illness. Severe or ongoing symptoms
should be closely watched and discussed with your doctor.

Common concerns

Do not hesitate to call your
doctor any time you have
concerns about your child’s teething. It is also a
good idea to talk to your doctor if your child has
unusual tooth development, such as late eruption of
the first tooth. Tooth development issues usually resolve on their own or are
easily treated.

Home Treatment

Controlling symptoms safely

If your baby has
discomfort while teething, you can:

  • Rub the affected gum. Use a clean finger (or cold
    teething ring) to gently rub the area of tooth eruption for about 2 minutes at
    a time. Many babies find this soothing, although they may protest at
    first.
  • Provide
    safe objects for babies to chew on, such as teething rings. Babies who are
    teething like to gnaw on things to help relieve the pressure from an erupting
    tooth. Having safe objects to chew on can help prevent your baby from chewing
    on those that are dangerous, such as electrical cords or window sills that have
    lead paint.
  • Give your baby an over-the-counter pain relief medicine that is labeled
    for his or her specific age.
    For example, acetaminophen or
    ibuprofen may help relieve your
    baby’s discomfort. Follow all instructions on the label. Do not give aspirin to anyone younger than 20, because it has been linked with
    Reye syndrome.

Do not use teething gels for children younger than 2. The U.S. Food and Drug Administration (FDA) warns against using teething gels that contain the medicine benzocaine because it can harm your child.

Promoting healthy teeth

You can give your child
the best chance for healthy teeth and gums.

  • Take measures to help
    prevent tooth decay in your
    child’s primary teeth. For example, as soon as your baby’s teeth come in, start
    cleaning them with a soft cloth or gauze pad. As more teeth erupt, clean teeth
    with a soft toothbrush, using only water for the first few months. Help
    to prevent baby bottle tooth decay by always taking a bottle out
    of your baby’s mouth as soon as he or she is finished. Clean your baby’s teeth
    after feeding, especially at night. When your baby
    starts eating solids, offer healthy foods that are low
    in sugar, and keep milk feedings during the night to a minimum.
  • Schedule regular
    well-child visits with your child’s doctor. During
    these exams, the doctor will check your child’s dental
    health.
  • Take your child to
    the dentist within 6 months
    of when your child’s first tooth comes in but no later
    than your child’s first birthday.footnote 1

For more information on caring for your child’s teeth,
see the topic
Basic Dental Care or
Tooth Decay.

When to Call a Doctor

Home treatment usually helps
relieve minor
teething symptoms such as discomfort, drooling, and
irritability. But talk to your doctor if your child has other symptoms that
become severe or last longer than a couple of days.

Also,
talk to your doctor about any other teething concerns, such as if your
child:

  • Is age 18 months and has not had any
    teeth come in.
  • Has visible signs of
    tooth decay.
  • Has permanent teeth coming in
    before the
    primary teeth are lost, resulting in a double row of
    teeth.
  • Has a small jaw or a birth defect of the mouth or jaw, such
    as
    cleft palate.
  • Has any facial injury that
    has damaged a tooth or gums.

Your doctor may refer
your child to a
dentist who specializes in children’s teething
problems, if this seems to be needed.

Routine Checkups

All children need early and regular
dental care. During
well-child visits the doctor will check
your child’s dental health. A visit to a dentist is recommended within 6
months of when your child’s first tooth comes in but no
later than your child’s first birthday.footnote 1

Some parents dread their child’s first visit to the dentist’s office.
You can make a trip to the dentist more positive for your child if
you choose his or her dentist carefully. Talk to your
child about what to expect. And if you want, use books that are
meant to help a young child prepare for the first dental
exam. If you have concerns about how your child will behave, talk to your
dentist before scheduling the visit. Your dentist may allow your child to come
in once or twice before being examined. These types of visits help prepare your
child and often make him or her more comfortable with the dentist, other staff,
and the office environment.

Regular dental visits are important to teach your child good dental care
and to help prevent
cavities and other problems. The exam also helps to
identify and treat problems early and prevent them from becoming more serious.
For more information on routine checkups and tooth care, see the topics
Basic Dental Care and
Tooth Decay.

Other Places To Get Help

Organization

HealthyChildren.org (U.S.)
www.healthychildren.org

References

Citations

  1. American Academy of Pediatrics (2008). Preventive oral health intervention for pediatricians. Pediatrics, 122(6): 1387-1394. Available online: http://www.pediatrics.org/cgi/content/full/122/6/1387.

Other Works Consulted

  • Fenick AM, Nelson LP (2011). Oral health supervision. In CD Rudolph et al., eds., Rudolph’s Pediatrics, 22nd ed., pp. 47-52. New York: McGraw-Hill.
  • Karp JM (2011). Delayed tooth emergence. Pediatrics in Review, 37(1): e4-e17.
  • Klein U (2014). Oral medicine and dentistry. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 490-501. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical Reviewer John Pope, MD – Pediatrics
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Thomas M. Bailey, MD – Family Medicine

Current as ofMay 4, 2017