* 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
The lower front teeth usually come in first. Upper front teeth usually come
in 1 to 2 months after the lower front teeth.
--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
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
* 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,
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?
--Give your baby a mild pain reliever that is labeled for his or her
specific age. For example, acetaminophen (such as Tylenol) or ibuprofen (
such as Advil) may help relieve your baby's discomfort. Do not give aspirin
to anyone younger than 20, because it has been linked to Reye's syndrome, a
rare but serious disease.
--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.
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. In 2007, the U.S. Consumer Product Safety
Commission (CPSC) found high lead content in many children’s toys and
jewelry made in other countries. For a complete list of recalled products,
see the CPSC Web site at www.cpsc.gov.
Many parents use other teething remedies, such as gels you put on a baby’s
gums. Many experts question if these work and are safe. If you want to try
these products, talk to your doctor about which types are safe and how often
to use them.
* 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. Such symptoms may include:
--Frequent ear pulling.
--Ongoing or severe diarrhea.
--A severe diaper rash.
Also, talk to your doctor about any other teething concerns, such as when
--Has not started teething by 12 months of age.
--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
--Has any facial injury that has damaged a tooth or gums.
If your doctor considers it necessary, he or she may refer your child to a
dentist who specializes in children's teething problems.
* Routine Checkup
All children need early and regular dental care. The American Academy of
Pediatrics (AAP) recommends that a health professional, such as a
pediatrician, perform a risk assessment for dental health problems by the
time your child is 6 months of age. If he or she is considered to be at
high risk, a visit to a dentist is recommended at 6 months of age or no
later than 6 months after the first tooth erupts. If your child is not in a
high-risk category, the AAP recommends that he or she visit the dentist by
Many parents dread their child's first visit to the dentist's office. 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. You may also try finding books about visiting
the dentist that are designed to help a young child prepare for the first
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
* Promoting healthy teeth
--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. Also, 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
--Schedule regular well-child visits with your child's doctor. During these
exams, your child's dental health is assessed. An appointment with a dentist
is recommended sometime between 6 months and 1 year of age (but no later
than 6 months after the first tooth erupts) if your doctor thinks that your
child is at high risk for tooth decay.