Teething

Causes

The first teeth start to come in when a baby is 6 to 12 months of age. 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

Teething is a natural process. Nothing increases the chance of teething.

Symptoms

Many babies do not have 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

Teething will be diagnosed by the baby's age, symptoms, and appearance of the gums. A teething baby's gums look 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

Many medical groups prefer basic steps to keep a baby comfortable instead of giving medicine or using numbing creams and gels. It is not clear if teething jewelry or homeopathic items are safe.

Comfort Measures

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

• Make sure anything given to the 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. Also, the cold could hurt tissue in the mouth.
• Avoid teething rings with liquid inside. They could break open, exposing the baby to the contents.
• Do not tie a teething ring or anything else around a baby's neck. If the ring or cord were to catch on something, the cord could choke the baby.

Note: Avoid using amber teething necklaces. Current evidence does not show that they help ease pain. A baby could choke on the necklace pieces or be choked if the necklace got caught on something.

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 giving crackers or teething biscuits, watch the baby carefully to prevent choking.
• Do not use alcohol.

Gum and Tooth Care

• After each feeding, wash the 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 the 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.

Take babies to a dentist when their first tooth comes in. Make sure babies have seen a dentist by one year of age. The dentist will check their mouth and teeth. The dentist will also explain how to care for the baby's teeth.

Prevention

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