Introduction
Teething is a normal developmental milestone. It can also be a stressful experience for both babies and caregivers. Infants begin teething at different ages, but they often share common symptoms. These include swollen gums, drooling, and irritability.
Pain from emerging teeth can disrupt sleep and feeding routines. Parents may feel helpless when they see their baby in discomfort.This guide explains the teething process, usual timelines, and practical steps to soothe symptoms. Each child has a unique pattern, so you might notice mild discomfort or more intense fussiness.
Although teething usually does not require medical intervention, certain symptoms may need a pediatric visit. By understanding what happens during teething and learning safe ways to reduce pain, caregivers can support a smoother transition into the toddler years.
Teething sets the stage for important oral health habits. Early experiences with gum care and gentle soothing help prepare children for brushing and good hygiene in the future. Beyond pain relief, teething becomes an opportunity to strengthen parent-child bonds. Simple acts like offering a gum massage or safe chewing toys can calm fussiness and foster a trusting relationship. Read on for essential teething tips to guide you through every stage.
When Does Teething Start?
Babies commonly experience their first tooth around six months of age. However, some infants begin teething as early as three months, and others might show no signs until after their first birthday. Genetics and family history can affect timing. While an “average” teething window exists, healthy babies may fall well outside that range.
Primary Teeth and Their Order
Babies eventually develop 20 primary teeth (also called baby teeth). These teeth tend to follow a typical eruption pattern:
- Lower Central Incisors (6–10 months): The two bottom front teeth usually appear first.
- Upper Central Incisors (8–12 months): The two top front teeth often follow.
- Upper Lateral Incisors (9–13 months): Next to the top front teeth come the upper lateral incisors.
- Lower Lateral Incisors (10–16 months): The bottom lateral incisors fill out the lower set.
- First Molars (13–19 months): These emerge behind the incisors and can cause notable discomfort.
- Canines (16–22 months): Located between lateral incisors and molars, canines sometimes produce tenderness in the gums.
- Second Molars (25–33 months): The last primary teeth usually appear around the second or third birthday.
Though most babies follow a version of this sequence, variations abound. Some infants get lower and upper central incisors almost simultaneously. Others sprout multiple teeth at once. Be flexible with timelines, and watch for unique patterns that match your baby’s development.
Recognizing the Signs of Teething
Parents sometimes confuse teething discomfort with other infant issues like colic or mild illness. Though individual symptoms differ, watch for these typical indicators:
- Excessive Drooling: Babies may drool more than usual, soaking through bibs or shirts. This can lead to a mild rash around the mouth or chin.
- Gum Swelling: Gums near the emerging tooth often look puffy or red. Gently running a clean finger along the gum can reveal a bump or ridge where a tooth pushes through.
- Chewing Urges: Infants may gnaw on toys, fingers, or nearby objects. This behavior puts pressure on the gums, which can provide temporary relief.
- Irritability and Fussiness: Teething pain might disrupt naps or night sleep, leading to crankiness or clinginess.
- Ear Pulling or Cheek Rubbing: Babies sometimes tug at their ears or rub their cheeks on the teething side. Inflammation in the jaw can create referred discomfort in these areas.
- Changes in Feeding: Sucking on a breast or bottle may aggravate gum pain, causing some babies to feed less or more frequently. Temperature from chilled foods or drinks might feel soothing.
Fever and Other Symptoms
Contrary to popular belief, teething does not cause high fever or diarrhea. Mild temperature elevation or slight changes in bowel movements can occur, but any fever over 38°C (100.4°F) warrants attention. In that case, consult a pediatrician to rule out infection or other medical conditions. Similarly, persistent vomiting or significant congestion are not typical teething symptoms and may indicate illness.
Stages of Teething and What to Expect
Teething unfolds in gradual stages. Recognizing these steps helps you prepare soothing measures beforehand.
- Pre-Teething (0–3 Months)
Babies display increased saliva production. They begin putting hands or objects into their mouth. Though no tooth appears, gum sensitivity may start. - Initial Eruption (4–7 Months)
The first tooth pushes through the gum. Gums may look swollen or white above the emerging tooth. Babies often exhibit fussiness, drooling, and a strong desire to chew. - Multiple Teeth (8–16 Months)
Several teeth can erupt close together—such as the upper and lower incisors. More advanced chewing and biting behaviors appear. Irritability might rise if multiple teeth break through at once. - Molars and Canines (13–22 Months)
Molars are larger and can cause more gum pressure. Many parents notice intensifying sleep disturbances or sudden bouts of crying. Some toddlers find these teeth more painful than incisors. - Second Molars (25–33 Months)
This final stage completes the primary set. By this point, toddlers can often articulate discomfort, though they might still need reassurance. Afterward, regular brushing routines and checkups help maintain healthy baby teeth until permanent teeth begin to replace them.
How to Soothe Teething Pain
Babies have limited ways to communicate discomfort, so supportive interventions can relieve gum pressure and calm fussiness. Several methods provide safe, drug-free relief:
- Gentle Gum Massage
Wash your hands thoroughly, then rub your baby’s gums with a clean finger. Apply mild pressure in a circular motion for a minute or two. This stimulates blood flow and can temporarily numb the area. - Chilled Washcloth
Dampen a soft washcloth with water and chill it in the refrigerator (not freezer). Let your baby chew on the cool fabric. The temperature soothes inflamed gums, and the texture offers chewing resistance. - Cold Teething Rings
Teething rings designed for chilling (not freezing) can reduce gum pain. Freezing them until rock-solid can injure a baby’s mouth or cause frostbite. Always follow product instructions for safe cooling methods. - Frozen Fruits in a Feeder
If your baby already eats solids, place a slice of frozen fruit (e.g., banana or peach) in a mesh or silicone feeder. The cold fruit relieves soreness, and the feeder prevents choking by containing small bits. - Breastfeeding or Bottle-Feeding
Extra nursing or bottle feeds sometimes ease irritability because sucking can comfort your baby. If the baby refuses feedings due to gum pain, consider short breaks or try a different nipple flow to reduce pressure. - Distractions and Comfort
Holding, cuddling, or rocking your baby can distract them from teething aches. Gentle lullabies or a calm environment lower stress, which can worsen pain perception.
Home Remedies: Dos and Don’ts
Families often share homegrown strategies for teething relief. While some are helpful, others can be unsafe or ineffective. Here are common suggestions, alongside guidelines on what to avoid:
Safe Options
- Breastmilk Popsicles: Freeze small quantities of breastmilk in specialized popsicle molds for babies already comfortable with some solids. The cold helps numb gums.
- Cool Metal Spoon: Chilling a metal baby spoon in the refrigerator can turn it into a soothing teether. Ensure edges are smooth, and supervise usage to prevent gagging.
- Rubbing the Gums: Repeated gentle massages can ease swelling. Always wash hands or use clean gauze.
Avoid
- Hard Foods Without Supervision: Raw carrots or apples can pose choking hazards for younger infants who lack the ability to chew thoroughly.
- Teething Biscuits High in Sugar: Some biscuits contain added sugar or honey, which is not recommended for babies under one year. Excess sugar can also harm developing teeth.
- Herbal Teething Gels or Beads: Products claiming herbal analgesics may contain compounds that aren’t regulated. Additionally, amber teething necklaces or beads can be choking or strangulation hazards.
- Freezing Teething Rings: Extremely cold objects may damage gum tissue. Refrigerated is usually enough.
- Alcohol or Spicy Rubs: Never use whiskey, adult pain gels, or spicy substances on baby’s gums. These can cause chemical burns or toxicity.
Commercial Teething Aids: What to Look For
Pharmacies and baby stores stock an array of items labeled for teething relief. Many are safe if you follow guidelines, but some pose hidden risks. Knowing how to select teething aids helps you choose effective, baby-friendly options.
- Silicone Teethers
Food-grade silicone teethers offer softness and durability. They often come in ring shapes or with ridged surfaces that babies can gnaw on to massage their gums. Look for BPA-free labels and simple designs without small parts. - Teething Rings or Toys
Some teething rings are filled with water or gel that can be cooled in the fridge. Confirm they are sealed properly to avoid leaks. Choose a shape that suits your baby’s grip and mouth size, avoiding products with detachable pieces. - Teething Mittens
These mittens wrap around the baby’s hand, featuring a textured area for chewing. They can be helpful if your infant constantly chews on their fingers. Double-check the material and secure velcro closures so they don’t slip off. - Avoid Topical Numbing Agents
Over-the-counter teething gels or ointments containing benzocaine are not recommended for infants under two years. Benzocaine can cause a rare but serious blood disorder called methemoglobinemia. Always consult a pediatrician before using medicated teething products. - Quality and Safety Standards
Reputable brands typically follow safety regulations for baby items. Read product labels to ensure compliance with local or international guidelines. Periodically inspect teething toys for cracks or weak seams that could break off.
Pain Management: Medications and Cautions
When a baby appears severely uncomfortable, some caregivers consider pain-relief medication. Medical professionals advise caution and a proper understanding of dosage, especially in very young infants.
- Acetaminophen (Paracetamol)
Infant acetaminophen is generally safe for babies over three months of age, provided you follow weight-based dosing. It can reduce teething-related pain or mild fever. Check instructions carefully, and ask a pediatrician if unsure about the correct dose. - Ibuprofen
Ibuprofen can relieve inflammation, but it is only recommended for babies older than six months unless a doctor advises otherwise. Like acetaminophen, correct dosing is crucial to avoid side effects. - Topical Gels Containing Benzocaine
As mentioned earlier, the FDA cautions against using benzocaine teething gels for infants under two years, due to potential complications like methemoglobinemia. A doctor may suggest alternatives if the baby’s pain is intense. - Avoid Aspirin
Aspirin is linked to Reye’s syndrome in children, a rare but serious condition affecting the brain and liver. Do not give aspirin to babies for any reason unless instructed by a specialist.
Medication should be a last resort if other remedies fail. Brief usage of acetaminophen or ibuprofen during peak teething distress can help a baby sleep or feed more comfortably. However, consistent reliance on medication might mask underlying issues or lead to accidental overdoses if guidelines aren’t followed.
Teething and Sleep: Strategies for Nighttime Comfort
Teething often disrupts sleep patterns, making infants restless or fussy at bedtime. Chronic night-waking exhausts both the baby and caregivers. These tips can help ease nighttime discomfort:
- Consistent Bedtime Routine
A warm bath, gentle massage, and a short lullaby help the baby relax. If their gums are inflamed, a chilled teething ring before bed can provide temporary relief. - Check the Sleeping Environment
Keep the baby’s room comfortably cool. Overheating might intensify irritability. If they wear pajamas, ensure the fit is not restrictive around the neck or face. - Soothing Techniques
If the baby wakes in distress, try gum massage or offer a small sip of cool water if they’re old enough (over six months). Avoid bright lights and loud noise so they can transition back to sleep more easily. - Short-Term Medication
Using an appropriate dose of acetaminophen or ibuprofen before bedtime may reduce gum pain, but consult your pediatrician about frequency. Reliance on nightly medication is not ideal. - Bedtime Feeding
Some babies find comfort in nursing or bottle-feeding right before sleep. If teething pain disrupts their latch, break down feeding sessions into shorter intervals.
Keep in mind that frequent nighttime waking may not be solely teething-related. Growth spurts, separation anxiety, or changes in routine can also impact sleep. Monitor patterns and speak to a healthcare professional if night disruptions become severe.
Feeding and Teething: Impact on Appetite
Babies who are teething may display changes in feeding habits. They may feed less due to gum pain, or they might seek extra feeding sessions for comfort.
- Breastfeeding
Some teething babies want to breastfeed more often for soothing. However, a painful latch can cause temporary refusal. Adjust positions or use a cool compress on gums before nursing. If biting occurs, calmly break the latch and redirect the baby’s mouth. - Bottle-Feeding
Switching nipple flow or temperature might help if babies refuse their usual bottle. A slow-flow nipple places less pressure on sensitive gums. Cooling formula or breast milk slightly can also be comforting. - Solid Foods
If your baby is already on solids, they might reject harder textures. Offer mashed fruits, yogurt, or other soft foods that do not require intense chewing. Experiment with chilled purees to reduce gum pain. - Staying Hydrated
Excessive drooling can cause mild dehydration. Encourage small sips of water if your baby is over six months old. Adequate fluids help maintain mouth moisture, especially when teething causes dryness.
Keep an eye on your baby’s weight and hydration. If feedings drop sharply or the baby shows signs of dehydration (fewer wet diapers, dark urine, lethargy), consult a pediatrician promptly.
When to See a Doctor
Teething discomfort is common, but certain signs may indicate a broader issue:
- High Fever or Persistent Fever
A temperature above 38°C (100.4°F) is unlikely from teething alone. Seek medical evaluation in case of infection or other causes. - Excessive Crying or Irritability
While mild fussiness is normal, nonstop crying for hours might mean more than teething is at play. - Refusal to Eat or Drink
If your baby consistently rejects breast, bottle, or solid foods, watch for dehydration. Medical guidance ensures they get the fluids and nutrition they need. - Rash Beyond the Mouth
Drool rash around the lips or chin is normal. However, widespread rash or hives could signal an allergic reaction or illness. - Unusual Symptoms
Diarrhea, severe cough, ear pulling with discharge, or other anomalies are not typical teething signs. These require pediatric assessment.
Contact the baby’s pediatrician if you are concerned about any aspect of their health. A professional exam can rule out ear infections, throat issues, or other ailments that might mimic teething discomfort.
Common Myths and Facts
Myth: “Teething causes high fever and vomiting.”
Fact: Mild temperature changes can happen. High fever, significant vomiting, or diarrhea suggest illness, not teething alone.
Myth: “Rub alcohol on the gums for pain relief.”
Fact: Applying alcohol is harmful. Alcohol can burn sensitive tissues and pose toxicity risks.
Myth: “Teething must begin by six months.”
Fact: Some babies do not cut their first tooth until 12 months or later. Individual variation is normal.
Myth: “Topical teething gels are always safe.”
Fact: Products containing benzocaine are risky for babies under two years. Consult your doctor for safer options.
Myth: “All babies lose appetite.”
Fact: Some babies nurse or bottle-feed more frequently for comfort. Others might reduce feedings due to gum pain. Both behaviors can be normal.
Frequently Asked Questions
- Does teething cause severe coughing?
Mild gum swelling can increase drool and lead to occasional coughing. Persistent or harsh coughing suggests another respiratory issue. Consult a doctor if coughing persists. - Is drooling rash harmful?
Excess drool can irritate the skin on the face and neck. Keep the area dry, and apply a gentle, fragrance-free moisturizer. Usually, the rash subsides once drooling decreases. - Should I stop breastfeeding when my baby starts biting?
Biting can be a phase. Calmly but firmly discourage biting by ending the feed briefly. Babies often learn to adjust their latch. Seek a lactation consultant for advice if it becomes a regular problem. - Can I use teething necklaces?
Experts advise against amber teething necklaces or any jewelry around the neck. These items pose choking and strangulation hazards. They do not have proven analgesic effects. - How do I clean my baby’s new teeth?
Start oral hygiene once the first tooth emerges. Gently wipe the tooth and gums with a soft, damp cloth or use an infant toothbrush with water. Fluoride toothpaste is often recommended after age one, but guidelines vary by region—ask your pediatric dentist. - Are there lasting complications from teething?
Teething is a natural process without serious complications. Misaligned teeth or prolonged fussiness may signal other issues, but teething itself is generally a healthy milestone.
Conclusion
Teething can challenge even the calmest babies and caregivers. By recognizing when it begins and understanding the usual symptoms, parents can better prepare. Simple actions like gum massage, cold compresses, or chilled teething rings address mild discomfort. If symptoms persist or seem out of the ordinary—such as high fever or refusal to eat—always consult a pediatrician for further evaluation.
As the baby’s mouth changes, each new tooth opens doors to varied textures and a bigger appetite for learning. Use this time to establish gentle oral hygiene routines and to reinforce the bond between you and your child. Teething is temporary, and once it subsides, your baby will have a set of teeth ready for chewing and early speech development. With patience, caution, and care, you can help your baby sail through these teething months with fewer tears and more smiles.
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