Eruption of primary teeth; Well child care - teething
Teething is the growth of teeth through the gums in the mouth of infants and young children.
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Teething usually begins when a baby is between 6 and 8 months old. All 20 baby teeth should be in place by the time a child is 30 months old. Some children do not show any teeth until much later than 8 months, but this is usually normal.
The two bottom front teeth (lower incisors) usually come in first.
Next to grow in are usually the two top front teeth (upper incisors).
Then the other incisors, lower and upper molars, canines, and finally the upper and lower lateral molars come in.
The signs of teething are:
Acting cranky or irritable
Biting or chewing on hard objects
Drooling, which may often begin before teething starts
Gum swelling and tenderness
Teething does NOT cause fever or diarrhea. If your child develops a fever or diarrhea and you are worried about it, talk to your health care provider.
Tips to ease your child's teething discomfort:
Wipe your baby's face with a cloth to remove the drool and prevent a rash.
Give your infant a cool object to chew on, such as a firm rubber teething ring or a cold apple. Avoid liquid-filled teething rings, or any plastic objects that might break.
Gently rub the gums with a cool, wet washcloth, or (until the teeth are right near the surface) a clean finger. You may place the wet washcloth in the freezer first, but wash it before using it again.
Feed your child cool, soft foods such as applesauce or yogurt (if your baby is eating solids).
Use a bottle, if it seems to help, but only fill it with water. Formula, milk, or juice can all cause tooth decay.
You can buy the following medicines and remedies at the drug store:
Acetaminophen (Tylenol and others) or ibuprofen can help when your baby is very cranky or uncomfortable.
If your child is 2 years or older, teething gels and preparations rubbed on the gums may help the pain for a short while. Be careful not to use too much. DO NOT use these remedies if your child is younger than 2 years old.
Be sure to read and follow package instructions before using any medicine or remedy. If you are not sure how to use it, call your child's provider.
What not to do:
Do not tie a teething ring or any other object around your child's neck.
Do not place anything frozen against your child's gums.
Never cut the gums to help a tooth grow in, because this can lead to infection.
Avoid teething powders.
Never give your child aspirin or place it against the gums or teeth.
Do not rub alcohol on your baby's gums.
Do not use homeopathic remedies. They may contain ingredients that are not safe for infants.
American Academy of Pediatric Dentistry. Clinical Affairs Committee - Infant Oral Health Subcommittee. Guidelines on infant oral health care. Pediatr Dent. 2012;34(5):e148-e152. PMID: 23211901 www.ncbi.nlm.nih.gov/pubmed/23211901.
Dean JA, Turner EG. Eruption of the teeth: local, systemic, and congenital factors that influence the process. In: Dean JA, ed. McDonald and Avery's Dentistry for the Child and Adolescent. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 19.
Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.