Teething

What to Expect

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 the 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

Some symptoms of teething may include:

• Being fussier than usual. It often begins about 3 to 5 days before a tooth erupts and goes away as soon as the tooth breaks through the baby's gums.
• Biting on fingers or toys. This may help relieve the pressure in the gums.
• Changes in eating and drinking. Teething babies may not want to eat and drink as much because their mouths hurt.
• Drooling. This can cause a rash on the baby's chin, face, or chest.
• A mild increase in the baby's temperature. 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.

Mild symptoms that get better usually are nothing to worry about.

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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.

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 may worry about 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 their dentist carefully. Talk to your child about what to expect. 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 them 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.

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Caring For Your Child

If your baby is uncomfortable while teething, try these tips.

• 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.

• Have safe objects for your baby to chew on.

  Try giving your baby teething rings. There are many different shapes, sizes, and materials to choose from. Avoid products that are filled with fluid.

• Give your baby an over-the-counter pain reliever, if needed.

  Use a pain reliever for your baby's specific age. Read and follow all instructions on the label.

  Do not give aspirin to anyone younger than 20, because it has been linked to Reye syndrome, a rare but serious disease.

• Be careful with teething gels.

  Don't use teething gels for children younger than age 2. Ask your doctor before using mouth-numbing medicine for children older than age 2. The U.S. Food and Drug Administration (FDA) warns that some of these can be dangerous.

• Avoid teething tablets.

  The FDA warns against these products. They may contain belladonna, a toxic substance that can harm your child.

Promoting healthy teeth

Follow these tips to give your child the best chance for healthy teeth and gums.

• Take measures to help prevent tooth decay in your child's primary teeth.
  • 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 your baby 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 for early and regular dental care.

  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.

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