Teething

DEFINITION

Teething is the normal process of new teeth working their way through the gums. Your baby's first tooth may appear any time between the ages of 3 months and 1 year. Most children have completely painless teething. The only symptoms are increased saliva, drooling, and a desire to chew on things. It occasionally causes some mild gum pain, but it doesn't interfere with sleep. The degree of discomfort varies from child to child, but your child won't be miserable. When the back teeth (molars) come through (age 6 to 12 years), the overlying gum may become bruised and swollen. This is harmless and temporary.

Since teeth erupt continuously from 6 months to 2 years of age, many unrelated illnesses are blamed on teething. Fevers are also common during this time because after 6 months infants lose the natural protection provided by their mother's antibodies.

DEVELOPMENT OF BABY TEETH

Your baby's teeth will usually erupt in the following order:

  1. Two lower incisors
  2. Four upper incisors
  3. Two lower incisors and all four first molars
  4. Four canines
  5. Four second molars

HOME CARE

Gum Massage. Find the irritated or swollen gum. Vigorously massage it with your finger for 2 minutes. Do this as often as necessary. If you wish, you may use a piece of ice to massage the gum.

Teething Rings. Your baby's way of massaging her gums is to chew on a smooth, hard object. Solid teething rings and ones with liquid in the center (as long as it's purified water) are fine. Most children like them cold. Offer a teething ring or wet washcloth that has been chilled in the refrigerator but not frozen in the freezer. A piece of chilled banana may help. Avoid ice or Popsicles that could cause frostbite of the gums. Avoid hard foods that your baby might choke on (such as raw carrots), but teething biscuits are fine.

Diet. Avoid salty or acid foods. Your baby probably will enjoy sucking on a nipple, but if he complains, use a cup for fluids temporarily. A few babies may need acetaminophen for pain relief for a few days.

Acetaminophen. If the pain increases, give acetaminophen orally for 1 day. Special teething gels are unnecessary. Many teething gels contain benzocaine, which can cause an allergic reaction. If you want to use a gel, do not apply it more than four times a day.

Common Mistakes in Treating Teething

  • Teething does not cause fever, sleep problems, diarrhea, diaper rash, or lowered resistance to any infection. It probably doesn't cause crying. If your baby develops fever while teething, the fever is due to something else.
  • Don't tie the teething ring around the neck. It could catch on something and strangle your child. Attach it to clothing with a "catch-it" clip.

CALL OUR OFFICE

During regular hours if

  • Your child develops a fever over 101°F (38.3°C).
  • Your child develops crying that doesn't have a cause.
  • You have other questions or concerns.
Instructions for Pediatric Patients, 2nd Edition, ©1999 by WB Saunders Company.
Written by Barton D. Schmitt, MD, pediatrician and author of Your Child’s Health, Bantam Books, a book for parents.


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