(Cutting Teeth)En Español (Spanish Version)
Teething refers to the eruption of a child's first set of teeth, which may cause sore gums.
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Teething is a normal part of child development. The first teeth start to come in when the baby reaches about 6 to 12 months old. Two bottom front teeth usually poke through first, followed quite quickly by several more. Teething lasts from six months to three years.
A risk factor is something that increases your chance of getting a disease or condition. There are no risk factors for teething because it is a natural condition that happens to all children as their teeth come in.
Many babies do not experience any problems or pain. When symptoms do occur, they generally are present for several days before and a few days after the tooth comes through the gums.
- Rubbing the gums or ears
- Wanting to chew on fingers or hard materials
- Increased sucking
- Reduced appetite for solid foods
- Slight rise in body temperature
- Swollen gums
- Sensitive gums
- Rash on face (resulting from drooling)
A teething baby's gums appear swollen and are tender. Sometimes small, white spots appear on the gums prior to a tooth coming through. There may be some bruising or bleeding. If the baby is feverish and acts sick or very upset, seek medical care. Something else may be causing the symptoms.
Pain-numbing gels and medications are usually not needed. The doctor may recommend a mild pain medication at an appropriate dose. The baby should visit the dentist when the first tooth comes in and no later than one year of age. The dentist will perform an exam and show you how to care for your child's teeth.
After each feeding, wash the baby's gums with a soft, damp cloth or gauze. When teeth come in, brush them daily with a small, soft-bristled toothbrush or a damp gauze pad. If possible, use toothpaste without fluoride. If this is not available, use only a tiny amount of fluoride toothpaste to reduce the risk of the child swallowing it. Remove any drool. Keep the baby's face clean and dry.
Teething babies usually like chewing on a cool teething ring or wet washcloth. The teething ring should be made of firm rubber and consist of only one piece. Do not freeze a teething ring. It will become too hard, which could damage new teeth. In addition, the cold could hurt tissue in the mouth. Avoid teething rings with liquid inside. They could break open, exposing the baby to the contents.
Make sure anything given to the baby is clean and too big to swallow. Do not tie a teething ring or anything else around the baby's neck. If the ring or cord were to catch on something, the cord could choke the baby.
Rubbing the gum with a clean finger or wet gauze may help reduce discomfort. Cool fluids may offer some relief. If crackers or teething biscuits are given, watch the baby carefully to prevent choking. Do not use alcohol.
Teething is a normal part of child development.
To prevent other dental problems from developing:
- Do not allow the baby to nurse continuously.
- Do not nurse the baby to sleep.
- Do not give the baby a bottle with milk, formula, or juice when napping or going to bed.
- Between feedings or at nap time, give the baby a bottle of cold water to suck on.
- Keep the pacifier clean.
- Do not dip a pacifier in honey or sugar.
- Break the thumb-sucking habit by age four.
- Follow your dentist's recommendations for brushing and using additional fluoride.
American Academy of Pediatric Dentistry
American Dental Association
Canadian Dental Association
The Canadian Dental Hygienists Association
American Academy of Pediatric Dentistry website. Available at: http://www.aapd.org .
American Academy of Pediatrics website. Available at: http://www.aap.org .
American Dental Association website. Available at: http://www.ada.org .
Griffith's 5-Minute Clinical Consult 2001. Lippincott, Williams, and Wilkins; 2001.
Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.
Macknin ML, Piedmonte M, Jacobs J, Skibinski C. Symptoms associated with infant teething: a prospective study. Pediatrics. 2000;105:747-752.
Last reviewed November 2007 by Kari L. Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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