Teething

Teeth development

When a baby is born, the fi rst set of teeth is almost completely formed inside the jaws and under the gums. Teething usually starts between 5 and 9 months. Most children have all 20 of their primary teeth by their third birthday. Generally the two bottom front teeth will appear fi rst, followed about 4 to 8 weeks later by the four upper teeth.

Baby’s teeth are important

Teeth not only help in chewing food, but also give your child a nice appearance, nice smile, and help in talking. The first set of teeth is also important in saving space for permanent teeth.

Signs and symptoms of teething

Often the gums around the new teeth will swell and become tender. Teething may cause restlessness, irritability, crying, low-grade temperature, excessive drooling, disruption of eating and sleeping habits, and a desire to bite something hard or rub on the gums. The drooling that accompanies teething can cause a rash on baby’s face, neck or chest. Teething does not cause serious health problems. Some parents have incorrectly blamed high fever, vomiting and diarrhea on teething, delaying proper medical attention. These are not symptoms of teething.

Tips for easing symptoms of teething

• Gently rub or massage the gums with one of your fingers to help your baby’s discomfort.
• Natural means that soothe the infl ammation such as ice cubes wrapped in cloth or cold food items are also helpful.
• Teething rings are useful, but avoid the ones with liquid inside. If they break, the liquid may not be safe, or they get too hard when you freeze them, and may cause more harm than good.
• Never tie a teething ring around baby’s neck. It may cause strangulation.
• Try to keep the child’s face dry. Wipe it often with a cloth to remove the drool.
• If you choose over-the-counter medication, be aware that products containing benzocaine (a local anesthetic) can interfere with the gag refl ex and cause your infant to choke.
• Pain relievers and medications you rub on the gums are not necessary or useful, since they wash out of the baby’s mouth within minutes.
• Do not use any medications that contain alcohol, as they can be toxic.
• If symptoms continue to worsen, with interruption of sleep or feeding, your health care provider may recommend infant pain reliever like acetaminophen (Tylenol). Follow the directions. Do not give a baby child aspirin or place aspirin tablets on the gums.

When to call for help

1. If the symptoms continue to worsen.
2. If the baby has significant bleeding of the gums.
3. If signs of gum infection such as pain, pus and excessive swelling occur.
4. If your baby seems miserable, or has a fever higher than 100 degrees, diarrhea or vomiting.
5. If the baby has high fever, diarrhea or serious sleep problems. Teething does not cause them.
6. If your child refuses to breastfeed or eat.
7. If no teeth have erupted by two years of age.

For additional information about teething and dental health contact: American Academy of Pediatric Dentistry at www.aapd.org American Academy of Pediatrics at www.aap.org