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What is teething?

The eruption of first milk tooth in babies is known as teething (Odontiasis). The symptoms of teething can develop as early as 2-3 months before a tooth actually makes its appearance in the mouth. Every child experiences teething differently. It can be a matter of one month for some, whereas others might experience it till the last milk tooth erupts in their mouth. Teething is a difficult phase for your child and it demands patience and a little knowledge of how to bring relief to your child in order to make it less uncomfortable for the baby as well as for you.

  1. Teething Complications
  2. What not to do when your child is Teething?
  3. Teething age in babies
  4. Order of Tooth Eruption
  5. Teething symptoms and problems
  6. Remedies for Teething problems
  7. Treatment for teething symptoms and complications
  8. Doctors for Teething in Babies: Age, Symptoms, Problems, Remedies

A few other conditions which are often associated (but are not normal and need medical attention) include:

  • Fever
    As mentioned above, teething is not proven to be associated with a true fever of more than 38⁰C (100.4⁰ F). Hence, if your baby is experiencing fever while teething, it is important to seek medical help to rule out any other underlying medical condition or infection.
     
  • Diarrhoea
    Sometimes, your child might chew on to a contaminated object which can lead to infection of the lower part of the digestive system. Mild infection might cause slight stomach discomfort or pain, but severe infection can be serious and may cause diarrhoea.
     
  • Vomiting
    Your baby might also gum on certain things which are contaminated and get an infection of the upper part of the digestive system. This may result in stomach pain and vomiting.  
     
  • Running Nose
    A runny nose is not a normal sign of teething. Your baby might have caught cold and will need treatment from a pediatrician for it.

As a concerned parent, you might want to bring comfort to your child as early as possible. However, it is common, yet dangerous, to do any of the following when your child is teething:

  • Rubbing alcohol
    Rubbing whiskey or alcohol on your child’s gum is dangerous because any form of alcohol (except for the medicated ones which are duly prescribed) is harmful to your child.
     
  • Clove oil
    Clove oil irritates the swollen gums and hence makes it even more difficult for your child to cope with the pain.
     
  • Frozen teethers
    Frozen teethers or solids exaggerate the pain and can also cause cold or a sore throat. Therefore, you are advised to give a cold (not frozen) teether or solid food, or give a teether which is at room temperature.
     
  • Teether necklaces
    Some teething toys can be worn in the neck, but we recommend that you avoid using them because they have a possibility of getting entangled and cause choking.
     
  • Unhygienic teethers
    Take good care of your child’s hygiene and do not give uncleaned or contaminated toys, washcloths or teethers to chew on. Poor hygiene will worsen your child’s condition and cause infections.

Teething is a milestone for you as well as your baby. Proper care and a gentle approach will ease your baby through this phase. Be patient, be attentive and do not leave your child crying in the best interest of his or her physical as well as psychological development.

The time of teething varies from 4 months to 10 months, but most babies have their first milk tooth erupt at around 6 months of age. Rest of the milk teeth erupt over a period of next 2-3 years. In most cases, a baby follows the familial pattern in tooth eruptions. The erupting teeth make their way through the gums into the mouth.

Tooth eruption is more related to heredity than environmental factors. The pattern of eruption runs in the family, hence it determines the time of teething to a large extent. If the parents have had a delayed tooth eruption in their childhood, their child is likely to have a delayed teething too. According to the time when the first tooth erupts, a baby can be an early, normal or late teether. However, if your child doesn’t get a tooth erupted till 12 months of age, you should visit your doctor for your baby’s detailed check-up.

Early tooth eruption is also mostly attributed to inheritance. In rare cases, some children are born with a tooth (natal tooth) or have a tooth erupted within a few days of their birth (neonatal tooth). Presence of such teeth in the mouth of a newborn baby is normal and should not be related to any superstition. It is advised to get your child’s check-up done by a pedodontist (a dentist for children below 14 years of age) and a paediatrician (a medical doctor for children).

The first teeth to erupt in your baby’s mouth are lower central incisors (middle front teeth) followed by upper central incisors (middle front teeth), upper lateral incisors (either side of the upper middle front teeth), lower lateral incisors (either side of the lower middle front teeth), upper and lower first molars (back or rear teeth), canines (between incisors and molars), and lastly by second molars (teeth behind first molars).

Upper Teeth

Eruption time (in months)

Central incisors

10  (8-12)

Lateral Incisors

11   (9-13)

Canines

19   (16-22)

First molars

16   (13-19)

Second Molar

29   (25-33)

 

Lower Teeth

Eruption time (in months)

Central Incisor

8    (6-10)

Lateral Incisor

13   (10-16)

Canines

20   (17-23)

First molar

16   (14-18)

Second molar

27   (23-31)

You might see the following signs and symptoms that indicate that your child is teething:

  • Drooling
    You may see an increased amount of saliva that drools from your baby’s mouth. Teething stimulates secretion of saliva in the mouth and thus can cause constant sogging of your baby’s clothes.
     
  • Teething rash
    Because of drooling, your child may develop redness, rashes, sores, or cracks on the lips, chin and the skin around the mouth.
     
  • Red and swollen gums
    As the teeth erupt, they put pressure and pierce through the gums, thereby causing redness (sometimes bluishness), swelling and soreness.
     
  • Erupting teeth
    Small upper portions of erupting teeth can be seen on the baby’s gums.
     
  • Coughing and gag reflex
    Your child might cough or gag because of the presence of large amounts of saliva in the mouth. It is not something to be worried about if your child doesn’t show any other symptom of cold or flu.
     
  • Biting
    When an erupting tooth pushes through the gums, it causes discomfort to your child. In response to this poking tooth, your baby tries to bite on to anything that is available around, be it teething rings, toys, finger, thumb, and often nipples while the mother breastfeeds them. This urge to gum on to things is because of the fact that chewing applies a counter pressure on the erupting tooth and comforts your baby.
     
  • Crying
    To most babies, teething is painful and uncomfortable, especially when the first tooth erupts. Since, they do not have a developed speech, they start whining and crying in order to express their pain and discomfort.
     
  • Irritability
    Erupting teeth cause swelling and pain in the gums which make your baby irritable. The irritability can last for a few hours to an entire day.
     
  • Refusal to eat
    During teething, your baby experiences pain in the gums which increases on suction and worsens the condition of their sore gums making them refuse to eat. Hence, your baby cries because of the pain as well as hunger.
     
  • Troubled sleep
    The swollen, aching and sore gums may wake your baby up, or worse, not let them sleep at all at night.
     
  • Ear pulling and cheek rubbing
    The gums, ears and cheeks share a common nerve supply, and hence, aching gums can refer the pain somewhere else, for example, ears and cheeks. Pulling ears and rubbing cheeks helps your baby in soothing the pain.
     
  • Body temperature change
    Your baby may experience mild temperature rise (not more than 38⁰C), but there is no evidence of association of a high degree fever with teething.

In most children, teething does not cause a lot of distress. However, for some children, it can get difficult to deal with. Following are a few things that could be done by you to relieve your child:

  • Teethers
    You can give cold teethers (not frozen) to your child to chew on because they relieve the pain by putting counter pressure on the erupting tooth. The cold temperature of the teether also helps in reducing the swelling and soreness in the gums.
     
  • Wet washcloth
    A clean, wet washcloth can also be given to the child to chew on because it works just like a teether.
     
  • Distract your child
    Children can be distracted by spending quality time with them, loving them more, and comforting them time to time. This helps them to cope with this phase in a better way. Pay attention and be careful of what they put in their mouth.
     
  • Solid cold food
    If your child is more than 6-9 months and is already on solid food, you can give them some cold fruits or vegetables to munch on as well.
     
  • Massage
    Massaging on to your child’s gums with a cold finger or wet washcloth provides pain relief. Doing it just before feeding the child helps them eat with less discomfort and a full tummy helps your child become less cranky.
     
  • Rest
    Try and comfort your child as much as possible because it will help your child in getting a sound sleep.
     
  • Hygiene
    Maintain good hygiene and keep your child as well as the surrounding area clean. Gentle and frequent wiping of drooling saliva will prevent the development of rashes around your child’s mouth. Start brushing your child’s teeth as soon as the first tooth erupts. This will prevent the development of cavities in teeth. Visit a dentist and ask for the type of toothbrush, the amount of fluoride toothpaste to be used each time, and the technique of brushing your child’s teeth. Also, clean your child’s mouth with mild antiseptic after every meal (consult your doctor for the correct concentration for babies).

Most children get do not require medical treatment while teething, but if your child is distressed and shows other symptoms like diarrhoea, vomiting, loss of weight, cold, etc. then we highly recommend that you visit your doctor (both a pediatrician and a pedodontist). The treatment options for teething are as follows:

  • Painkillers
    Painkillers (acetaminophen or ibuprofen) and other drugs for children have different doses (calculated and prescribed according to their body weight, age, and other physical and medical conditions) than those of adults. Hence, it is highly recommended that you do not administer any medicine without a doctor’s consultation.
     
  • Numbing gels
    These gels are given to be applied on the gums for their numbing effect. They are usually applied before feeding the child to help them eat comfortably. However, excessive drooling can wash them away and they might not be of much use for your child. Also, these gels have a numbing effect on the throat which can cause difficulty in swallowing.
     
  • Other treatments
    Depending on your child symptoms (such as diarrhoea, vomiting, common cold, fever), the doctor will provide treatment best suited for your baby.

Note: Do not give Aspirin to babies and teenagers because it can cause Reye’s syndrome (a serious disease which causes swelling in the liver and brain). Always consult a doctor before giving medications to your child, because an overdosed medicine might act like a poison for children.

Dr. Rajesh Gangrade

Dr. Rajesh Gangrade

Pediatrics
20 Years of Experience

Dr. Yeeshu Singh Sudan

Dr. Yeeshu Singh Sudan

Pediatrics
14 Years of Experience

Dr. Veena Raghunathan

Dr. Veena Raghunathan

Pediatrics
16 Years of Experience

Dr. Sunit Chandra Singhi

Dr. Sunit Chandra Singhi

Pediatrics
49 Years of Experience

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