Vrinda Kumar, M.D.
Teething: Can you handle the tooth?
The teething process generally begins between four to eight months of age. Some babies will start earlier, and some babies won’t get their first tooth until after a year old. Usually (but not always), the two bottom middle teeth come first, then the two upper middle teeth, then the teeth to the side of those, and then finally the teeth in the back. By the age of two, most kids will have all 20 of their baby teeth!
It is normal for the teeth to not come in straight, and it is normal for those first few teeth to have wide gaps in between them. Don’t worry! They usually straighten themselves out as the other teeth start coming in.
Symptoms of teething:
- drooling
- gum swelling/redness
- fussiness
- difficulty sleeping
- solid food aversion
- biting and chewing everything in sight!
Some babies may also have:
- low grade fevers (<101 degrees F)
- loose stools (they can be green and slimy from all that extra drool making its way through the gut)
- diaper rash (from all those loose stools)
- ear pain (it is normal for teething babies to pull on their ears because in babies, tooth pain is felt in the ears)
If your child has high fevers >101 F, signs of dehydration (not a lot of wet diapers, not a lot of drooling, no tears when crying), or other symptoms that are persistent, you should call your doctor.
Things you can try to help your teething baby deal with the pain:
- give your child something clean and safe to chew on (firm teething toys or a cold clean washcloth, for example)
- try giving your baby cold foods if he/she is eating solids
- Orajel naturals (The active ingredient Benzocaine in regular Orajel has some rare but serious side effects: the benzocaine, if swallowed, can numb a child’s airway cause them to potentially choke on their saliva, and it can also affect the hemoglobin in your child’s red blood cells, a condition called methemoglobinemia)
- teething tablets and teething gels are available, and are generally safe if used as directed
- for those nights where nothing else seems to help, an occasional dose of Tylenol
Teething necklaces with amber beads are available as alternative to medication. Even though some parents say they work, it makes me very nervous to have a choking hazard hanging around a child’s neck, and I do not generally recommend it.
I hope this helps. And remember your child won’t teethe forever, so hang in there!