At what age do babies typically begin teething. What are the common signs and symptoms of teething in infants. How can parents soothe a teething baby and provide relief. What is the typical order of tooth eruption in babies. Which teething remedies should parents avoid.

Understanding the Teething Process in Infants

Teething, also known as odontiasis, is a natural developmental stage when a baby’s teeth begin to emerge through the gum line. This process can be both exciting and challenging for parents and infants alike. Understanding the teething timeline, symptoms, and appropriate remedies can help make this period more manageable for everyone involved.

When Do Babies Usually Start Teething?

The age at which babies begin teething can vary significantly. Most infants start teething between 4 and 7 months old, but some may begin earlier or later. It’s important to note that the timing of teething can differ for each child, and there’s generally no cause for concern if your baby’s teeth come in on a different schedule.

Can teething start as early as 3 months or as late as 12 months? Yes, while less common, some babies may begin teething as early as 3 months or as late as 12 months. Every child develops at their own pace, and the timing of teething can be influenced by various factors, including genetics.

Factors Influencing Teething Timelines

• Genetics and family history
• Overall physical development
• Nutritional status
• Individual variations in growth patterns

Recognizing the Signs and Symptoms of Teething

Teething symptoms can vary from baby to baby, but there are several common signs that parents should be aware of. Recognizing these symptoms can help you provide appropriate care and comfort to your teething infant.

Common Teething Symptoms

• Swollen, tender gums
• Increased fussiness and crying
• Slightly elevated temperature (less than 101°F or 38.3°C)
• Desire to chew on hard objects
• Excessive drooling
• Facial rash (caused by excessive drooling)
• Coughing
• Ear pulling or cheek rubbing
• Changes in eating or sleeping patterns

Is teething always accompanied by fever? While a slight temperature increase is common during teething, a high fever (over 101°F or 38.3°C) is not typical and may indicate other health issues. If your baby develops a high fever, experiences diarrhea, vomiting, or shows signs of illness beyond normal teething symptoms, it’s essential to consult your pediatrician.

The Typical Order of Tooth Eruption in Babies

Understanding the usual sequence of tooth eruption can help parents anticipate their baby’s teething journey. While the exact timing can vary, most babies follow a similar pattern of tooth emergence.

General Timeline of Tooth Eruption

1. Lower front teeth (central incisors): 6-10 months
2. Upper front teeth (central incisors): 8-13 months
3. Upper lateral incisors: 9-13 months
4. Lower lateral incisors: 10-16 months
5. First molars: 13-19 months
6. Canine teeth: 16-23 months
7. Second molars: 23-33 months

By the age of 3, most children will have all 20 of their primary teeth, also known as “baby teeth.”

Do all babies follow this exact teething order? While this timeline represents the typical order of tooth eruption, it’s important to remember that each child is unique. Some babies may experience variations in the order or timing of tooth emergence. As long as teeth are coming in and your baby is developing normally, minor deviations from this pattern are usually not a cause for concern.

Effective Methods to Soothe a Teething Baby

Teething can be uncomfortable for babies, but there are several safe and effective ways to provide relief. It’s important to note that what works for one baby may not work for another, so parents may need to try different methods to find what best soothes their child.

Safe Teething Remedies

• Offer cold items: A clean, cold washcloth, a chilled (not frozen) teething ring, or a cold spoon can provide relief.
• Massage gums: Gently rubbing your baby’s gums with a clean finger can help alleviate discomfort.
• Provide teething toys: Soft rubber teething toys or teething rings can offer a safe chewing surface.
• Try hard, unsweetened teething crackers: For babies over 6 months, these can provide relief.
• Offer cool water: Babies over 6-9 months can be given cool water from a sippy cup.
• Use a clean, damp washcloth: Wipe your baby’s face frequently to prevent skin irritation from excessive drooling.

Are there any natural teething remedies that are safe and effective? Some parents find success with natural remedies such as chamomile tea (cooled and used to dampen a washcloth for gum massage) or diluted clove oil for older babies. However, it’s crucial to consult with your pediatrician before using any natural remedies to ensure they are safe and appropriate for your baby.

Teething Treatments and Products to Avoid

While there are many safe ways to soothe a teething baby, some treatments and products should be avoided due to potential risks or lack of proven effectiveness.

Unsafe or Unproven Teething Remedies

• Teething necklaces: These pose a risk of strangulation and choking.
• Amber teething necklaces: There’s no scientific evidence supporting their effectiveness, and they pose safety risks.
• Teething gels containing benzocaine: The FDA advises against using these products in children under 2 years old due to potential side effects.
• Frozen teething rings: These can be too hard and may harm your baby’s gums.
• Homeopathic teething tablets: Some have been found to contain potentially harmful ingredients.
• Alcohol: Never use alcohol to soothe teething pain.

Why are teething necklaces considered dangerous? Teething necklaces, including those made of amber, pose significant risks of strangulation and choking. The necklace can get caught on objects or wrap around the baby’s neck, and if it breaks, the small beads can be a choking hazard. The potential risks far outweigh any unproven benefits.

Proper Oral Care for Teething Babies

Maintaining good oral hygiene is crucial even before your baby’s first tooth appears. Establishing a routine early on can help prevent dental problems and set the foundation for lifelong oral health.

Oral Care Tips for Infants

• Clean gums: Before teeth emerge, gently wipe your baby’s gums with a soft, damp cloth after feedings.
• Start brushing early: Once the first tooth appears, begin using a soft-bristled, infant-sized toothbrush.
• Use appropriate toothpaste: Use a rice-grain sized amount of fluoride toothpaste for children under 3 years old.
• Avoid bottle decay: Don’t put your baby to bed with a bottle of milk or juice.
• Schedule dental visits: Plan your baby’s first dental visit by their first birthday or within six months of the first tooth appearing.

How often should you clean your baby’s gums and emerging teeth? It’s recommended to clean your baby’s gums at least twice a day, especially after feedings and before bedtime. Once teeth start to emerge, brush them gently twice a day using an age-appropriate toothbrush and toothpaste.

When to Consult a Pediatrician About Teething

While teething is a normal part of development, there are times when it’s appropriate to seek medical advice. Understanding when to consult a pediatrician can help ensure your baby’s health and comfort during the teething process.

Signs That Warrant Medical Attention

• High fever (over 101°F or 38.3°C)
• Diarrhea or vomiting
• Rashes on the body (not related to drooling)
• Persistent cough or congestion
• Bleeding or swollen gums
• Signs of an ear infection
• Significant changes in eating or sleeping patterns
• Excessive irritability or discomfort that doesn’t respond to usual soothing methods

Should you be concerned if your baby hasn’t started teething by 12 months? While it’s less common, some babies may not start teething until after their first birthday. If your baby hasn’t shown any signs of teething by 12 months, it’s a good idea to consult with your pediatrician. They can assess your baby’s overall development and determine if any further evaluation is necessary.

Monitoring Your Baby’s Teething Progress

Keeping track of your baby’s teething journey can be helpful for both you and your pediatrician. Consider maintaining a simple log of when teeth emerge and any notable symptoms or concerns. This information can be valuable during check-ups and can help you better understand your baby’s individual teething pattern.

Long-Term Dental Health Considerations for Infants

While teething is a temporary phase, it marks the beginning of your child’s dental health journey. Establishing good oral care habits early on can have lasting benefits for your child’s overall health and well-being.

Building a Foundation for Lifelong Oral Health

• Model good oral hygiene: Let your child see you brushing and flossing regularly.
• Make oral care fun: Use songs, games, or apps to make brushing time enjoyable.
• Introduce healthy eating habits: Limit sugary foods and drinks to protect developing teeth.
• Encourage water consumption: Water helps rinse the mouth and promotes overall health.
• Continue regular dental check-ups: Maintain a schedule of dental visits as recommended by your pediatric dentist.

How does early oral care impact a child’s long-term dental health? Establishing good oral hygiene habits in infancy and early childhood can significantly reduce the risk of tooth decay, gum disease, and other dental problems later in life. It also helps children develop a positive attitude towards dental care, making them more likely to maintain good oral health practices as they grow older.

The Role of Diet in Dental Health

As your baby transitions to solid foods, it’s important to consider the impact of diet on dental health. Offering a balanced diet rich in fruits, vegetables, and whole grains not only supports overall growth and development but also promotes healthy teeth and gums. Limiting sugary and acidic foods and drinks can help prevent early childhood caries and set the stage for a lifetime of good oral health.

Remember, every baby’s teething experience is unique. By staying informed, attentive, and proactive, you can help make the teething process as comfortable as possible for your little one while laying the groundwork for excellent oral health in the years to come.

Teething in Babies: Symptoms and Remedies

Written by WebMD Editorial Contributors

Reviewed by Amita Shroff, MD

on November 30, 2022.

Reading time: 4 minutes

In this Article

• What Is Teething?
• When Do Babies Start Teething?
• Signs and Symptoms of Teething
• Order of Tooth Eruption
• Soothe a Teething Baby
• Treatments to Avoid
• Teething Necklaces
• Teething Medicine
• How to Care for Baby’s New Teeth

Teething is when your baby’s teeth start to come through their gum line. Another word for it is odontiasis.

Most babies begin to teethe between 4 and 7 months old, but some start much later. There’s no need to worry if your baby’s teeth come in on another timetable — it can be different for every baby.

The symptoms aren’t the same for every baby, but they may include:

• Swollen, tender gums
• Fussiness and crying
• A slightly raised temperature (less than 101 F)
• Gnawing or wanting to chew on hard things
• Lots of drool, which can cause a rash on their face
• Coughing
• Rubbing their cheek or pulling their ear
• Bringing their hands to their mouth
• Changes in eating or sleeping patterns

Teething can be painful, but it doesn’t usually make babies sick. Call your doctor if your baby has diarrhea, vomiting, rashes on the body, a higher fever, or cough and congestion. These aren’t normal signs of teething.

You also should call the pediatrician if your baby’s gums are bleeding or you see any pus or swelling of their face.

When and how teeth come in can be different for every baby and may be based on family history. But most of the time, the lower front two teeth come in first between 6 and 10 months, followed by the opposite top two teeth and the two on either side of those between 8 and 13 months. Next come the two on either side of the bottom front teeth, then the first molars appear between 10 and 16 months. The teeth in front of the first molars are next, and the back molars are the last ones to come in.

In all, 20 “baby teeth” will eventually be in place, usually by age 3.

What works to soothe a friend’s baby might not work for yours. You may need to try different things to help your little one feel better:

• Something cold in your baby’s mouth, like a cold pacifier, spoon, clean wet washcloth, or a solid (not liquid) refrigerated teething toy or ring. Some experts say frozen teething toys are too cold and may hurt your baby’s mouth. Make sure to clean teething toys, washcloths, and other items after the baby uses them.
• Try offering a hard, unsweetened teething cracker.
• If your baby is older than 6-9 months, you can offer cool water from a sippy cup, too.
• Massage the gums by gently rubbing them with your clean finger. If the teeth haven’t come in yet, you can let your baby gnaw on your finger. If you’re nursing your baby, try dipping your fingers in cool water and massaging their gums before each feeding. That may keep them from biting your nipple while nursing.

Never put anything in your baby’s mouth that isn’t specifically approved to help soothe teething. Even some products described as teethers or teething aids aren’t safe choices, including ones:

• Filled with liquid that can tear and spill
• Made of breakable material, like plastic, that can possibly lead to choking
• That are frozen solid — these can be too hard on a baby’s mouth

Another reason to be aware of the material used to make the teethers: Some can be made from harmful substances, like lead. Look for ones made of rubber.

Child health experts don’t recommend teething necklaces. They’re dangerous: They can strangle the baby. They also can choke if the necklace breaks and they swallow the beads.

If you do choose to use one, make sure to:

• Put it on a wrist or ankle, not around the baby’s neck.
• Always watch your baby when they wear it.
• Take it away when you aren’t watching your baby, even for a very short time.

You may have heard that amber teething necklaces release a pain reliever when heated. That’s not proven, and doctors say using one is not a good idea.

Medicine that you rub on your baby’s gums to stop the pain of teething may not help. It quickly washes away in the mouth and may numb the back of their throat and make it hard for them to swallow.

Stay away from over-the-counter teething gels and liquids that have the ingredient benzocaine. The FDA says this ingredient shouldn’t be given to children under 2. It can cause rare but serious side effects.

A small dose of a children’s pain reliever, such as acetaminophen, may help your baby. Don’t use ibuprofen for an infant under 6 months old, and ask your doctor before giving your baby any medication. Use it exactly as the doctor says.

Teething can be rough for you and your baby at first. But it’ll get easier as you both learn how to soothe each new tooth that pops out.

Good oral hygiene is important, even before your baby has teeth:

• Until teeth start to come in, clean your baby’s gums with a wet washcloth or piece of gauze at least once a day.
• Once they have teeth, clean your baby’s mouth the same way at least twice a day. After feedings is a good time for this.
• After their first birthday, you can start to use a soft-bristled baby toothbrush with water and a small amount of toothpaste that doesn’t have fluoride in it. You can also start flossing between their teeth.

Your child should see a pediatric dentist when the first tooth appears, or no later than their first birthday.

Top Picks

When Do Babies Start Teething, and How Long Does It Last?

Updated

14 April 2020

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Published

12 August 2019

Fact Checked

Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist

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Teething is a major milestone for a baby, and many new parents ask the questions, “When do babies start teething?” and “How long does teething last?” Because all babies are different, there’s no one answer, but most infants follow a similar teething pattern. Knowing the general time frame for teething helps parents keep babies comfortable during the process.

For most babies, teething begins between 5 and 8 months of age. Some, of course, begin a few weeks or months earlier, while others start teething much later. Early teethers might start sprouting the first tooth at 3 months, while late teethers may not begin until 10 months or so.

The answer to “When do babies start teething?” might also depend on genetics, as the age teething starts seems to run in families. Siblings or parents who were early or late teethers may give a clue as to when teething might begin for a particular baby. In addition, babies born prematurely may start teething later than the average for their age.

Parents sometimes notice symptoms of teething before they actually see teeth poking through the gums. Teething symptoms may show up a few days before the tooth appears. Some common symptoms of teething include:

• Drooling
• Restless sleep 
• Fussiness that comes and goes instead of being continual
• Refusal to eat
• Chewing on the hands or other objects
• A mild rash around the mouth caused by drool
• Rubbing the ears or cheeks when the molars are erupting

Babies who are teething don’t typically have a fever, diarrhea, coughing, vomiting, rashes on the body, or excess fussiness for long periods of time. Parents shouldn’t consider these signs an indication that the teeth are coming in. Some babies might have a mild fever when teething starts, but it won’t be above 101 degrees Fahrenheit. Any fever that high indicates another illness.

Not all babies have symptoms during teething. Some infants breeze through the process without becoming fussy at all. Most have at least a small amount of crankiness or exhibit chewing behaviors associated with teething, though. You might also be able to see swelling or a slight blister that appears on the gums before the tooth actually pops through.

Because the earliest symptoms of teething can be subtle, new moms who are distracted by other concerns or moms with insomnia might not notice until the teeth appear. Knowing the timeline for typical tooth eruption helps you know when to expect teething symptoms to appear.

Once those first teeth start breaking through the gums, the entire teething process lasts about 1.5 years. The baby teeth, also known as primary teeth, tend to come out in pairs, starting when the infant is around 6 months old and continuing until the child is around 24 months old. 

Most babies get their two bottom middle teeth first, then the matching top two teeth a couple of months later. Some babies have their own patterns, though, so it’s perfectly normal if your infant already has three or four teeth at the top or bottom before the others start coming in. If you don’t see any teeth at all by the age of about 15 months, check with your child’s pediatrician or a pediatric dentist to make sure no problems exist.

The baby teething chart below can help you anticipate which teeth are coming in next. 

• 6 months: lower central incisors
• 8 months: upper central incisors
• 10 months: upper and lower lateral incisors
• 14 months: first molars
• 18 months: canine teeth
• Between 20 and 30 months: second molars

Knowing the answer to the question “When do babies start teething?” gives you a head start on helping your infant get through the process smoothly. The process itself can be stressful, though.

When your baby is young, there are a lot of things demanding your attention. Issues such as postpartum depression can make it difficult to pay attention to subtle signs of teething or other physical baby milestones. You might be preoccupied with weight loss after pregnancy or dealing with postpartum birth control. Having a clear idea of how to help your child gives you a plan of action to deal with teething.

Taking care of yourself is the first step to helping your child get through teething. Moms and dads with postpartum depression or excess stress after the birth might also feel overwhelmed by the fussiness of teething. Just remember that your baby is feeling uncomfortable and that any fussiness is simply their way of letting you know. It might also help to know that babies often adapt to teething after the first few teeth are out and may not be as fussy for later teeth. 

Your baby is likely to try putting objects in their mouth to ease the pain and discomfort of teething. Pressure on the gums relieves the soreness. You can press gently on your child’s gums to help.

Providing teething rings or a small towel gives your baby something safe to chew on. You can chill these objects beforehand to make them feel even better on your baby’s sensitive gums. The cold has a numbing effect that reduces pain. Be careful not to leave ice or frozen objects on your baby’s gums for too long because this could cause tissue damage. Slightly chilled teething rings are better than frozen ones.

If your teething infant is refusing food because of the discomfort, you might try different bottle nipples to see if any are more comfortable. Distractions can also help during teething. Your child might want extra cuddling sessions or might want to breastfeed more often during teething as a way to self-comfort.

Medicines aren’t generally recommended for teething. Oral medications with benzocaine, including rub-on gels, could be dangerous for babies. If your baby is experiencing a lot of pain during teething, your doctor might recommend ibuprofen or acetaminophen if the infant is over 6 months old. 

Don’t use alcohol on a baby’s gums to ease teething pain, and avoid feeding your child hard or frozen objects, such as hard crackers or frozen banana chunks, during teething. These hard foods could break apart and become a choking hazard. 

Now that you know the answer to the question “When do babies start teething?” you are prepared for this exciting milestone. Soon, your infant can start exploring foods that weren’t possible before their teeth came in. 

References

https://www.parenting.com/article/guide-teething-symptoms

History of updates

Current version
(14 April 2020)

Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist

24 July 2019

Teething in children – symptoms you need to know

Teething in children is a complex process. Unfortunately, its course is not determined by the efforts of the parents, but depends solely on heredity. If dad-mom’s teeth erupted late, then you should not expect from the heir that his first incisor will appear by 6 months. And vice versa, if close relatives began teething early, then the baby, most likely, will acquire a “toothy” smile in the first half of the year. In any case, a healthy child will have at least 1 tooth by 12 months!

The eruption itself can also proceed in different ways. Some lucky ones discover a baby’s first incisor by accident, simply by touching it with a spoon while feeding. But most have to endure not the most pleasant manifestations.

Main symptoms during eruption:

• Fever. As a rule, children tolerate “tooth” temperature easily, but if this is not the case, the baby can be given an age-appropriate antipyretic in the dosage indicated on the package.
• Runny nose. Here you just have to be patient. As soon as the tooth erupts, the runny nose will disappear. Since babies at this age still do not know how to blow their nose, special baby suction can remove mucus from the nose. This should be done before the baby goes to bed to make breathing easier.
• Whims, tears, bad sleep. These teeth are “pushed” through the gum, giving the child a lot of discomfort. To get rid of them, you can use a variety of dental gels or give 1-2 times paracetamol or ibuprofen, this time already as a painkiller (in the form of syrup and at a dosage according to age).
• Endless nibbling. Trying to calm the itching in the gums a little, children pull everything into their mouths. Here, teethers or soft rags cooled in the freezer come to the rescue.

Teething is a difficult time for both the child and the parents. But it will fly by quickly, and all difficulties will be forgotten!

Symptoms of teething in children

The signs of teething in children listed above can easily be confused with a cold. How to understand that the baby is teething, and there is nothing more serious? There are several signs that are associated specifically with dentition:

• The gum swells and turns red, a small edematous tubercle may appear in the place of the future incisor.
• Increased salivation: transparent and liquid saliva flows almost constantly.
• The child puts everything into his mouth, and if there are no suitable objects nearby, he begins to “chew” his fingers.
• A thin red or white line appears on the gum: this means that the incisor has almost appeared and will soon erupt.

Teething discomfort is similar to some other conditions:

• Cold or flu. The difference is that with a cold, the child will have a runny nose or cough, a high temperature will rise. This may be accompanied by signs of dehydration (dry skin, crying without tears). All this requires urgent medical attention.
• Stomatitis. Appears if the child, along with a dirty object, has brought an infection into the mouth. Inflammation appears on the gum, cheek or lip from the inside, an abscess may form. At the same time, the temperature is high, the child refuses to eat, and there are no signs of teething on the gums.
• Reaction to vaccination. In the first year of life, vaccination is carried out several times and often coincides with eruption. If you have recently vaccinated your baby, monitor his well-being. If the temperature rises above 38°C and other symptoms of illness appear, consult a doctor.

Timing and pattern of teething in children

The first to erupt are the incisors – the central teeth. First they appear on the lower gum, and then on the upper one. Next come the lateral incisors, molars (molars) and canines. The second molars are cut last. The first baby tooth usually appears between 6 and 10 months of age. The eruption is completed by the 30th month.

Both the timing and order of teething in children are individual. Often this happens the same way as one of the parents. Sometimes one tooth is “delayed”, sometimes they appear in groups, several at once. If it seems that the eruption is going wrong, late, or the baby is taking it too hard, you can seek advice from a pediatric dentist.

How to help a child during teething?

Sometimes the appearance of teeth does not cause any discomfort to the baby at all, but more often this period is difficult for both the baby and the parents. There are several ways to make teething easier:

• Cooling ointments or gels. Use them only on the advice of a doctor. They temporarily relieve pain and remove discomfort, but you should not use them too often: they may contain components that increase the load on the baby’s liver.
• Teethers and rubber toys. When a tooth begins to climb, the child feels not only pain, but also itching. To remove it, you need to chew something. Thick cutters work well for this.
• Gingival massage. The gums can be massaged with a finger, wearing a special fingertip. Movements should be soft, careful, you can not put much pressure on the sore spot.
• Chilled items. It can be a nipple, a rubber teether, a wet cloth. Cold reduces swelling and pain, removes discomfort.

If the baby continues to act up, has a high temperature, or shows signs of illness, contact your pediatrician or dentist to make sure that the problem is related to the teeth.

How long does it take for teeth to erupt?

The timing of teething may vary: for some children, everything goes away in just a couple of days, while others do not feel well for a week or even longer. Please note that milk teeth can be cut immediately after each other. If a second incisor appears immediately after the first incisor in the lower jaw, and then the incisors in the upper jaw are cut, it may seem that this is an endless process.

It usually takes 2 to 8 days for one tooth to appear, but the child only experiences severe discomfort for two to three days. Pain and discomfort disappear when the crown is shown from the gums: this completes the eruption, and then the tooth grows without causing discomfort.

how to relieve? Ointments, drops, syrups, suppositories

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