INFANT TEETHING

What is teething?
When do teeth appear?
Order of appearance
Symptoms of teething
How long do symptoms last?
When it’s NOT teething
Teething – myth or fact
What you can do to help
Keep baby’s teeth healthy
When to see a doctor

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What is teething?

Teething refers to the tooth breaking through the skin, during which time the gums can become red, shiny and swollen. If you touch your baby’s gums with your finger you can feel the hard point of the tooth underneath.

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When do teeth appear?

Your baby’s ‘milk’ teeth are all formed and waiting to emerge at the time of birth. The first tooth usually appears in the gums at around 6 months of age, but babies can be born with teeth or for some the first tooth may not appear until 15 months.

By 12 months babies usually have 4 to 8 teeth. By 18 months, 12 teeth and by age three, all 20 milk or baby teeth will generally be in place. These teeth will be lost between 6 and 12 years to make way for permanent or adult teeth.

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Order of appearance

Teeth usually appear in a certain order. They also tend to appear in pairs, generally one after the other, with the lower pairs appearing first.

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Symptoms of teething

Some babies show no signs of discomfort whilst teething and others may appear bothered by each one of their twenty teeth as they come through. Apart from being able to see or feel the tooth, it’s possible that all other symptoms commonly thought to be signs of teething could be due to other causes.

• Red swollen gums or a visible bump in the gum
• Pain or discomfort in mouth
• Irritable or clingy behavior
• Pulling ears
• Wakefulness
• Slightly raised temperature
• Flushed cheeks
• Drooling/dribbling
• Chewing or biting
• Coughing due to excessive saliva
• Chin or facial rashes
• Loss of appetite
• Difficulty breastfeeding

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How long do symptoms last?

Symptoms are minor and relatively infrequent; discomfort due to the tooth breaking though the skin will usually last for less than a couple of days (maybe a little longer if multiple teeth are breaking through at the same time).

If symptoms continue past a 3 of days without a tooth in sight, there’s likely to be other reasons for your baby’s discomfort or distress.

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When it’s NOT teething!

Epstein Pearls

During your baby’s early months of life whitish pearly-appearing bumps (technically cysts) appear in the roof of the mouth and gums of 80% of newborns. They sometimes resemble emerging teeth. They are quite harmless and will disappear.

Normal developmental changes

Parents often become concerned about teething when their baby is around 3 months old. This is an age when a baby’s salivary glands begin to produce more saliva, but at this age he’s not mature enough to move the saliva to the back of his mouth and swallow it. The saliva therefore, just flows out of his mouth.
Babies are in an oral stage of development and find it comforting to suck or chew on any object they can get near their mouth. By about 3 months of age a baby has developed enough control his arm movements to be able to place his fingers or hand in his mouth at will or guide objects to his mouth. This is not an indication of teething but a normal developmental response.

Illness

Many people believe teething can cause fever and diarrhea; however this has not been proven. Many symptoms thought to be caused by teething may actually be caused by an illness. The important thing is not to use teething to explain away what might be the signs of illness.

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Teething - myth or fact

1. Drooling and chewing on things are sure signs of teething.

FALSE: Although drooling and mouthing of objects may be more obvious when a baby is teething, these signs can also be due to normal developmental changes (see above). The only sure sign of teething is when you can see or feel the emerging teeth.

2. Teeth can move up and down in the gums.

FALSE: The child’s permanent teeth are forming below the baby teeth and as they develop they slowly push the baby teeth to the surface. There’s no room for baby teeth to move back down again. However, once the tooth has broken through the surface it’s possible for the skin to cover over the tooth again temporarily.

3. Teething pain can last for weeks or months before a tooth finally appears.

FALSE: Teething only causes discomfort around the time the tooth is ready to break through the gums. Discomfort generally last for only a couple of days. Many babies experience no discomfort from teething.

4. Extended periods of discomfort are due to teeth moving within the gums.

FALSE: Even before birth, all baby teeth are formed and are slowly progressing to the surface. The final baby tooth will appear somewhere around between the ages of 2 and 3 years. If the movement of teeth, as they gradually progress to the surface was painful, then the pain would be constant because all baby teeth are gradually progressing towards the surface at the same time (some simply arrive sooner).

5. Teething causes a temperature.

FALSE: A temperature is due to an infection somewhere in the body. Although the gum can become red and swollen just as the tooth is about to break through the surface, this is NOT due to infection.

6. Teething causes diarrhea.

FALSE: Many people claim diarrhea is a sign of teething, contributing this to swallowing excess saliva. As a child’s stomach contains a mild hydrochloric acid, the amount of saliva swallowed is unlikely to make a great difference. Mild diarrhea at the time of teething would more likely be explain as a result of a tummy upset brought about because a teething child bites or chews on just about anything they can get into their mouth, clean or not so clean.

7. It’s safe to use painkillers and teething gels.

TRUE & FALSE: It can be but only under the advice of your doctor. All medications (including natural therapies) can have side effects and can be potentially dangerous. Prolonged use of medications is not recommended unless under the advice of a doctor.

8. Teething causes a child to wake at night.

TRUE: Although, it’s true that teething discomfort could increase wakefulness, prolonged periods of wakefulness (more than a couple of nights) are often due to reasons other than teething.

9. A baby can be irritable for weeks because of teething.

FALSE: Understandably, teething is often blamed for irritability. Indeed when a tooth is about to break through the gum this can cause a child feel uncomfortable. However, irritability lasting more than a few days without the emergence of a tooth is likely to be due to reasons other than teething.

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What you can do to help

To help reduce the pain associated with teething the following measures may be useful.

• Gently, but firmly, massage or press on your baby's gum with a clean finger or soft cloth. If this obviously upsets your child don’t continue.
• Give your baby something cold to suck or chew on. You can buy plastic teething rings which you can cool in the refrigerator. Some babies find it great to chew on a face washer that has been moistened and put in the freezer for a few hours.
• Regularly clean teething rings toys or anything else your child chews on to prevent the growth of germs.
• Prevent skin rashes on the face by washing away saliva with a warm, clean face washer and applying a protective ointment.
• A teething rusk is good to chew on, but be careful pieces don't break off.
Teething aids such as teething gels, pain killers or sedatives should only be used if advised by your doctor.

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Keep baby's teeth healthy

DO

• Start cleaning your baby's teeth twice a day, as soon as teeth appear. Use a clean cloth to wipe over baby’s teeth.
• As more teeth develop you can use a soft toothbrush. (Until around the age of 8 years a child lack the coordination to adequately clean their own teeth. Parents need to assist their child with teeth brushing until that time).
• Begin using a low-fluoride toothpaste (made for children) at around 2 years. Only a smear of toothpaste (as big as a pea or less) should be put onto the toothbrush. Try not to let your children eat or swallow toothpaste after brushing. Teach them how to spit it out.
• Keep toothpaste tubes out of reach of children.
• Take your child to the dentist twice a year.

DON’T

• Don't suck baby's pacifier and give it back to them, as you transfer bacteria from your mouth to theirs.
• Don't dip a pacifier or teething rings in honey or sweet foods as it may lead to dental decay. (Honey is not recommended for infants under 12 months.)
• Don’t give your baby or young child a bottle of milk, formula or fruit juice to suck on after a feed, or to go to sleep with. The sugar in milk and fruit juice can lead to decay if it’s in the baby's mouth for a lot of time
• Don't leave the bottle in your baby's mouth while baby is asleep.
• Don’t use lemon juice on the gums once the teeth come into the mouth, because lemon juice has a lot of acid and can dissolve the tooth enamel
• Don’t use toothpaste before 2 years of age (at an age where she can be taught to spit it out).

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When to see your doctor

Teething may cause your baby to be mildly off-color but it does not cause serious illness. Take your child to the doctor if teething troubles last longer than 3 days or sooner if your child has a high temperature, diarrhea, or is not drinking.

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CLICK HERE FOR HOW WE CAN HELP YOU to discover the source of your baby’s distress.

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See also:
How we can help
Infant colic
Crying baby

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