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Teething

Definition

  • Questions about teething, the normal process of new primary teeth working their way through the gums
  • Teeth come in between 6 and 24 months of age
  • Caution: At least one tooth should be visible before using this topic

Symptoms

  • Main symptoms are increased saliva, drooling and desire to chew on things.
  • Occasional symptoms: mild gum pain.  Usually, not enough to cause crying or interfere with sleep.
  • Does not cause fever, diarrhea, diaper rash, ill appearance or lowered resistance to infection.
  • Caution: Blaming teething for fevers can lead to a delayed diagnosis of ear infections, urinary tract infections, meningitis and other infections.
  • Caution: Blaming teething for crying can lead to a delayed diagnosis of ear infections or other causes of pain.
  • There are 2 reasons for the onset of infections between 6 and 12 months of age: The loss of transplacental antibodies and the developmental milestone of chewing on everything.

When to call your doctor

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick

Call Your Doctor During Weekday Office Hours If

  • You think your child needs to be seen
  • You have other questions or concerns

Parent Care at Home If

  • Normal teething and you don't think your child needs to be seen

HOME CARE ADVICE FOR TEETHING

  1. Reassurance:  
    • Teething is a natural process.  
    • It's harmless and it may cause a little gum pain.
    • It doesn't cause fever or crying. If present, look for another cause.
  2. Gum Massage:  
    • Find the irritated or swollen gum.  
    • Massage it with your finger for 2 minutes.  
    • Do this as often as necessary.  
    • Putting pressure on the sore gum can reduce pain.
    • Age over 12 months: You may use a piece of ice wrapped in a wet cloth to massage the gum.
  3. Teething Rings:
    • Infants massage their own sore gums by chewing on smooth, hard objects.
    • Offer a teething ring, pacifier or wet washcloth that has been chilled in the refrigerator, but not frozen in the freezer.  
    • Age over 12 months: A piece of chilled banana may help.
    • Avoid hard foods that could cause choking (e.g., raw carrots).
    • Avoid ice or popsicles that could cause frostbite of the gums.
  4. Cup Feeding:  If your infant refuses nipple feedings, use a cup, spoon or syringe temporarily.
  5. Pain Medicine: If the pain increases, give acetaminophen (e.g., Tylenol) orally for 1 day. Special teething gels are not recommended (FDA 2011). They can cause allergic reactions, choking or bluish skin.
  6. Call Your Doctor If:
    • Develops unexplained crying
    • Develops fever
    • Your child becomes worse
Author: Barton D. Schmitt, M.D.
Last reviewed: 9/15/2011
Last revised: 1/28/2012 2:32:48 PM

Copyright 1994-2012 Barton D. Schmitt, M.D.