A nice set of white little teeth does not come easy. Tender, painful and swollen gums during the teething process can make your baby feel really miserable. And as we parents know, having a cranky baby is not a pleasant situation to be in…
Here are some basics about teething, what to expect, how to soothe your distressed baby, as well as how to care for the pearly white teeth when they finally emerge.
When Does Teething Occur?
For the vast majority, the baby’s first tooth typically emerges around the 6th month. But teething can occur as early as the 3rd month or as late as 14th month.
Teething symptoms often arrive before the actual emergence of the first tooth. And for the anxious parents, it is worth noting that the symptoms may persist for as long as 1-2 months before the first tooth finally pokes through the gum.
Unfortunately, not all the teeth come out at the same time! This is a long and ongoing process, and it is only by age 3 that the toddler will have the complete set of 20 primary teeth.
Babies usually get their teeth in pairs. The lower front teeth (or lower central incisors) are the first to sprout, followed by the upper front teeth 1-2 months later. The second molars are the last to join the party.
Here’s a chart on the general timeline of teething:
Signs Of Teething
It is difficult to know exactly how long it takes for the tiny tooth to break through their little gums. Teething symptoms may appear for weeks (the actual timing varies from baby to baby) before the tooth actually emerges. How babies experience the symptoms also vary very widely.
For some babies, teething can lead to some very painful symptoms for a longer period of time, while others may only experience a few days of mild symptoms.
The GOOD NEWS is that the teething symptoms tend to be the most severe for the first pair of teeth. After which, the others will come through the gums more easily… UNTIL the large molars when your child is about a year old.
Some Of The Most Common Teething Symptoms:
Teething is a painful process as the tooth breaks through the gum. Your baby will also have to deal with the odd sensation of something emerging in his/her mouth.
All these make the little one more cranky, irritable and fussy compared to the ‘normal self’ (highly subjective…). If he/she is feeling upset, cuddles and kisses always help.
- Disturbed sleep, especially in the night
The eruption of the tiny tooth tends to come in stages, often with increased activity at night compared to the day. As such, you’ll find that your baby tends to be more irritable at night, may not be able to fall asleep, or waking up more often in the nights.
However, stick to the usual bedtime routine and comfort him/her if he/she is unsettled.
- Red and swollen gums
As the new tooth tries to break through the gums, it will cause the gum to become red, swollen, tender, and probably even bruised-looking. You will see the gum bulging with faint small bumps. That’s the tooth buds. If you managed to get your little one to open his/her mouth long enough for you to run a clean finger over them, you’ll be able to feel the hard tooth beneath the gums.
- Flushed cheeks
You will also notice that your baby’s cheeks look rosy-red and feel warm.
- Heavy drooling
A teething baby often drools excessively, which can lead to facial rash and skin irritation. Hence, it is important that you keep your baby’s chin dry by keeping a clean cloth handy.
You might also want to apply some moisturizer for extra protection.
- Chewing objects or fingers
You will notice that a teething baby instinctively puts things into the mouth to chew or puts his fingers into the mouth to nibble. Gnawing on something is somewhat soothing as it helps to relieve the pain and pressure of the emerging teeth by exerting a counter-pressure.
- Refusing food or experiencing change in eating habits
The sore and swollen gums can make eating painful for your baby. Teething babies may start feeding eagerly from the bottle or breast, but keep coming off the breast or bottle even if they’re still hungry because of the uncomfortable pressure on the gums and ear canals.
If your child has started on solids, you can try feeding him/her cold food or softer foods like puree and yogurt. Some kids might refuse to eat because the spoon irritates their gum, hence preferring to drink from a bottle or sippy cup.
On the other hand, some kids might eat more because the counter-pressure from chewing and nibbling helps to relieve the pressure from the emerging tooth.
- Rubbing the ear on the same side of an erupting tooth
Last but not least, some parents noticed that their babies tend to have loose stools or even develop a fever before the emergence of the new tooth. However, experts are diverged in their views as to whether diarrhea and a mild fever are teething symptoms.
The American Academy of Pediatrics disagree that fever and diarrhea are normal symptoms of teething. One of the many possible explanations is that these symptoms are completely unrelated to teething, but they occur coincidentally at the same time as the new teeth because teething babies keep putting things into their mouth, so they have a higher tendency of ingesting more germs and virus during this period.
On the other hand, William Sears, pediatrician and author of The Baby Book, thinks that the baby’s excessive drool ends up in the gut resulting in loose stool and the inflammation in the gums can cause a low fever (rectal temperature of less than 100.4 degrees Fahrenheit).
Having said that, NEVER assume that fever and diarrhea are symptoms of teething. These signs may be signs of other illnesses. See a doctor to rule out anything serious if symptoms worsen (such as fever reaching 101° F or higher) or linger for few days, or if it’s accompanied by other symptoms such as lethargy, lack of appetite or vomiting.
How Do I Soothe A Teething Baby?
Most methods to soothe a distressed teething baby make use of pressure and coldness. Exerting a counter-pressure on their gums (by chewing or massage) is soothing as it helps to relieve (or distract) the pressure and pain of the new tooth emerging from the gum. The cold helps to numb the pain.
- Give your child something cold to chew on to soothe the sore gums
This works on the same idea of using a cold pack for cold compression on a sprained ankle to numb the pain and reduce swelling.
- Cold wet washcloth
Some babies find comfort from munching and sucking on a cold wet washcloth because the fabric massages the gums while the cold numbs the pain. You can prepare it by placing the wet washcloth in a clean plastic bag to chill in the refrigerator.
Some parents also find that soaking the washcloth in chamomile tea helps to better soothe and calm their fussy babies, helping them to sleep better as a consequence.
There are also teething blankets on sale. These are often created with few cloths of different textures so that your child can get the right pressure they are seeking to soothe themselves.
- Chilled teethers
Many babies and toddlers intuitively grab onto anything and start chewing to soothe themselves. However, biting on hard toys can hurt the teeth or even be poisonous. As a safer option, you may want to offer your child a chilled teether.
There’s a huge variety of teething toys and teething rings available – in terms of materials and designs. When choosing which teether to buy, the most important factors to look out for are the material and design.
Is the material safe and non-toxic?
Is the design non-choking?
They should also be designed such that it is easy for the little hands to grab and hold. Some even provide a few different teething surfaces so that the teething babies can get just the right pressure they are seeking. Some of the teething toys are also designed to be colorful, produce rattle sounds, and provide opportunities for the development of the babies’ sensory and gross motor skills.
Solid food-grade or medical-grade teethers are highly recommended as they can be sterilized.
There are some teething toys or teething rings that are gel-filled (to keep the teether cool for longer periods of time). The downside of such liquid-filled gel is that you will have to regularly check for any leaks (due to wear and tear after the gnawing by your child) and they can’t be sterilized.
- Chilled food
You can also try offering your child cold food such as cold fruit puree or yogurt.
- Chilled fruit in a food holder
If your baby is older than 6 months and got started on solid food, you can try giving them fresh chilled fruit in a food feeder. Again, chilled but not frozen. Feeding the fruit on its own can be a choking hazard, so it is advisable to use a food holder. Your baby can chew, suck on, and enjoy the fruit safely, with only tiny digestible pieces coming through the fruit feeder.
There are generally 2 types of food holder – Mesh fruit feeder or a silicon food feeder.
- Homemade frozen popsicle
You can also make your own popsicle using fresh fruit juice or puree, so that there’s something healthy for the teething baby to suck on.
You can easily purchase popsicle molds online, such as the Nuby’s Garden Fresh Fruitsicle Frozen Popsicle Tray. What’s nice about Nuby’s popsicle tray and mold is that the popsicle handles are perfectly sized for the baby’s small hands and designed to catch drips as the popsicle melts.
- Chilled water in a bottle or sippy cup
You can also offer your baby some chilled water in a bottle or sippy cup, but be careful that too much cold drinks can lead to a tummy upset.
Before a painful bruised-looking gum is formed, try rubbing a clean finger gently and firmly over your baby’s sore gums. You can do so using your bare finger or wrapped in a washcloth.
- Teether – made of natural rubber or wooden
If your little one do not enjoy chewing on something cold, you can also consider teethers made of natural materials like natural rubber and wood.
Teething can cause chronic low-grade discomfort, which you can sometimes help alleviate by distracting them. Take their mind off the pain by offering a new toy or simply with more cuddles.
More Tips For Soothing Your Teething Baby
If you do decide to give your baby a teething biscuit to gnaw at, you will have to keep an eye and be aware of the choking risk.
If your child is accustomed to his/her pacifier, do not take it away now as he/she can self-soothe by chewing and sucking on the pacifier.
Even though your child is distressed by the teething pain, do not let your child get into the habit of chewing or biting you to relieve the pain and pressure. Do discipline your baby against biting others by pulling him away from you, telling him firmly not to bite and offer an alternative teether to chew on.
Should I Try Alternative Remedies To Soothe A Teething Baby?
- Homeopathic teething gel, drops and tablets
Some parents swear by homeopathic teething drops, gel or tablets. Yet on the other hand, some parents and studies have found that these homeopathic remedies have no conclusive effect.
Teething gel can be applied directly onto the sore gum right where it hurts with your clean finger. Your gentle touch and soft massage is also calming for the baby. Teething tablets quickly dissolve in the mouth to provide relief, or you can dissolve them in a spoon of water.
These homeopathic teething gel, tablets or drops can be easily purchased online or over the counter. However, they have not been evaluated by the US Food and Drug Administration (FDA).
Make sure that the teething tablets, gels or drops are benzocaine-free as the FDA has warned against topical medications containing benzocaine for children under 2 without proper guidance from a doctor. Benzocaine can cause a rare but serious condition where the amount of oxygen in the blood drops dangerously low.
Also, check that what you are buying is sugar-free. You wouldn’t want to literally sugar-coat the new teeth as that can lead to tooth cavities.
- Amber necklace or bracelet
Wearing a baltic amber necklace, bracelet or anklet, is an old remedy. However, it carries the risk of strangling or choking when the child is sucking or chewing on the beads.
Can I Give My Teething Child Painkillers?
If nothing seems to work and your teething baby is in need of pain relief, your doctor may recommend giving children’s painkillers. This may include infant acetaminophen, infant paracetamol, or infant ibuprofen. However, do note that there are side-effects; for example ibuprofen can irritate the stomach.
If your child is under 2, be sure to first check with your doctor before giving any new medicine. Also check the dosage with your doctor or pharmacist.
If your child is persistently unwell, it is advisable to bring your baby to the doctors to check if there is anything else that is upsetting his/her before giving him/her any over-the-counter medication. For example, ear infection may be mistaken for teething.
How To Care For Your Baby’s Gums And Emerging Teeth?
- Before teething
Even before your baby’s first tooth appears, it is actually a good idea to start a habit of massaging and cleaning his/her gums. You can do so by wrapping a soft wet washcloth or gauze around your index finger to gently wipe and rub over the gums during bath time or after feedings to clean out leftover milk.
By doing so, you get your baby used to a daily routine of cleaning his mouth and the sensation of having something in the mouth, which will eventually aid the transition into brushing the teeth with a toothbrush.
During the teething stage, the massage will provide a counter-pressure on the gums to relieve the pain.
- After the baby teeth come in
Initially you can continue the cleaning regime using your finger and a washcloth. As your baby’s teeth start coming in, look for a baby toothbrush with a small head and soft bristles. It should be easy for you to grip. Replace the baby toothbrush regularly when the bristles start to wear out, probably once every 1-3 months.
Brush twice a day gently on the inside and outside of the teeth, as well as on the tongue, to dislodge food particles and bacteria that cause bad breath.
According to the American Dental Association, parents should only use a tiny smear (no more than the size of a grain of rice) of fluoride toothpaste for children under 3 years. For children between 3 and 6, do not use fluoride toothpaste more than a pea-size.
Sweet and starchy foods can cause tooth decay, so serving them water after food can help to get the food particles dislodged and not sit on or in between the teeth for too long.
At this stage, do not put your baby to sleep with a bottle of milk or juice, as these liquid is a form of food for the bacteria in the mouth which can lead to tooth decay.
- Bringing your baby to the dentist
It is advised that you take your child to the dentist by his/her first birthday or within 6 months after the first tooth emerged, whichever comes first.
Teething is a painful process, so hopefully with these tips, you can help to soothe your teething baby. However, that’s not the end as you have to ensure that your baby’s new set of teeth are well taken care of.
All the hard work will be worth it when you see your little one’s smile with his/her set of pearly-white teeth.