By: Dina DiMaggio, MD, FAAP & Julie Cernigliaro, DMD
1. Most babies will develop teeth between 6 and 12 months.
There is a wide range of variability of when a first tooth may appear—some babies may not have any teeth by their first birthday! Around 3 months of age, babies will begin exploring the world with their mouth and have increased saliva and start to put their hands in their mouth. Many parents question whether or not this means that their baby is teething, but a first tooth usually appears around 6 months old.
Typically, the first teeth to come in are almost always the lower front teeth (the lower central incisors), and most children will usually have all of their baby teeth by age 3.
2. Fluoride should be added to your child's diet at 6 months of age.
Fluoride is a mineral that helps prevent tooth decay by hardening the enamel of teeth. The good news is that fluoride is often added to tap water. Give your baby a few ounces of water in a sippy or straw cup when you begin them on solid foods (about 6 months of age). Speak with your pediatrician to see if your tap water contains fluoride or whether your child needs fluoride supplements. Fluoride is not typically found in most bottled water. See FAQ: Fluoride and Children for more information.
3. Massaging sore gums, offering something cold, or acetaminophen, on an occasional rough night, can help soothe your baby's teething pain.
Usually teething doesn't cause children too much discomfort, however, many parents can tell when their baby is teething. Babies may show signs of discomfort in the area where the tooth is coming in, the gums around the tooth may be swollen and tender, and the baby may drool a lot more than usual.
Parents can help ease teething pain by massaging their baby's gums with clean fingers, offering solid, not liquid-filled, teething rings or a clean frozen or wet washcloth. If you offer a teething biscuit, make sure to watch your baby while they are eating it. Chunks can break off easily and can lead to choking. Also, these biscuits are not very nutritious and most contain sugar and salt.
A baby's body temperature may slightly rise when teething; however, according to a 2016 study in Pediatrics, a true fever (temperature over 100.4 degrees Fahrenheit or 38 degrees Celsius) is not associated with teething and is actually a sign of an illness or infection that may require treatment. If your baby is clearly uncomfortable, talk with your pediatrician about giving a weight-appropriate dose of acetaminophen (e.g., Tylenol) or if over 6 months, ibuprofen (e.g., Advil, Motrin). Make sure to ask your pediatrician for the right dose in milliliters (mL) based on your child's age and weight.
Many children, however, will have no problems at all when their teeth come in!
4. Do not use teething tablets, gels with benzocaine, homeopathic teething gels or tablets, or amber teething necklaces.
Stay away from teething tablets that contain the plant poison belladonna and gels with benzocaine. Belladonna and benzocaine are marketed to numb your child's pain, but the FDA has issued warnings against both due to potential side effects.
In addition, amber teething necklaces are not recommended. Necklaces placed around an infant's neck can pose a strangulation risk or be a potential choking hazard. There is also no research to support the necklace's effectiveness. See Teething Necklaces and Beads: A Caution for Parents for more information.
5. You should brush your child's teeth twice a day with fluoride toothpaste.
Once your child has a tooth, you should be brushing them twice a day with a smear of fluoride toothpaste the size of a grain of rice, especially after the last drink or food of the day. Remember not to put your baby to bed with a bottle—it can lead to tooth decay.
Once your child turns 3, the American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD)recommend that a pea-sized amount of fluoride toothpaste be used when brushing.
When your child is able, teach them to spit out the excess toothpaste. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Parents should monitor and assist their child while brushing until they are around 7 or 8 years old. When your child can write their name well, he or she also has the ability to brush well.
6. Ask your pediatrician about your baby's teeth and fluoride varnish.
During regular well-child visits, your pediatrician will check your baby's teeth and gums to ensure they are healthy and talk to you about how to keep them that way. The AAP and the United States Preventive Services Task Force also recommend that children receive fluoride varnish once they have teeth.
If your child does not yet have a dentist, ask your pediatrician if they can apply fluoride varnish to your baby's teeth. Once your child has a dentist, the varnish can be applied in the dental office. The earlier your child receives fluoride varnish the better to help prevent tooth decay.
7. Make your first dental appointment when the first tooth appears.
Try to make your baby's first dental appointment after the eruption of the first tooth and by his or her first birthday.
Both the AAP and the AAPD recommend that all children see a pediatric dentist and establish a "dental home" by age one. A pediatric dentist will make sure all teeth are developing normally and that there are no dental problems. They will also give you further advice on proper hygiene. If you don't have a pediatric dentist in your community, find a general dentist who is comfortable seeing young children.
Brushing Up On Oral Health: Never Too Early to Start
How to Prevent Tooth Decay in Your Baby
Brush, Book, Bed: How to Structure Your Child's Nighttime Routine
Give Your Baby the Best Possible Start
Dina DiMaggio, MD, FAAP, is a board certified pediatrician at Pediatric Associates of NYC and at NYU Langone Medical Center. She is the co-author of The Pediatrician's Guide to Feeding Babies and Toddlers, a comprehensive manual written by a team of medical, nutrition, and culinary experts. Follow her on Instagram @Pediatriciansguide.
About Dr. Cernigliaro:
Julie Cernigliaro, DMD, is a board certified pediatric dentist and the Associate Director of the Pediatric Dental Residency Program at Lutheran Medical Center in Brooklyn, NY. She holds a faculty position at NYU College of Dentistry and currently works in private practice at Happy Smile Pediatric Dentistry, PC in NYC.
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Teething Signs and Symptoms - American Dental Association
It’s not hard to tell when your baby starts teething. He or she may irritable during the day and sleepless at night. (And you might be too!) Here’s what to expect and how to keep your baby comfortable.
When Does Teething Start?
Your baby was born with all 20 primary teeth below their gumline. They typically start to come through between 6 and 12 months. Children usually have their full set of baby teeth in place by age 3.
Loss of appetite
Drooling more than usual
What’s not normal?
If your baby has any of these symptoms while teething and continues to be cranky and uncomfortable, call your pediatrician.
How to Soothe a Teething Baby
Your child may have sore or tender gums when teeth begin to erupt. Gently rubbing their gums with a clean finger, a small cool spoon, or a moist gauze pad can be soothing. A clean teether for your child to chew on may also help. Look for teethers made of solid rubber, and avoid liquid-filled teething rings or plastic objects that could break.
Also, be aware of what the teethers you choose for your child are made from. Just because something is marketed as a teether doesn't always mean it's safe. In a September 2017 report, the Center for Disease Control published a case reporter of an infant who suffered lead poisoning after chewing on a bracelet. The bracelet, which the child's parents said was a homeopathic magnetic hematite health bracelet intended to help ease the child's discomfort from teething, had metal beads which contained lead.
Are Numbing Gels or Teething Tablets Safe For My Baby?
The Food and Drug Administration recommends that parents and caregivers not use benzocaine products for children younger than 2. “We are also warning that benzocaine oral drug products should only be used in adults and children 2 years and older if they contain certain warnings on the drug label," the FDA said in a May 2018 statement. "These products carry serious risks and provide little to no benefits for treating oral pain, including sore gums in infants due to teething.” Benzocaine is an over-the-counter anesthetic, which the FDA notes are usually under the product names Anbesol, Hurricaine, Orajel, Baby Orajel and Orabase. Benzocaine has been associated with a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood stream is greatly reduced.
The FDA also urges parents not to use – and dispose of homeopathic teething tablets – after lab testing found “inconsistent amounts of belladonna, a toxic substance, in certain homeopathic teething tablets, sometimes far exceeding the amount claimed on the label.”
“The body’s response to belladonna in children under two years of age is unpredictable and puts them at unnecessary risk,” said Janet Woodcock, M. D., director of the FDA’s Center for Drug Evaluation and Research.
Homeopathic teething products have not been evaluated or approved by the FDA for safety or effectiveness, and the agency says it is unaware of any proven health benefit of the products.
"Consumers should seek medical care immediately if their child experiences seizures, difficulty breathing, lethargy, excessive sleepiness, muscle weakness, skin flushing, constipation, difficulty urinating, or agitation after using homeopathic teething tablets or gels," the FDA states.
If you have any questions about how to relieve your child’s teething symptoms, talk to your dentist or pediatrician.
More from MouthHealthy
Why baby teeth are so important
When your child will get (and lose) his teeth
What to know about baby bottle tooth decay
Breastfeeding and your baby's mouth
Pacifiers and thumbsucking
Timing of teething - Articles
| Checked by: Shteba Victoria Petrovna | Last revised: October 18, 2020.
Most parents are very concerned about how teething (and gums) affects their babies in everyday life. Although we cannot fully predict exactly how each baby will react to their first tooth. However, we can learn about teething symptoms and how to soothe your baby during this difficult time. In general, the more we know about teething, the better we can help our babies get through it. Let's figure it out.
Timing of teething
One of the most common questions parents ask is, “How long does it take for babies to teeth?”. It is useful to know both the time frame for the appearance of the first tooth and the time frame in which all teeth erupt. In general, teething is an ongoing process that occurs between the ages of 6 and 24 months. Although your baby has twenty milk teeth that will appear within two years, teething, fortunately, only causes pain and irritation at the time when the tooth is about to break through the gum. It is not known exactly how long it will take for a tooth to fully erupt, but on average experts say it can erupt within 1-7 days per tooth. However, teething symptoms usually only last a couple of days, so if a baby experiences discomfort for an extended period of time, it's safe to assume it's not teething.
Most babies erupt their first teeth between 6 and 7 months of age, but this may happen earlier or later. Typically, your baby's teeth are likely to appear in the following timeline windows:
During this time, the first teeth begin to erupt. The first teeth to erupt are usually the lower central incisors, which are the two middle teeth at the bottom. Children at this age become more active. They begin to grab and pull objects towards them, transfer objects from one hand to the other, and may even begin to crawl. It's important to keep an eye on small objects within your baby's reach, as he'll want to put everything in his mouth during teething!
8 to 13 months
Between 8 and 12 months your baby will have upper central incisors. In addition, sometime between 9 and 13 months they will have upper and lower teeth next to their upper central incisors (these are called lower and upper lateral incisors). In addition to teething, it is important to understand that other important milestones in gross motor development are also achieved during this developmental window. Most babies are able to sit up, stand up unassisted, take their first steps, pick up and throw objects, roll a ball, and grasp objects.
13 to 20 months
Typically, between 13 and 16 months of age, your baby's first molars appear at the bottom and top at about the same time. Shortly thereafter, their fangs will appear in both the top and bottom rows, between about 16 and 20 months.
From 20 to 30 months
At the final stage of teething, the back teeth or second molars appear in the bottom row of the baby. While most teething symptoms appear the same in both toddlers and babies, there are some differences as your baby grows older. First of all, your baby can now tell you about their discomfort and pain, unlike non-verbal babies. On the other hand, many toddlers will not show any signs of discomfort and will not complain of pain at all during the passage of molars. For other babies, the pain can be significantly worse because their first molars are larger than their other molars. They may even complain of a headache or jaw pain!
Toys that can help
Teethers - Teething toys that help to significantly relieve the symptoms of teething in children, while keeping them occupied during play. Because teething babies are always looking for something they can chew on, teething toys are specifically designed to soothe gums and temporarily ease teething.
“6 months? But my 3 month old is teething right now!”
Some babies start teething early at 6 months - and usually it's a minor thing to worry about!
Many babies begin to drool more often and explore their world by bringing their hand to their mouth to chew at about 3-4 months. This is completely normal and is often accompanied by teething after some time.
If you suspect that your little bundle of joy, which can be much less joyful during gum pain attacks, is teething, look for symptoms such as:
saliva, the surest sign;
capriciousness - unfortunately, also a frequent indicator of common childhood worries;
slight temperature increase approx. 37.2 - 38 ° C.
The bottom two teeth usually appear first, so keep an eye on this area and be prepared to be over-the-top when they appear.
When your child has their first teeth, you can use a small, soft-bristled toothbrush. You can also wipe your child's gums daily with a clean, damp cloth.
Remember that your child's pediatrician is your ally! Let him know about your child's teeth at your next appointment. The doctor can make sure that everything is in order and, if necessary, recommend visiting a pediatric dentist.
It's really impossible to tell exactly how long teething lasts, but fortunately, regardless of your baby's age or stage of teething, one of the best ways to help your little one is to provide a variety of fun and lovable teething toys.
To help relieve discomfort to the child, you can use special gels during teething. One of the best and safest is the Italian gel Dentinale natura. It is harmless if swallowed. It does not contain synthetic anesthetics and analgesics. The herbal ingredients that make up the gel relieve pain and inflammation from irritated gums. After its application, a protective film forms on the baby's gums. At this time, the baby can safely eat or sleep.
Timing of teething
The birth of a baby is happiness for any family. The first smile, the first step always brings happiness to parents. The moment of teething in a child's first teeth may not be the most pleasant for the crumbs. The child is naughty, the temperature may rise, the child becomes restless, cries often and does not sleep well. To exclude diseases that are much more difficult to diagnose in babies than in adult children, you should consult a doctor. Very often, such conditions occur at the time of eruption of the first teeth.
Due to the fact that many parents do not know at what age their children's teeth are cut, panic sets in and children are even given, in fact, unnecessary medicines for various diseases. According to statistics, this time falls on the 6th month of a baby's life. The order of teething is the same for everyone, but the timing is approximate. It happens that these boundaries are expanding, both in one direction and in the other. Sometimes a baby can be born with teeth, and sometimes they begin to erupt after a year. It all depends on genetic characteristics and the absence or presence of various diseases associated with bone tissue.
Which teeth are cut first? Usually, incisors appear first - sharp front teeth from below, then, after about a month, upper incisors appear. Next - the lower lateral incisors, then the upper ones. After all the incisors, fangs and chewing teeth appear. This period is from one to two years. It is difficult to say the timing of the eruption of milk teeth - it is very individual. By the age of three, the baby should have all the milk teeth.
Timing of teething - what mothers need to know
In general, the timing of teething is the same for all babies. The first front teeth appear at 6-8 months of a baby's life. How to understand that a child is teething, and the temperature has risen not from a cold? Look at the mouth. The gums turn red, and in places of eruption it becomes white. Saliva flows profusely, the child pulls toys and hands into his mouth, because the gum itches. These are the main symptoms that will tell every mother about the first teeth.
Another symptom may be indigestion. When the gums swell, it can be difficult for the baby to suck on the breast or bottle. He may throw food, not gorge or pass. As a result, bloating and other problems are possible, which go away as soon as the teeth erupt.
What to do when teething - tips for young mothers
First of all, if the child has a fever, the baby is naughty, and the parents cannot determine the cause, you should consult a doctor. If everything shows that these are teeth, do not panic.
Children's doctors recommend choosing a gum chew toy for your child. They are sold in children's stores and pharmacies. Most often, they are made of transparent material. When buying a chew toy, be sure to ask for a quality certificate and do not buy in spontaneous markets or kiosks. It is best to purchase it at a pharmacy, where the quality of the material will be guaranteed.
However, you should not get carried away with this toy. Milk teeth have a very short root, and strong pressure can damage it. When carried away with a teether, an incorrect bite may form, which, in turn, will interfere with the proper development of speech and chewing.
Gum creams and gels
To relieve pain and discomfort, your baby can be rubbed with a gum paste recommended by the dentist. Such gels have a general analgesic effect, relieve inflammation and soothe the baby. It is worth using gels only after consulting a doctor, weighing all the pros and cons of the drug. Applying a cool compress to the gums can soothe the baby a bit if the gums are swollen.
May, but not necessarily, disturb sleep. The baby often wakes up and cries. Some mothers immediately begin to feed the child, which is not the right choice. If the baby is not hungry, he will still suck on the breast or nipple from a bottle of milk to soothe the gums. When teething and you know for sure that the child is not hungry, use other methods to soothe the gum.
Bibs and skin creams
A child may cough when teething. This is because the baby is constantly running saliva, which he does not have time to swallow. To exclude another inflammatory process, it is worth showing the child to the doctor.
Another point that young mothers should take into account is that due to excessive salivation, redness and diaper rash may appear around the mouth and on the chin. The baby's bib should be soft so that the saliva gets wet, and does not rub and cause more irritation. To dry and soften the skin, you can use a greasy baby cream.
Choose a cream that is hypoallergenic, oily and moisturizing. In order not to harm the baby, you should choose a cream based on natural herbs. When buying, be sure to pay attention to the composition. Some herbs can individually cause allergies. It is worth using only children's certified cosmetics, and in no case should you use adult cosmetics.
Oils specially designed for the delicate skin of babies give a good effect. Of the brands, JOHNSON'S Baby cosmetic oils are the most famous and popular. They will not cause allergies, soften the skin and neutralize peeling.
We take care of teeth from the first days of life
It is worth noting that not always, when teeth are cut, all symptoms become aggravated. It happens that this process is completely painless and without problems. The main thing is to start proper care of milk teeth in order to avoid caries and the formation of malocclusion.
Pastes for babies have not yet been invented. You can teach your child to use a toothbrush after two years.