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 Tots (for Parents) - Nemours KidsHealth
What Is Teething?
Teething is when teeth first come through a baby's gums. It can be a frustrating time for babies and their parents. Knowing what to expect during teething and how to make it a little less painful can help.
When Does Teething Start?
While teething can begin as early as 3 months, most likely you'll see the first tooth start pushing through your baby's gum line when your little one is between 4 and 7 months old.
The first teeth to appear usually are the two bottom front teeth, also known as the central incisors. They're usually followed 4 to 8 weeks later by the four front upper teeth (central and lateral incisors). About a month later, the lower lateral incisors (the two teeth flanking the bottom front teeth) will appear.
Next to break through are the first molars (the back teeth used for grinding food), then finally the eyeteeth (the pointy teeth in the upper jaw). Most kids have all 20 of their primary teeth by their third birthday. (If your child's teeth come in much slower than this, speak to your doctor.)
In some rare cases, kids are born with one or two teeth or have a tooth emerge within the first few weeks of life. Unless the teeth interfere with feeding or are loose enough to pose a choking risk, this is usually not a cause for concern.
What Are the Signs of Teething?
As kids begin teething, they might drool more and want to chew on things. For some babies, teething is painless. Others may have brief periods of irritability, while some may seem cranky for weeks, with crying spells and disrupted sleeping and eating patterns. Teething can be uncomfortable, but if your baby seems very fussy, talk to your doctor.
Although tender and swollen gums could cause your baby's temperature to be a little higher than normal, teething doesn't usually cause high fever or diarrhea. If your baby does develop a fever during the teething phase, something else is probably causing the fever and you should contact your doctor.
How Can I Make Teething Easier?
Here are some tips to keep in mind when your baby is teething:
Gently wipe your baby's face often with a cloth to remove the drool and prevent rashes from developing.
Rub your baby's gums with a clean finger.
Give your baby something to chew on. Make sure it's big enough that it can't be swallowed or choked on and that it can't break into small pieces. A wet washcloth placed in the freezer for 30 minutes makes a handy teething aid. Be sure to take it out of the freezer before it becomes rock hard — you don't want to bruise those already swollen gums — and be sure to wash it after each use.
Rubber teething rings are also good, but avoid ones with liquid inside because they may break or leak. If you use a teething ring, chill it in the refrigerator, but NOT the freezer. Also, never boil to sterilize it — extreme changes in temperature could cause the plastic to get damaged and leak chemicals.
Teething biscuits and frozen or cold food are only OK for kids who already eat solid foods. Don't use them if your child has not yet started solids. And make sure to watch your baby to make sure that no pieces break off or pose a choking hazard.
If your baby seems irritable, ask your doctor if it is OK to give a dose of acetaminophen or ibuprofen (for babies older than 6 months) to ease discomfort.
Never place an aspirin against the tooth, and don't rub alcohol on your baby's gums.
Never tie a teething ring around a baby's neck or any other body part — it could get caught on something and strangle the baby.
Don't use teething necklaces made of amber. These can lead to strangulation or choking if pieces break off.
Don't use teething gels and tablets because they may not be safe for babies.
How Should I Care for My Baby's Teeth?
The care and cleaning of your baby's teeth is important for long-term dental health. Even though the first set of teeth will fall out, tooth decay makes them fall out more quickly, leaving gaps before the permanent teeth are ready to come in. The remaining primary teeth may then crowd together to attempt to fill in the gaps, which may cause the permanent teeth to come in crooked and out of place.
Daily dental care should begin even before your baby's first tooth comes in. Wipe your baby's gums daily with a clean, damp washcloth or gauze, or brush them gently with a soft, infant-sized toothbrush and water (no toothpaste!).
As soon as the first tooth appears, brush it with water and fluoridated toothpaste, using only a tiny amount.
It's OK to use a little more toothpaste once a child is old enough to spit it out — usually around age 3. Choose one with fluoride and use only a pea-sized amount or less in younger kids. Don't let your child swallow the toothpaste or eat it out of the tube because an overdose of fluoride can be harmful to kids.
By the time all your baby's teeth are in, try to brush them at least twice a day and especially after meals. It's also important to get kids used to flossing early on. A good time to start flossing is when two teeth start to touch. Talk to your dentist for advice on flossing those tiny teeth. You also can get toddlers interested in the routine by letting them watch and imitate you as you brush and floss.
Another important tip for preventing tooth decay: Don't let your baby fall asleep with a bottle. The milk or juice can pool in a baby's mouth and cause tooth decay and plaque.
The American Dental Association (ADA) recommends that kids see a dentist by age 1, or within 6 months after the first tooth appears, to spot any potential problems and advise parents about preventive care.
Reviewed by: Larissa Hirsch, MD
Date reviewed: January 2018
When do baby's first teeth erupt?
All babies teething according to their own individual program: for some, this process begins earlier, for others later. As practice shows, the first tooth in most children appears at the age of 6 to 8.5 months, and by the year every healthy child has at least one milk tooth in his mouth.
At the age of three or four months, teeth preparing for eruption begin to actively declare themselves: the baby becomes capricious, cries, tries to bite everything that gets into his hands.
The first to appear are usually the two lower, centrally located teeth (lower central incisors or "ones"). Then - the central upper incisors, after which, by about ten months, the upper "twos", or lateral upper incisors, erupt. By eleven to twelve months, the lateral incisors can also be seen on the lower jaw. Thus, ideally, a one-year-old child is the proud owner of eight milk teeth.
By about sixteen months, many babies already have first molars on the bottom and top. Fangs ("threes") appear at the top and bottom later, in the eighteenth - twenty-second month of a child's life. The second upper and lower molars erupt at the age of 24-33 months. But again, it should be remembered that this process is individual and the order of teething may also be different.
Teeth often grow in pairs: two, and sometimes four at the same time. In girls, for the most part, teeth erupt earlier than in boys. By the age of 2.5-3 years, a complete set of twenty fully erupted teeth can be found in a baby.
Alertness must be shown if a child who is almost a year old does not have a single tooth. In principle, some children may have a congenital feature in the form of late teething, but you should not draw any conclusions on your own, you should definitely consult with a qualified specialist who, if necessary, will prescribe additional examinations.
Causes of late teething in children:
hereditary predisposition, which is a variant of the norm and can be traced in other blood relatives;
decreased thyroid function;
diseases of the digestive system;
violations of enzymatic (fermentation) metabolism;
lack of calcium in the child's body;
genetically determined diseases.
For the baby himself, the process of teething can proceed in different ways. Some children practically do not experience discomfort, others suffer from pain, their sleep is disturbed, their appetite worsens, their temperature rises (up to 38-39 ° C), salivation increases, nasal congestion, wet cough (due to profuse salivation), constipation or, conversely, , increased stool.
Experts recommend starting caring for the child's oral cavity even before the first teeth erupt: in the morning and evening, before going to bed, the child's gums should be gently wiped with a swab previously moistened with warm water. After the first teeth appear, you need to clean them with a special fingertip brush, which can also be used to massage the gum tissue. The front teeth should be cleaned with vertical movements, the side teeth with circular movements.
The network of Healthy Smile dental clinics employs experienced pediatric dentists, to whom you can book your baby for a free consultation.
Healthy Smile clinics provide discounts for regular customers, family discounts, various payment methods are possible, and the list of promotional offers to reduce the cost of certain types of services, including for children, is regularly updated.
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First teeth - articles from the specialists of the clinic "Mother and Child"
Bogorad Maria Vladimirovna
Ophthalmologist, Ophthalmologist for children
Clinic "Mother and Child" Kuntsevo, Clinical Hospital Lapino-1
When to expect
The milk teeth of the future baby are laid at the 7th–8th week of intrauterine development, and the permanent teeth at the end of the 4th month of pregnancy. In total, 20 milk teeth are laid in a child, while permanent ones - 32. To provide the crumbs with a Hollywood smile, the expectant mother needs to eat right throughout all nine months of pregnancy. There are no calcium preparations that would be 100% absorbed, so it is very important to draw “natural” calcium from food, especially cottage cheese. And, of course, the most pregnant woman needs to cure all her teeth - now there are very sparing technologies for this.
The eruption of the first milk teeth in most cases begins at the 3-8th month of a baby's life and ends closer to three years. But it also happens that children are born already with one or two teeth, or teeth can erupt in the first weeks of life. Often the timing of teething depends on genetic characteristics, but much more - on other factors. They affect the teeth and diseases of the crumbs (for example, with rickets, frequent SARS and dyspepsia, teeth erupt later). It is worth paying attention to the nature of nutrition, the quality of drinking water, even the climate! In northern residents, teeth erupt on average a little later than in southerners. Sometimes teething is delayed, and the first tooth appears closer to the year. Usually there is nothing wrong with this. It is believed that not so much the timing as the order of teething speaks about the health of the child. If it is broken, pay attention to this fact and show the baby to a pediatric dentist.
The process has begun
Profuse salivation indicates that the teething process has begun. In addition, the baby begins to pull into his mouth everything that only comes to his hand. This means that the gums itch, causing him discomfort. Trying to relieve itching, the baby instinctively acts correctly - micro-massage of the gums improves microcirculation in them, teeth erupt easier and faster. During this period, provide the child with teethers: hypoallergenic silicone toys filled with water. The teether should not be cooled in the freezer - only in the refrigerator: otherwise the crumb will get hurt on a hard surface. If the gums are very swollen, and the baby is crying in pain, use special dental gels that have a mild local anesthetic effect.
For most children, the process of teething goes fairly smoothly. There may be short periods of anxiety, violations of the regime of the day and nutrition. Sometimes even teething is accompanied by diarrhea, runny nose, cough and fever. And during the period of the appearance of teeth, the baby is vulnerable to all kinds of infections. The immunity of the crumbs decreases these days, and it is easier to “pick up” the virus, so it’s not worth writing off the worsening of the condition only on the teeth. If a child has a fever when a tooth is cut, it is necessary to look for another inflammatory focus in the body.
At 6 months the baby usually boasts central lower incisors. This is an excuse to start brushing your teeth. Why so early? Milk teeth are small and sharp, have an uneven wavy edge, are close to each other and, as a rule, have a yellowish tint. These teeth have a low degree of mineralization. Their enamel and dentin are very thin. All this contributes to the rapid emergence and spread of caries. In order to prevent it, you need to brush your teeth regularly: for this, you can use various massage brushes that not only teach the child to hygiene, but also facilitate the process of teething. Teeth are immediately taught to clean correctly - from the gums to the edge, slightly "sweeping", semicircular movements, and in no case horizontal. If possible, brush your teeth after every meal (and at least twice a day). Is there no such possibility? Give the baby a drink - the water will wash away the remnants of food.
At 8 months the upper central incisors usually erupt. In 9 months the upper lateral incisors appear. At 11 months and the lower lateral incisors are already in place in many children! By , the baby has eight normal teeth . But there may not be a single one - delayed teething occurs in 25% of cases with normal psychomotor development of the child. In extremely rare cases, the absence of teeth is associated with adentia - the absence of their rudiments. You can check this with a pediatric dentist using the radiovisiography method. By 13–15 months , first the upper first molars appear, and then the lower ones.
From the age of one, the baby's teeth can be brushed with children's toothpaste and a special children's brush. The service life of the brush is no more than 2 months, even if it looks like new. Many babies swallow delicious pasta. You should not be afraid of this if it is childish and its quantity is no more than a pea. Of course, up to 2–2.5 years, brushing your teeth should be done with the help of, and then under the vigilant control of your mother.
B 18 months fangs erupt. Usually these teeth cause more problems than others, their eruption is more painful, and this process is often accompanied by malaise. At 20 months the second molars erupt. And sometimes already at this age, the mother may notice the first problems. Doctors reassure: carious milk teeth are not a reason to worry that permanent ones will also be bad. As practice shows, there are no regularities here. Of course, if parents do not neglect the prevention of diseases and dental hygiene. At 2.5 years old, a normal baby has a full set of milk teeth. There are 20 of them - 10 on each jaw .
Milk teeth do not last long - soon they will fall out and permanent ones will appear in their place. Usually the change of teeth begins at about 5-6 years and lasts until 20, when the wisdom teeth erupt.
From the age of 6 months, it is obligatory to come for preventive examinations twice a year. When this becomes a habit, the baby will not be afraid of doctors, and by the age of 7–8 (when a visit to the clinic can no longer be avoided) he will sit in the dental chair quite calmly
In order for the baby's teeth to grow strong and healthy, you need to start taking care of them almost before conception. And it is also better to get to know the dentist early
Terms of eruption and loss of milk teeth
8 months - 1 year
6-7 years old
9 months - 1 year 2 months
7-8 years old
1 year 3 months - 1 year 10 months
10-12 years old
1 year - 1 year 6 months
9-11 years old
2 years - 2 years 8 months
10-12 years old
6 months -10 months
6–7 years old
10 months -1 year 4 months
7-8 years old
1 year 4 months - 2 years
9-12 years old
1 year 2 months - 1 year 7 months
9-11 years old
1 year 10 months - 2 years 8 months
10-12 years old
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to the doctor - Bogorad Maria Vladimirovna
Clinical Hospital Lapino-1 "Mother and Child" Clinic "Mother and Child" Kuntsevo
Pediatric Ophthalmology for ChildrenOphthalmology
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