Teething

Teething is a normal part of your baby's development. The first tooth to appear is usually one of the lower front teeth (central incisors), which generally erupts between 4 and 12 months of age. A few infants get their first tooth before 4 months; some do not get their first tooth until after their first birthday. Several months may pass between the time when you see the first two lower teeth and the next teeth, which are usually the upper central teeth.

The salivary (spit) glands of infants begin to work at about 2 to 3 months of age, at which time you will notice that your baby drools constantly. Parents often think that drooling is a sign of teething, but it is just part of your baby's normal development (as is putting the hands in the mouth). Likewise, parents often associate waking at night with teething, but waking is more often related to changes in your baby's environment or behavior or development changes than it is to teething. If you have concerns about your child waking often at night, please see Night Awakening.

For centuries, parents and physicians have believed that teething can cause pain, fever, diarrhea, and many other symptoms. Despite recent research, we still do not know how teething affects an infant. There does not seem to be one specific symptom that can tell us that a child is teething, and there is no symptom that predicts that a tooth is about to erupt. Increased biting, gum rubbing, wakefulness, and decreased appetite for solids may predict teething, but not necessarily. Most parents believe that their infant is more fussy and irritable when teething, but even this is not true of every baby.

Teething does not cause diarrhea or fever, although it may cause a very slight increase in your baby's normal temperature. If your child has a rectal temperature above 38° C (100.4° F), however, teething is probably not to blame--it's most likely a virus.

If you believe your child is teething, you can help him (or her) feel more comfortable by:

Allowing him to bite on something cold— such as a clean, damp wash cloth, chilled (but not frozen) teething ring, frozen bagel, or frozen banana. A Popsicle also can be given to an older infant.
Giving acetaminophen or ibuprofen, especially one daily dose just before bedtime..
Topical anesthetic agents, such as Oragel, Numzit, or Anbesol, may cause a serious reaction in some babies; their use is therefore discouraged by many experts.
Please call the pediatrician if you have any questions about teething. If your child appears ill—especially if his temperature is above 38° C (100.4° F)—do not assume that teething is the cause. Instead call your pediatrician for advice.

Adapted from Contemporary Pediatrics 07/2004