Teething time: How to care for your baby’s new teeth

As a pediatrician, I often get asked about teething so I wanted to offer some tips for parents. 

When does the first tooth come in? 

Teething usually starts sometime between 4 to 7 months, but every baby is different. Some babies will not get the first tooth until after their 1st birthday! Typically, the two front bottom teeth come first, but that can also vary and is not anything to worry about. 

Signs that teething is starting include drooling, gnawing on hands or other object and just seeming uncomfortable. Sometimes you may notice their gums are swollen or even see bumps where the teeth will come through. Other symptoms may include low grade fever (typically not above 100.4 degrees) and diarrhea. Often, your child may show signs of teething for weeks before you see the first tooth. If you have any concerns that your baby’s symptoms are not related to teething, I recommend contacting your child’s pediatrician to discuss further. 

Soothing your baby’s discomfort

It’s never easy to see a baby in pain, but there are things you can do to help soothe your baby as their teeth come in. Teething pain is usually most severe in the days before a tooth cuts through the gums.

Teething toys: Find something for your baby that is cool to the touch but tough to chew on. Make sure whatever you give your baby, it is big enough so they will not choke on it. A few ideas include: 

• You can stick a wet washcloth in the freezer for about 20-30 minutes. If you can knot it or twist it, it will last a little longer. 

• A chilled, but not frozen, solid teething ring (not liquid filled, more on that later).

• If your baby has been introduced to solids, try freezing banana or strawberry slices to gnaw on. 

• Frozen bagel slices work, too.

Please note: Keep an eye on your baby while they are trying out items to soothe their teething pain, especially food. Chunks bigger than what they are able to swallow can break off, which can lead to choking.

Massage: A light, gentle massage can help give your baby a little relief. Make sure you wash your hands and rub with your finger or knuckle. This works best before their first teeth arrive.

Medication: If your baby is really uncomfortable, talk to your pediatrician about over-the-counter pain relievers like Tylenol.

Avoid these products for teething

Liquid filled teething toys: Kids with a strong bite can chew leaks in them and the liquid inside can potentially have bacteria growing in it. 

Teething necklaces and bracelets: I’ve seen teething bracelets and necklaces made of amber, wood, marble and silicon. Don’t use these. If they break, they pose a choking hazard and anything around the neck can present a strangulation risk.

Benzocaine or other numbing medications: These are products that claim to numb your baby’s gums. In most cases, it’s a waste of money because the baby’s saliva naturally washes it away. In other cases, it can numb your baby’s throat and interfere with their ability to swallow. Please also note that adult products for numbing tooth and gum pain are not recommended for babies.

Teething tablets: Some may claim to be all natural, which sounds safe, but many contain a plant poison called belladonna. The FDA has issued warnings on these kinds of gels and tablets for teething due to potential side effects.

Caring for teeth

Now that your baby has teeth, how do you care for them? Is it too soon to brush? The answer is no! Start taking care of teeth when they appear. Put a little dot of fluoride toothpaste on a soft baby-size toothbrush or even your finger, and then gently smear it on your baby’s teeth. This is especially important to do after the last drink or food of the day. Remember not to put your baby to bed with a bottle as this can cause tooth decay. I also recommend scheduling your child’s first dentist appointment after the first tooth comes in. Taking care of their teeth is an important part of taking care of your baby’s overall health.

While I’ve just focused on the first two teeth that poke through, your kids won’t have all 20 of their baby teeth until they are about 3 years old. They will experience teething discomfort on and off, and molars can be especially uncomfortable. If your child seems to be experiencing anything abnormal, check with your pediatrician or dentist to make sure it’s not something besides teething. 

Anjali Sharma, MD Pediatrician Pewaukee Pediatrics

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