Teething is an important milestone in a child’s life. Although it can be a painful time for the child and parents alike, how you care for your child’s teeth is important. According to pediatricians at University of Utah Health, questions about teething are common. Here are some answers about your baby’s teeth.
When will my baby have their first tooth?
It’s important to keep in mind that all babies vary. The most common time for babies to start teething is between four and seven months old—with the first tooth appearing at six months old. The two bottom teeth usually come through first, followed by the two top teeth. You’ll most likely talk about this with your pediatrician at your child’s two- and four-month-old visit.
While most kids will have at least one tooth by six months, some children don’t have teeth on their first birthday—but don’t panic. Usually by 15 months, pediatricians will begin to look into whether there’s an issue.
What are common signs of teething?
Some signs of teething include:
- Fussiness
- Excessive drooling
- Chewing on objects
- Sore or tender gums
- Elevated temperature (less than 100 degrees)
If your child has symptoms of high fever (100.4 or greater), diarrhea, significant diaper rash, cough, congestion, vomiting, or acting ill, then they should be evaluated by a doctor. "A lot of parents will say, ‘Oh, they have a fever of 102, they must be teething,’ but that’s not teething—it’s a true fever," says Elizabeth Smith, MD, associate professor in the Department of General Pediatrics at University of Utah Health. "And if those things persist, they need to be evaluated for another cause."
My baby is drooling—does that mean they’re teething?
While drooling can be a sign of teething, it’s most likely a developmental sign between two and three months of age. "Kids find their hands at this age, and as soon as they see them, they bring their hands to their mouth," Smith says. "This is what stimulates saliva production." Developmentally, most kids get very drooly by three months.
My child is fussy—are they teething?
A child tends to be fussier before the tooth shows, but not all children have the same fussiness. Some children that are teething may not be fussy at all. Smith says most parents feel like the molars cause more fussiness due to more surface area coming through the gums. Fussiness from teething should last one to two weeks at the most.
My child is not sleeping through the night—is it teething?
Smith says this is a common question she receives. She tells parents that teething can cause a child to be fussier or wake up more at night. But if fussiness is persistent or seems abnormal, the child should be seen by a doctor.
What can I do to help my teething child?
There are several things a parent can do to help a teething child. One of the most helpful things is giving them something to chew on, such as a solid teething ring or a wet or frozen wash cloth. "This gives them the stimulation of cold, which can numb any pain or swelling they are having," Smith says.
Medications like acetaminophen or ibuprofen can also be helpful, but Smith cautions parents about using them around the clock for weeks on end. "A dose here and there, especially before bedtime, is appropriate," Smith says. "Parents should check with their child’s doctor about dosage to make sure they’re giving them an appropriate dose."
Pediatricians like Smith do not recommend several products. "There’s a lot of stuff that is sold to parents or marketed to them that probably doesn’t help much and is not recommended by pediatricians," she says. These include:
- Fluid-filled teething rings: Some studies have found potentially harmful chemicals inside these rings, which can contain bacteria and cause infections if the child were to puncture the ring.
- Teething tablets or benzocaine numbing gels: According to the Food and Drug Administration (FDA), topical medications for teething pain in children offer little to no benefit and can have serious risks.
- Amber necklaces: These necklaces can be a choking hazard or a strangulation risk. The FDA advises parents not to use them.
- Alcohol on the gums of any sort should never be used on your baby.
What are the stages of teeth?
In total, there are 20 primary teeth or baby teeth—10 lower teeth and 10 upper teeth. Most children will have their primary teeth by the age of three. The second molars usually develop between two and three years old.
When will my child’s teeth fall out?
The most common time for children to start losing their teeth is around their sixth birthday. That’s when they will lose all 10 of their primary teeth—between the ages of six and 12.
How can parents help care for their child’s teeth?
Parents should start helping their child with their teeth when they first erupt. Smith recommends initially wiping the tooth with a washcloth until it comes fully through the gums. Then, parents should start brushing their child’s teeth with a soft toothbrush.
Smith recommends using a rice-sized amount of fluoride toothpaste. "Fluoride helps with the outer surface of the tooth and helps prevent tooth decay," Smith says. "Fluoride is helpful even when the teeth are developing under the gums." Aside from fluoride, Smith says other ingredients like whitening and tartar control are unnecessary. She also recommends finding a dentist for your child by age one—if your child has teeth.
Did you know? Parents can ask their pediatricians about applying fluoride varnish starting at six months (if a baby has teeth). Fluoride varnish is a dental treatment that can help prevent tooth decay. This can be applied up to four times a year until the child has all their primary teeth.