Teething

Teething

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Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

• What is teething?
• When do babies start teething?
• What are the signs and symptoms of teething?
• What is the order of tooth eruption in infants?
• How long does teething last?
• When should I call the pediatrician?
• What medications are used to treat teething pain?
• What home remedies provide relief for teething pain?
• How do I care for my baby's new teeth?
• When should my child see the dentist?
• Teething At A Glance

What is teething?

Teething is the process by which an infant's teeth erupt, or break through, the gums. Teething is also referred to as "cutting" of the teeth. Teething is medically termed odontiasis.

When do babies start teething?

The onset of teething symptoms typically precedes the eruption of a tooth by several days. While a baby's first tooth can present between 4 and 10 months of age, the first tooth usually erupts at approximately 6 months of age. Some dentists have noted a family pattern of "early," "average," or "late" teethers.

A relatively rare condition, "natal" teeth, describes the presence of a tooth on the day of birth. The incidence of such an event is one per 2,000-3,000 live births. Usually, this single and often somewhat malformed tooth is a unique event in an otherwise normal child. Rarely, the presence of a natal tooth is just one of several unusual physical findings which make up a syndrome. If the possibility of a syndrome exists, consultation with a pediatric dentist and/or geneticist can be helpful. The natal tooth is often loose and is commonly removed prior to the newborn's hospital discharge to lessen the risk of aspiration into the lungs.

What are the signs and symptoms of teething?

Teething is generally associated with gum and jaw discomfort as the infant's tooth prepares to erupt through the gum surface. As the tooth moves beneath the surface of the gum tissue, the area may appear slightly red or swollen. Sometimes a fluid-filled area similar to a "blood blister" may be seen over the erupting tooth. Some teeth may be more sensitive than others when they erupt. The larger molars may cause more discomfort due to their larger surface area that can't "slice" through the gum tissue as an erupting incisor is capable of doing. With the exception of the eruption of the third molars (wisdom teeth), eruption of permanent teeth rarely cause the discomfort associated with eruption of "baby" (primary or deciduous) teeth.

Teething may cause the following symptoms:

• increased drooling,



• restless or decreased sleeping due to gum discomfort,



• refusal of food due to soreness of the gum region,



• fussiness that comes and goes,



• bringing hands to the mouth,



• mild rash around the mouth due to skin irritation secondary to excessive drooling, and



• rubbing the cheek or ear region as a consequence of referred pain during the eruption of the molars.

Importantly, teething is not associated with the following symptoms:

• fever (especially over 101 F),



• diarrhea, runny nose and cough,



• prolonged fussiness, or



• rashes over the body.