Teething

What is it?

Teething can be one of the most frustrating and heartbreaking experiences in raising a healthy child. Babies are of course born without teeth in their mouths, which makes nursing easier. But those teeth are actually in their jaws even before they are born, and they actually start to grow almost from birth. Most babies begin teething at around 4 months of age. It’s almost always the bottom teeth that emerge first – another plus if you happen to be breastfeeding, since the baby’s tongue covers the sharp little edges! The baby feels those edges, though, from inside his or her gums, as they push through. Doctors and dentists call the process of new teeth coming out "erupting," which is probably exactly what it feels like to the baby. Imagine having a very slow surgeon making an incision in your gums from the inside out!

After the two lower front teeth, the upper two usually follow, and then additional teeth erupt over the next 2-3 years. Baby’s first molars (back teeth) are usually in place by 2 years of age (doctors and dentists sometimes call this the "2-year molar").

The baby needs teeth as s/he approaches the age when solid food is appropriate, but teeth are important for another reason as well. Scientists now know that babies begin to practice using their mouths for speaking long before they ever say their first words. We use our teeth and our tongues in making words (try saying the word "teeth"), so properly formed teeth in infancy are important to our speech for the rest of our lives.

The biggest concern in teething is the baby’s comfort. Some babies get through teething without much trouble, while others seem to suffer miserably. The pain seems to be a nagging, irritating kind of pain that just won’t go away, rather than a sudden sharp pain. The other concern as more and more teeth erupt is that they come in properly. This is important not only for eating and for a nice smile in childhood, but also because the baby teeth set the stage for the adult teeth later on. This is why most doctors recommend taking your child to a dentist for a first visit at around age 2.

Many parents (and quite a few nurses and doctors) have some beliefs about teething that aren’t accurate. Many people believe that teething can cause fever, nasal congestion, rashes, or diarrhea. Recent studies have shown that, other than occasional mild facial rash and low-grade fever (below 102 °F or 38.4 °C) these things are not associated with teething.

Probably the most important thing you can do for your teething baby is to understand how uncomfortable s/he is. Extra love and attention can be very helpful. Properly designed and built teething toys are also very helpful. A good teething toy or ring has no loose parts that could come off – those are choking hazards to the baby. Most teething toys are made of a semi-hard plastic-like material that the baby can rub against his or her painful gums. Some people recommend putting the toy in the refrigerator to make it cool, which may soothe the gums. Unless specifically instructed, please don’t put the toy in the freezer – this could hurt your baby’s delicate gums. Many babies like to just chew on their own hand, or on their parent’s knuckle.

You can use one of the over-the-counter oral gels that contain benzocaine (Anbesol®, Ora-Base-B®, Orajel®, and others), but please check with your doctor first. Benzocaine is safe when used as directed, but it can cause serious side effects, including seizures, if your baby gets too much of it. Benzocaine gels are for use only on the gums – please don’t give it to your baby as an oral medicine for him or her to swallow.

You can also give your child acetaminophen (Tylenol®) or ibuprofen (Advil® or Motrin®) as directed for pain. Please avoid giving either of these medications for more than three days in a row; they can cause harmful side effects.

Teething doesn’t usually cause worrisome conditions. Babies can get cranky for other reasons, though, so if your baby seems unusually fussy or irritable, please be sure to look him or her over for something else that could be causing it. Here are a few things to watch for that are probably not caused by teething:

• Fever over 102 °F or 38.4 °C
• Cough
• Diarrhea and/or vomiting
• Extreme irritability or fussiness
• Crying non-stop for more than 4 hours
• Evidence of abdominal pain such as pulling up the knees
• If any of these occur, please be sure to call your doctor’s office right away.

Almost everyone has heard some home remedy or folk remedy for teething. There’s usually nothing wrong with these remedies, and if you want to use one it’s probably fine. Please do just let your doctor know what you are using and how you are using it, so that s/he can know about it and be sure s/he doesn’t prescribe any medicine that might interfere. A few folk remedies can be dangerous for small babies, especially those that contain oils or alcohol. Please check with your doctor before you use any such medicine for your baby. Also, please avoid using any so-called "teething pills." These are a choking hazard.

Crying babies are frustrating for parents and others who care for them – no matter how much they really love the baby. When a person has other stresses in their life, like financial or marital problems, the frustrations all add up. Sometimes people take out their frustration on the baby – not even always on purpose. It’s easy to be so desperate for a moment’s peace and quiet that you try to calm the baby too vigorously. Babies love to be rocked to sleep – frustrated parents can rock too hard, or even shake a baby without really meaning to. NEVER, EVER, SHAKE A BABY. If you feel yourself getting overwhelmed, get out, even for a minute or two. There are times when a baby is safer in a crib with the parent standing in the yard cooling off for just a few minutes.

Other things that can make a baby cry or fuss a lot can include a scratch on the eye (corneal abrasion), or a bit of hair or thread wrapped around a small part like finger or toe. Bad constipation can also cause a baby to cry for long periods. Finally, a broken bone can be a cause of pain that the baby can’t tell you about. Sadly, this kind of injury is often the result of someone hurting the baby. It’s best to get medical care right away, no matter what, if you think that might have happened to your baby.

Caring for a teething child can be tiring and frustrating. As badly as you feel for your child, you yourself may feel out of control, inadequate, or even angry – these are normal feelings. Teething babies are often fussy and irritable, and parents often feel stressed to the breaking point, especially when there are other children or adults to take care of. One of the best things you can do for your child is to be sure you take care of yourself. If possible, try to have other adults take care of your child for an hour or two each day so you can get some rest or just some quiet time. If you get so stressed that you are worried about your baby’s safety, call your local Parents’ Anonymous Hotline or visit the Parents Anonymous website to find a group near you.