A Teething Tutorial: Recognizing Signs & Addressing Symptoms
Few topics regarding infant health have gone through wider swings in medical opinion than teething. Just over a century ago, teething was actually considered the leading cause of infant death. By the turn of the 21st century, popular opinion swung entirely in the opposite direction, pronouncing that teething probably did not produce any symptoms at all -- no pain, crying, or problems sleeping.
Most parents know that this isn’t true from firsthand experience and I strongly believe that teething can be an uncomfortable process. For a baby, the mouth is an exquisitely sensitive portal connecting the world around him to his developing mind and body. When the mouth becomes a source of pain or even change, it can be quite unsettling. Some kids get used to it quickly, but at first, it can be more uncomfortable than a pebble in a shoe.
Typically, the first teeth appear between five and seven months of age, but there is a wide variation of timing that’s considered normal. First teeth might come in as early as one month of age, or they might not appear until a child is almost one-and-a-half-years old. Anything in this range can be normal, but typically if no teeth have appeared by one year of age, I recommend a dental visit just to be sure everything is growing fine.
Generally, lower teeth come in before upper teeth, and generally, girls' teeth erupt earlier than those of boys (much like with everything else).
The actual experience of teething usually starts about 2 months before the first tooth erupts, and symptoms may occur intermittently for up to 20 to 30 months - until all of the primary teeth have grown in. But, don’t worry, most children do not have major symptoms with each tooth.
How a child responds or what kinds of symptoms appear varies from child to child. It is often the first tooth that causes the most discomfort -- or those big molars, when they arrive. For many babies, working on several teeth at once is the worst.
In some children, teething can cause irritability, low-grade fevers, increased saliva and mucus, or loose stools. Parents may notice their babies drooling and bringing their hands to their mouths.
Try these simple remedies to help soothe a sore mouth:
Massage -- You’ll notice when babies are teething, they bring their hands to their mouths because pressure on the gums brings relief. But, massage tends to be more soothing when it comes from someone else. Rub your child’s gums firmly and gently with a clean finger. (At first your baby might find this a bit uncomfortable, but don’t give up - babies get more and more relaxed as the massage continues.)
Something cool to chew on -- Wet washcloths or terrycloth toys fresh from the fridge or freezer have been the most popular with babies and toddlers in my practice. Some babies are delighted with smooth, hard objects, like the handle of a hairbrush or even a spoon. And many babies go gaga over teethers. Whatever you choose, be sure it’s not something your child could choke on. (And, even if you’re in a pinch - don’t let babies chew on your keys. I see it all the time, but many keys contain lead which is a dangerous neurotoxicant even in very small amounts.)
Homeopathic teething tablets or natural teething gel --Many parents report that these gentle remedies have been lifesavers.
Infant pain-relievers -- Infant acetaminophen or ibuprofen can provide stronger pain relief on occasion, if necessary.
Topical anesthetic gels have mixed results. I do not routinely use or recommend them. They do indeed deaden the pain, but many babies object to the strange sensation of mouth numbness. The medicines can also suppress the normal protective gag reflexes, as well as trigger allergic reactions in some children. If you choose to use them for your baby, a little bit often works better than a lot.