Teething

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Teething

What is teething?
Teething is the normal process of new teeth working their way through the gums. Your baby's first tooth may appear any time between the time he is 3 months to 1 year old. Most children have completely painless teething. The only symptoms are increased saliva, drooling, and a desire to chew on things. Teething occasionally causes some mild gum pain, but it doesn't interfere with sleep. The degree of discomfort varies from child to child. Your child won't be miserable. When the back teeth (molars) come through (age 6 to 12 years), the overlying gum may become bruised and swollen. This is harmless and temporary.

Because teeth erupt almost continuously from 6 months to 2 years of age, many unrelated illnesses are blamed on teething. Fevers are also common during this time because after the age of 6 months, infants lose the natural protection provided by their mothers' antibodies.

Which baby teeth come in first?
Your baby's teeth will usually erupt in the following order:

2 lower incisors
4 upper incisors
2 lower incisors and all 4 first molars
4 canines
4 second molars.
How can I take care of my child?
Gum massage
Find the irritated or swollen gum. Massage it with your finger for 2 minutes. Do this as often as necessary. You may also massage the gum with a piece of ice.

Teething rings
Your baby's way of massaging his gums is to chew on a smooth, hard object. Teethers or teething rings are helpful. Most children like them cold. Offer a teething ring that has been chilled in the refrigerator, but not frozen in the freezer. A piece of chilled banana may help. Avoid ice or Popsicles that could cause frostbite of the gums. Also avoid hard foods that he might choke on (like raw carrots). Teething biscuits are fine.

Diet
Avoid salty or acid foods. Your baby probably will enjoy sucking on a nipple, but if he complains, use a cup for fluids temporarily.

Pain medicine
If the pain increases, give acetaminophen (Tylenol) for 1 day. Special teething gels are unnecessary and probably not beneficial. Many teething gels contain benzocaine, which can cause an allergic reaction. In addition it's unlikely they can numb the gums because they are washed out of the mouth and swallowed within a few minutes. If you still want to use a gel, do not apply it more than 4 times a day.

Common myths about teething
Teething does not cause fever, sleep problems, diarrhea, diaper rash, or lowered resistance to any infection. It probably doesn't cause crying. If your baby develops fever while teething, the fever is caused by something else.
Don't tie a teething ring around your baby's neck. It could catch on something and strangle your child. Attach it to your baby's clothing with a "catch-it-clip."
When should I call my child's health care provider?
Call during office hours if:

Your child develops a fever over 101°F, or 38.3°C.
Your child develops crying that doesn't have a cause.
You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Published by McKesson Provider Technologies.
Last modified: 2005-03-14
Last reviewed: 2005-03-01
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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