May 28, 2024
Signs of Teething in Babies

Teething is an important developmental milestone that most babies go through starting around 6 months of age. As babies’ teeth begin pushing through the gums, they can experience some discomfort. While teething is a natural process, it can be distressing for both babies and their caregivers. Understanding the common signs of teething can help provide relief and reassurance. So, let me tell you some really important things about baby teething and significant signs of the process.

The Teething Process

Teething occurs when a baby’s teeth begin emerging through the gums. The first teeth that typically erupt are the lower central incisors around 6-10 months, followed by the upper central incisors around 8-12 months. Teeth generally emerge through the gums in pairs. All 20 primary teeth should be present by around 3 years of age.

The teething process is facilitated by localized inflammation in the gums caused by pressure from the tooth cutting through. This inflammation leads to symptoms like tender, swollen, or bleeding gums. Teething may occur with varying degrees of difficulty depending on the baby. Some babies experience very mild or no discomfort, while others find it more troublesome.

Common Signs and Symptoms

Some of the most common signs and symptoms associated with teething include:

  • Irritability or fussiness – Due to discomfort, babies may cry more than usual or have trouble sleeping
  • Drooling – Excess drool and damp clothing from constant drooling are hallmarks of teething. The extra saliva may also cause a facial rash.
  • Gum swelling and sensitivity – The gums around erupting teeth may be tender, red, and inflamed. One cheek may appear flushed.
  • Biting or chewing behaviors – Babies may gnaw on toys, clothing, or their own hands. This pressure on the gums brings relief.
  • Low grade fever A slightly elevated temperature under 100°F can sometimes accompany teething but higher fevers indicate illness rather than teething.
  • Rash around the mouth – Caused by drool and irritation

Symptoms typically onset about 3-5 days before a tooth emerges and peak on the day the tooth breaks through the gums. Symptoms tend to resolve once the tooth has fully erupted. However, teething is a cyclical process that may cause discomfort on and off until all baby teeth have emerged.

Teething Pain Relief Methods

Here are some evidence-based methods to help relieve teething discomfort:

Local Pain Relief

  • Gently rub swollen gums with a clean finger or wet washcloth
  • Allow baby to chew on a chilled (not frozen) teething ring or wet washcloth
  • Use an over-the-counter oral anesthetic gel or solution under medical supervision

Systemic Pain Medication

  • Give appropriate dose of infant acetaminophen or ibuprofen for pain and fever
  • Homeopathic tablets or granules can provide soothing relief

Other Soothing Techniques

  • Gently massage gums with clean fingers
  • Provide cold items like refrigerated (not frozen) fruits or vegetables to chew on
  • Distract baby with songs, toys, or books
  • Ensure baby remains well-hydrated

Caregivers should avoid teething gels containing benzocaine or lidocaine due to the risk of methemoglobinemia. Only use systemic medications under the guidance of a pediatrician and avoid any unproven home remedies.

Teething Timeline

While every baby is different, here is a general timeline for primary tooth emergence:

6-10 months: Lower central incisors
8-12 months: Upper central incisors
9-13 months: Upper lateral incisors, lower lateral incisors
14-18 months: First molars
16-22 months: Canines
17-23 months: Second molars

Typically, the two lower central incisors come in first around 6-10 months of age, followed by the four upper incisors. The first molars don’t usually emerge until around 14-18 months. All 20 primary teeth should have erupted by age 3. If a child is older than 3 and lacks some baby teeth, see a pediatric dentist.

Teething Myths and Facts

There are many myths surrounding teething. Here are some common teething myths and corresponding facts:

Myth: Teething causes fever over 100°F
Fact: While low-grade fever under 100°F can accompany teething, higher fevers warrant medical evaluation for infection.

Myth: Teething leads to serious conditions like diarrhea, vomiting, or rash
Fact: These symptoms are likely not caused by teething alone and may indicate illness.

Myth: Teething causes ear infections or other illnesses 
Fact: Ear infections are caused by bacterial or viral infections, not teething. However, tugging on the ear from teething discomfort could exacerbate irritation from an existing ear infection.

Myth: Gum rubbing remedies help teeth erupt
Fact: Nothing speeds up the eruption process. Just provide soothing relief for symptoms.

Myth: You can feel the tooth under the gums before it emerges
Fact: Dentists can feel teeth under the gums via palpation, but visibility gives the first clear signs of imminent eruption. Red, swollen gums and increased drooling and chewing behaviors all indicate eruption will occur soon.

Understanding common teething myths can prevent misdiagnosis of more serious childhood illnesses as well as unnecessary medical intervention. While teething can cause some predictable discomfort, serious symptoms should be evaluated by a pediatrician.

When to Seek Help

Consult your pediatrician if your baby has:

  • Fever over 100°F
  • Diarrhea or vomiting lasting more than 24 hours
  • Rash or signs of infection
  • Persistent crying or discomfort unrelieved by teething remedies
  • Symptoms that worsen or persist longer than 3 days
  • Lack of appetite or poor fluid intake

Though teething can cause irritability, it should not seriously interfere with a baby’s appetite, sleep, or normal behavior. Seeking medical guidance can rule out other issues and provide treatment if needed.

Conclusion

Teething can be an uncomfortable process for babies as their teeth push through the gums. Understanding common teething signs and using evidence-based pain relief measures can help babies feel more comfortable. Separating teething facts from myths is also important to determine when medical evaluation is warranted. With patience and attentive care from caregivers, babies can pass through this temporary phase and erupt a full set of 20 healthy baby teeth.

References:

[1] https://pubmed.ncbi.nlm.nih.gov/21189758/

[2] https://www.semanticscholar.org/paper/5fdfc48ab8f18b3bbc65786011d09a8c04b6b2a8 

[3] https://pubmed.ncbi.nlm.nih.gov/26696106/ 

[4] https://www.semanticscholar.org/paper/5f5a8e6e90dc62dfedf14b7185a4a3b3ba2d69fe 

[5] https://pubmed.ncbi.nlm.nih.gov/11491477/ 

[6] https://pubmed.ncbi.nlm.nih.gov/1203692/ 

[7] https://www.semanticscholar.org/paper/0b90f078db94d84134a1bf03811e894c5ea8b2bc

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