Infant and toddler health

When a baby's teeth start coming through the gums, it's known as teething. Teething might make your baby drool, act cranky and want to chew on things. It may cause gum pain. Here's how to help your baby get through the teething process with a smile.

What's typical?

Many babies start teething around 6 months of age. Others start teething a few months later. The two bottom front teeth called the lower central incisors are often the first to appear. The two top front teeth called upper central incisors usually come in next.

Often, teething doesn't cause symptoms. But teething babies can have symptoms such as:

• Drooling more than usual.
• Chewing on objects.
• Acting cranky.
• Having sore or tender gums.
• Getting a face rash.
• Having a slight rise in temperature but no fever.

Many parents and caregivers think that teething causes fever, diarrhea and crying. But these symptoms often have causes other than teething. Talk with your baby's healthcare professional if your baby cries a lot, gets diarrhea, or has a rectal temperature of 100.4 degrees Fahrenheit (38 Celsius).

What's the best way to soothe sore gums?

If your baby doesn't seem comfortable while teething, try these simple tips.

Rub your baby's gums

Use a clean finger or wet gauze to rub your baby's gums for two minutes. The pressure can ease your baby's discomfort. You can rub the gums as often as needed. If your baby is older than age 1, rub the gums with a piece of ice wrapped in a wet cloth.

Cool gums with chilled items

Chill teething rings, pacifiers, or wet washcloths in the refrigerator. Do not freeze them. These chilled items can soothe a baby's gums. To help prevent cavities, don't dip these items in sugary substances. While your baby chews these items, watch to make sure your baby doesn't choke.

If your baby is older than age 1, you can offer a chilled piece of soft fruit such as a banana or chilled berries in a small mesh teether. But do not use hard foods that could cause choking.

Also do not use ice or frozen pops because these can cause frostbite of the gums. Make sure any teething rings are filled with distilled water instead of gel in case your baby's new teeth put a hole in a ring.

Try pain relievers made for babies

If your baby is very cranky, you can give infants' or children's pain medicines such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). Stop use of the medicine after 1 to 2 days. Longer use can damage the liver or kidneys.

Try cup feeding

If your baby usually breastfeeds but doesn't want to do so because of teething pain, try putting the breastmilk in a cup. You can feed your baby from the cup as needed for a short time. Or you could use a spoon or a syringe.

What treatments should I not use?

To keep your baby safe, do not use:

• Remedies such as homeopathic teething tablets. Research hasn't shown that topical gels and teething tablets can help teething babies. Some homeopathic remedies may have higher amounts than labeled of an ingredient called Atropa belladonna. This ingredient can cause seizures and trouble breathing.
• Teething medicines that have benzocaine or lidocaine in them. These pain relievers can be harmful, even fatal, to your baby.
• Teething necklaces, bracelets or anklets. These items pose a risk of choking, strangling, mouth injury and infection of the skin.

Do I need to call my baby's healthcare professional?

Teething can usually be handled at home. But call your baby's healthcare professional if your baby:

• Seems very cranky or cries a lot.
• Has trouble eating, drinking, or sleeping.
• Gets diarrhea or has a fever.
• Has symptoms that become worse.

How do I care for my baby's new teeth?

Run a soft, clean cloth over your baby's gums twice a day. Do this after the morning feeding and before bed. The cleansing can keep food debris, sugars, and germs from building up in your baby's mouth.

When your baby's first teeth appear, use a small, soft-bristled toothbrush to clean the teeth twice a day. You can start using a toothpaste containing fluoride, but only use an amount that's about the size of a grain of rice.

Once the first tooth comes in, ask your baby's dentist or healthcare professional if your child's teeth would benefit from a dental product called fluoride varnish. This is a higher concentration of fluoride applied by a healthcare professional.

Until your child is good at spitting out extra toothpaste, continue using an amount that's about the size of a grain of rice. Once your child can spit, you can use a pea-sized amount of toothpaste.

Be sure to schedule your child's first dental visit at or near your child's first birthday. At this visit the dentist likely will:

• Tell you about tooth-healthy foods.
• Show you how to brush and the amount of toothpaste to use.
• Talk about preventing tooth trauma from things such as falls as your little one starts to walk.
• Talk with you about pacifier use or finger sucking.
• Ask how teething is going and offer recommendations.
• Check your baby's mouth to make sure it's healthy.

Remember, regular dental care during childhood helps start a lifetime of healthy teeth and gums.