Teething

Page last reviewed: 13/07/2011

Introduction 

A baby’s first teeth (known as milk or deciduous teeth) usually develop while the child is growing in the womb. In most babies, these teeth start to emerge through the gums when they are around six months old. This process is known as teething.

The teething process

Most babies start teething at around six months. However, all babies are different and the timing of teething varies.

Some babies are born with their first teeth. Others start teething before they are four months old, and some after 12 months. Early teething should not cause a child any problems, unless it affects their feeding.

A rough guide to the different stages of teething is:

  • bottom front teeth (incisors) – these are the first to come through, at around 5-7 months
  • top front teeth (incisors) – these come through at around 6-8 months
  • top lateral incisors (either side of the top front teeth) – these come through at around 9-11 months
  • bottom lateral incisors (either side of the bottom front teeth) – these come through at around 10-12 months
  • canines (towards the back of the mouth) – these come through at around 16-20 months
  • molars (back teeth) – these come through at around 12-16 months
  • second molars – these come through at around 20-30 months

Most children will have all of their milk teeth by the time they are two and a half years old.
 
Some babies show very few signs or symptoms of teething, while others experience some discomfort. However, there are lots of ways you can make teething easier for your child, such as:

  • giving your baby something hard to chew on, such as a teething ring
  • using sugar-free teething gel on your baby if they are more than four months old

See Teething - treatment for more information.
 

Page last reviewed: 13/07/2011

Some babies do not feel any pain during teething, while others can be severely affected. The pain is caused by movement within the developing jaw bone as the new teeth make their way through the gums.

Some teeth may come through easily, while others cause pain and discomfort. Once the teeth have emerged, the discomfort normally stops.

Your baby may have a number of other symptoms while they are teething. These are usually mild and go away without the need for treatment. They include:

  • a slightly raised temperature but not a fever (a fever is a temperature of 38ºC (100.4ºF) or above)
  • facial rash – your baby's cheeks may be flushed
  • reddened gums – the gums may be swollen and tender when they are pressed, and your child may rub their gums
  • excessive dribbling – this may cause a red rash to develop on their chin
  • poor appetite – your baby may be more reluctant to eat as a result of the pain in their gums
  • chewing – you may find your baby starts chewing more (it may be toys or other objects, or their fingers)
  • restlessness and irritability – the pain of teething may also cause crying
  • disturbed sleep

Some people attribute a wide range of symptoms to teething, such as diarrhoea and fever. However, there is no research to prove that these other symptoms are linked.

You know your baby best. If their behaviour seems unusual, or their symptoms are severe or causing you concern, then seek medical advice.

Page last reviewed: 13/07/2011

There are several ways you can help make teething easier for your baby. Every child is different, and you may have to try several treatments until you find one that works for your baby. Some of the most common treatments are outlined below.

Comforting or playing with your baby can sometimes distract them from the pain in their gums. Your baby may be feeling too irritable or restless to play, but at other times, it may be a good way of getting them to concentrate on something other than their teething pain.

Teething rings

Teething rings give your baby something to safely chew on, which may ease their discomfort and provide a distraction from any pain.

Some teething rings can be cooled first in the fridge, which may help to soothe your baby's gums. Follow the instructions that come with the ring so you know how long to chill it for. Never put a teething ring in the freezer as it could damage your baby's gums if it becomes very hard or cold.

Also, never tie a teething ring around your baby's neck, as it may be a choking hazard.

A useful alternative to a teething ring is a cold, wet flannel.

Chewing

One of the signs that your baby is teething is that they start to chew on their fingers, toys or other objects they get hold of. Try and give healthy things for your baby to chew, such as raw fruit and vegetables. For example, pieces of apple and carrot are often ideal. You could also try giving your baby a crust of bread or a breadstick. It is best to avoid rusks because nearly all brands contain some sugar.

Avoid any items that contain lots of sugar as this can cause tooth decay even if your child only has a few teeth. Make sure you always supervise your child when they are eating, and stay close in case they choke.

Painkilling medicine

If your baby is in pain or has a raised temperature, you may want to give them a painkilling medicine that has been specifically designed for children. These medicines contain a small dose of paracetamol or ibuprofen to ease any discomfort. The medicine should also be sugar-free. Always follow the dosage instructions that come with the medicine. If you are not sure, ask your GP or pharmacist.

Cool drinks

Cool, sugar-free drinks will help to soothe your baby's gums and may help if they are dribbling excessively. The best option is to give them cool water – just make sure it is not too cold.

Preventing rashes

If teething is making your baby dribble more than usual, make sure you frequently wipe their chin and the rest of their face. This will help to prevent them from developing a rash. You may also find it useful for your baby to sleep on an absorbent sheet.

 Teething gels

Teething gels may contain antiseptic ingredients, which help to prevent infection in any sore or broken skin in your baby's mouth.

Make sure you use a teething gel specifically designed for young children and not a general oral pain relief gel, which is not suitable for children. Your pharmacist can advise you.

You should discuss with your GP or pharmacist the teething gel options for babies.

Salicylate salts have been found to have the same effect on the body as aspirin. Aspirin should not be given to children because it can potentially increase their risk of developing a rare but serious condition called Reyes syndrome (which can cause serious liver and brain damage). 
 
It is recommended that you check with your GP or pharmacist before buying a teething gel, to make sure that it is suitable for your child. 

Page last reviewed: 13/07/2011

When should I start brushing my baby's teeth?

Start cleaning your baby's teeth as soon as they start to appear. Your baby's teeth can still be affected by harmful decay, even at a very young age.

Clean your baby's teeth twice a day .At first, you may find it easier to use a piece of clean gauze or cloth wrapped around your finger.

As more teeth appear you should use a small soft toothbrush that is specifically designed for babies. These toothbrushes have soft, small heads, which will help to prevent any damage to the gums. Make sure you gently massage around the teeth and gums with the toothbrush.

For children under 2 years of age, just use tap water to clean your child’s teeth.. Fluoride Toothpaste is not generally recommended for children under 2 years unless your dentist specifically advises it.

A pea-sized amount of fluoride toothpaste is recommended for children over 2 years.  Parents should supervise brushing until your child is 7 years and avoid toothpaste being swallowed. Teeth should be cleaned in the morning and at bedtime and remember to change your child’s toothbrush when the bristles get ragged, approximately every 3 months.

Dummies, teething rings and bottles

Never dip your baby's dummy or teething ring into fruit syrups, honey, fruit juices or anything that contains sugars. These can expose your baby's teeth to harmful acids, which can attack the newly formed teeth and cause decay.

Also, never add sugar to bottle feeds or use sugary drinks. Milk and water are the best drinks for teeth.

Bottle-feeding with drinks that contain sugar can lead to 'bottle caries' (tooth decay). Babies are not born with a sweet tooth, so they only have a taste for sugar if it is given at an early age.

Dental check-ups

Your dentist can advise you about when to take your baby for their first dental appointment. You may want to take your baby with you to your own dental check-ups, as this may help your baby get familiar and comfortable with the surroundings.
 
Your baby’s check-up appointments can start from around six months of age or from the age that the teeth start to appear. 

See the Health A-Z topic Dental care for babies and children for more detailed information about caring for your baby's teeth.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

Browse Health A-Z