Baby Teething Guide: Symptoms, Timeline, and Safe Relief Remedies

Teething is a major milestone that can bring discomfort for babies and concern for parents. Understanding what to expect and how to help makes this phase easier for everyone.

Teething Timeline

When Teething Starts

• Average: 6 months old
• Range: 3-12 months (completely normal)
• Some babies: Born with teeth
• Others: First tooth after first birthday
• Genetics: Often follows family pattern

Tooth Eruption Order

Lower Central Incisors (6-10 months)

• Usually first to appear
• Bottom two front teeth
• Often come in together

Upper Central Incisors (8-12 months)

• Top two front teeth
• May appear crooked initially
• Straighten as more teeth come in

Upper Lateral Incisors (9-13 months)

• Teeth beside front teeth (top)
• Fill out upper smile

Lower Lateral Incisors (10-16 months)

• Beside bottom front teeth
• Complete the eight front teeth

First Molars (13-19 months)

• Back teeth for chewing
• Top and bottom
• Can be most painful (larger surface area)

Canines (16-23 months)

• Pointed teeth
• Between incisors and molars
• Top and bottom

Second Molars (25-33 months)

• Very back teeth
• Last to come in
• Complete set of 20 baby teeth by age 3

True Teething Symptoms

Confirmed Signs

Drooling

• Increases significantly
• May cause chin rash
• Start around 3-4 months
• Constant wetness

Gum Changes

• Swollen, red, or bulging gums
• White spot where tooth emerging
• May see tooth under surface
• Tender to touch

Chewing Everything

• Constant need to gnaw
• Puts hands, toys, anything in mouth
• Seeks pressure on gums
• Biting during nursing

Irritability

• Fussier than usual
• More clingy
• Harder to soothe
• Worse before tooth breaks through

Sleep Disruption

• More night wakings
• Shorter naps
• Difficulty falling asleep
• Usually temporary

Decreased Appetite

• May refuse food (sore gums)
• Prefers cold items
• May want to nurse more
• Temporary change

Ear Pulling or Cheek Rubbing

• Pain radiates to ears/cheeks
• Not necessarily ear infection
• More common with molars
• Check for other symptoms

NOT Caused by Teething

High Fever (Over 100.4°F/38°C)

• Teething causes slight temp elevation only
• High fever = illness, see doctor
• Don't blame serious symptoms on teething

Diarrhea

• Not directly caused by teething
• May be coincidental illness
• Monitor hydration
• Call doctor if severe

Vomiting

• Not a teething symptom
• Could be illness
• Don't attribute to teething

Severe Diaper Rash

• Extra drool may change stool
• But not primary cause
• Treat as usual

Cough or Congestion

• Not from teething
• Likely separate illness
• Evaluate other symptoms

Safe Teething Remedies

Chilled Items (Not Frozen)

Refrigerated Teething Toys

• Keep in fridge, not freezer
• Frozen items too hard for gums
• Many shapes available
• Silicone or rubber best

Cold Washcloth

• Wet and chill in fridge
• Let baby chew
• Textured ones good
• Can tie knot for easier holding

Chilled Pacifier

• If baby uses one
• Cool in fridge
• Special teething pacifiers available
• Textured surface helps

Pressure and Massage

Gum Massage

• Wash hands thoroughly
• Gently rub baby's gums
• Use clean finger
• Firm but gentle pressure
• 2-3 minutes
• Baby may bite!

Teething Toys

• Various textures
• Different shapes reach different areas
• BPA-free, non-toxic
• Easy to clean
• Age-appropriate size

Food Solutions (6+ Months)

Cold Foods

• Chilled applesauce
• Cold purees
• Yogurt from fridge
• Smoothies (age-appropriate)

Frozen Fruit in Mesh Feeder

• Banana, mango, peach
• Safe from choking
• Soothing cold
• Nutritious
• Supervise always

Cold Cucumber or Carrot

• Large pieces only (can't break off chunks)
• Supervise constantly
• Remove before gets mushy
• Refrigerated, not frozen

Safe OTC Medications

Infant Acetaminophen (Tylenol)

• Age 3+ months
• Follow dosing chart
• Give if very uncomfortable
• Not for long-term use
• Check with pediatrician

Infant Ibuprofen (Motrin/Advil)

• Age 6+ months
• Follow dosing chart
• Longer-lasting than acetaminophen
• Give with food
• Check with pediatrician

Homeopathic Teething Tablets (Controversial)

• FDA warns against some
• Not enough evidence
• Check with pediatrician
• Some recalled for safety

What to AVOID

Teething Gels with Benzocaine

• FDA warns against use
• Can cause rare but serious condition
• Risk of methemoglobinemia
• Numbness dangerous for babies

Teething Necklaces

• Strangulation risk
• Choking hazard
• No proven benefit
• AAP recommends against

Frozen Teething Rings

• Too hard for tender gums
• Can damage gum tissue
• Refrigerated is safer

Alcohol on Gums

• Never safe for babies
• Can cause serious harm
• Old remedy, now known dangerous

Aspirin Products

• Never for babies/children
• Risk of Reye's syndrome
• Serious complications

Dental Care During Teething

First Tooth Care

Start Brushing Immediately

• Use soft infant toothbrush
• Tiny smear of fluoride toothpaste (rice grain size)
• Twice daily
• Gentle circular motions

Wipe Gums

• Even before teeth
• Clean, damp cloth
• After feedings
• Removes bacteria

Avoid Bottles in Bed

• Milk/juice pools around teeth
• Causes early cavities
• If needed, water only
• Wean from night bottles

First Dental Visit

Timing:

• By first birthday
• Or within 6 months of first tooth
• Establishes dental home
• Prevents future problems

What to Expect:

• Exam of teeth and gums
• Check for proper development
• Discuss oral hygiene
• Address concerns
• Usually quick and easy

Nighttime Teething Pain

Bedtime Routine Adjustments:

• Extra cuddles before bed
• Pain medication 30 min before sleep
• Cold teething toy right before bed
• Maintain consistent routine
• White noise may help

Night Waking:

• Offer comfort
• Cold water (if age-appropriate)
• Teething toy
• Pain medication if severe
• Usually resolves within days

Soothing Techniques

Distraction Methods

• Play and interaction
• New toys or activities
• Go outside
• Bath time
• Music or songs

Comfort Measures

• Extra cuddles
• Skin-to-skin
• Rocking or swaying
• Gentle talking/singing
• Remain calm (babies sense stress)

When to Call the Doctor

See Pediatrician If:

• Fever over 100.4°F (38°C)
• Diarrhea lasting more than 2 days
• Vomiting
• Rash with fever
• Refusing all food/drink
• Extremely lethargic
• Symptoms interfere with daily activities

See Dentist If:

• Teeth coming in crooked
• Extra teeth
• Missing teeth (by age 1)
• Discolored teeth
• Visible cavities
• Gum bleeding
• Asymmetric tooth eruption

Making It Through

Remember:

• Teething is temporary
• Each tooth gets easier
• First ones are hardest
• You'll develop routine
• Pain typically lasts 3-5 days per tooth

Self-Care:

• Take breaks
• Ask for help
• Sleep when baby sleeps
• Don't blame everything on teething
• You're doing great

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Disclaimer: This article provides general information about baby teething. Always consult your pediatrician or pediatric dentist for personalized medical advice. Call your doctor if your baby has a high fever, severe symptoms, or if you have concerns about tooth development. The information here does not replace professional medical care.