If your baby is shoving fists—or anything else—in his mouth, chances are you have a teether, says Dr. Ken Haller, MD, pediatrician at SSM Cardinal Glennon Children’s Medical Center and assistant professor of pediatrics at Saint Louis University. Other telltale signs of teething include fussiness, crying, and needing something, anything, to chew on, adds Dr. Haller.
Teething is a trying time for parent and child alike. Take a look at these most-asked teething questions and find helpful answers from pediatricians and pediatric dentists.
1. What can you expect?
“Teething is a normal process of new teeth pushing through the gums—and this process takes time. While a baby is teething you may notice increased saliva, drooling, and a desire to chew, mild gum pain, slightly swollen gums over the cutting tooth, changes in appetite, and low-grade fever less than 100,” says Dr. Vivian Lennon, medical director of Primary Care at the Children’s Hospital in Atlanta.
2. Why do kids drool when they are teething?
“The saliva helps cool off inflamed and tender gums,” explains Dr. Haller.
3. Are high fevers and runny noses related to teething?
“No. The temperature elevation during teething is very mild and rarely exceeds 100.4. The most common symptom will be increased drooling,” says Dr. Lennon.
4. Is diarrhea a symptom of teething?
“An association between teething and diarrhea has never been scientifically proven—many unrelated illnesses are blamed on teething,” points out Dr. Lennon. “If your child is particularly miserable with excessive crying or fever greater than 100.4, they may not be teething and you should contact your pediatrician.”
5. Is refusing solids common during teething?
The answer is yes, according to Dr. Lennon. “A child’s gums will be sore for several days until the tooth breaks through the gum. They may show some decrease in appetite.”
6. When are kids most likely to be cranky due to teething?
“The height of scary teething behavior is four to six months,” says Dr. Haller. Babies—even those without teeth—are usually used to the teething sensation after this age.
7. What are the best safe and soothing teething objects?
“Hard and cold stuff is best to give,” says Dr. Haller. He suggests hard plastic toy rings (in a variety of different textures), washcloths soaked in cold water, frozen bagels, and frozen waffles (when they start to thaw out and get gummy, be sure to remove them). Leaving safe chew toys in a child’s reach is also a good idea, he adds.
Dr. Lennon suggests a cool teething ring to soothe pain and satisfy a baby’s desire to chew. “It can be chilled in the refrigerator but should not be frozen,” she adds. (Frozen plastic teething rings can potentially cause gum damage as well as hurt new teeth.)
8. Besides medication, what can parents do?
“Comfort is helpful,” points out Dr. Haller, who also mentions that teething pain usually doesn’t last that long and medicine should only be used as a last resort. “If you get on top of it right away you can usually fix it quickly [through comfort].”
Dr. Lennon suggests comfort measures as well. “Gently massage the gum with a clean finger or cool washcloth,” she says. “Acetaminophen may help control the pain,” she adds as a caveat for that last-ditch effort to help little ones feel better, “But follow the directions on the box carefully or ask your child’s doctor how much to give.”
9. Which teeth appear first?
“The bottom front teeth (central incisors) usually appear first, followed by the four upper teeth (central and lateral incisors),” says Dr. Lennon.
10. When should parents worry if teeth are not coming in?
Is there a benefit to either early or late teething? Dr. Lennon says there is no benefit to one versus the other. “A baby’s first tooth usually appears any time between three to twelve months of age. Some babies may already have their first tooth by three months, while other may not see their first until 12 months.” Dr. Lennon adds that whether a baby’s teeth come in early or late is usually determined by heredity. So if you and/or your husband had teeth at three months, chances are your baby will, too.
“If [a child] has not had any teeth by 14 months it could be a manifestation of another problem—like ectodermal dysplasia,” says Dr. Haller. Ecodermal dysplasia is a hereditary condition characterized by abnormal development of the skin, hair, nails, teeth, and sweat glands. “This has to do with various types of tissues of the ectoderm [or skin]—it can affect the skin and the nervous system so it’s best to talk to the doctor and get some X-rays done,” he adds.
“Baby teeth are important because they hold the place for permanent teeth and help guide them into correct position,” explains Dr. Sherwood. “Severely decayed teeth may need to be extracted which could affect the development of permanent teeth, a child’s speech, and chewing.”
A consumer poll by the American Academy of Pediatric Dentistry shows that nearly 70 percent of parents wait until their children are three years old before taking them to the dentist. But, Cynthia E. Sherwood, DDS, and spokesperson for the Academy of General Dentistry, encourages parents to take children to a dental visit by age one—within six months of the eruption of the first baby tooth. This early visit will cover proper cleaning techniques and include an introductory examination of the teeth and gums. Parents will also learn what drinks kids should avoid, how they can help prevent tooth decay, and other dental care information.