Teething

• The normal process of new teeth working their way through the gums
• Questions about teething
• Baby teeth come in between 6 and 24 months of age
• Caution: At least one tooth should be seen before using this care guide

Proven Symptoms of Teething

Teething has been researched in-depth. Kids who are teething are little different from kids who are not teething. Here are the main symptoms that have been proven:

• Drooling. Increased spit and drooling.
• Rash. Face rash from drooling. The drool contains little bits of food that are irritating to the skin.
• Chewing. Increased need to chew on things.
• Gum Pain. Gum pain is mild and not always present. May be due to mouth germs getting into the new break in the gum. Most often, your baby just acts a little more fussy. There's not enough discomfort to cause crying. It also doesn't hurt enough to cause sleep problems.

False Symptoms of Teething

• Teething does not cause fever, diarrhea, diaper rash or runny nose.
• It does not cause a lot of crying.
• It does not cause your baby to be more prone to getting sick.
• Caution about Fevers. Blaming teething for fevers can lead to a delay in seeking care for infections. Examples are ear and urinary tract infections. Another example is meningitis.
• There are 2 reasons why infections start between 6 and 12 months of age. One is the loss of antibodies transferred to baby from the mother at birth. The other is the developmental milestone of chewing on everything.
• Caution about Crying. Blaming teething for crying can lead to a delay of care for other illnesses. Examples are ear infections or other causes of pain.

Call Doctor or Seek Care Now

• Your child looks or acts very sick

Contact Doctor During Office Hours

• You think your child needs to be seen
• You have other questions or concerns

Self Care at Home

• Normal teething

Care Advice for Teething

1. What You Should Know About Teething:
   • Teething is a natural process.
   • It's harmless and it may cause a little gum pain.
   • The main symptoms of teething are drooling and rubbing the gums.
   • It does not cause fever or crying. If these are present, look for another cause.
   • Here is some care advice that should help.
2. Gum Massage:
   • Find the irritated or swollen gum.
   • Rub it with your clean finger for 2 minutes.
   • Do this as often as needed.
   • Putting pressure on the sore gum can decrease pain.
   • Age over 12 months. You can use a piece of ice wrapped in a wet cloth to rub the gum.
3. Teething Rings (Teethers):
   • Babies rub their own sore gums by chewing on smooth, hard objects.
   • Offer a teething ring, pacifier or wet washcloth that has been chilled. Chill these items in the fridge. Do not use items frozen in the freezer.
   • Age over 12 months. A piece of chilled banana may help.
   • Do not use hard foods that could cause choking. An example is a raw carrot.
   • Do not use ice or popsicles that could cause frostbite of the gums.
   • Avoid "teething necklaces." They are not approved by the FDA and are not helpful. They also have harmful risks including choking and death.
4. Cup Feeding:
   • If your baby refuses nipple feedings, try a cup.
   • A spoon or syringe can also be used for a short time as needed.
5. Pain Medicine:
   • Pain medicines usually are not needed for the mild discomfort of teething.
   • Fussiness often gets better with gum massage. If not, you can give an acetaminophen product (such as Tylenol). If age over 6 months, another choice is an ibuprofen product (such as Advil). Just do this for one or two days. (Reason: Frequent use can cause liver or kidney damage).
6. Teething Gels: Do Not Use
   • You can get special teething gels without a prescription.
   • Most have benzocaine in them. They are not approved by the FDA at any age.
   • Reason: Benzocaine can cause choking, bluish skin and allergic reactions. It can be very harmful if used during the first 2 years of life.
   • Also, teething gels only give brief pain relief.
   • Gum massage works much better.
7. What to Expect:
   • Most often, teething does not cause any symptoms.
   • If your child is having some discomfort, it should pass in 2 or 3 days.
8. Call Your Doctor If:
   • Crying occurs
   • Fever occurs
   • You think your child needs to be seen
   • Your child becomes worse