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The Informed Parent

Teething Do’s and Don’t's

by Lori A. Livingston, M.D., F.A.A.P.
Published on Jun. 27, 2011
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Normal Tooth Development:

Infants often show the first signs of teething (primary teeth moving thru the gums) at 3 to 4 months of age, which includes drooling, biting and ear tugging or poking.  However, the first tooth often does not erupt until 6 to 8 months of age or as late as one year old.  Primary teeth (the first 20 teeth) continue to erupt every few months until almost 3 years of age when the last molars emerge.  Some infants seem to have more sensitivity to the pain associated with teething, while others seem to have no discomfort at all.  Studies show that fever is not associated with teething.  A temperature over 100.5 to 101 is more likely to be an infection and you should call your pediatrician. 

 

Primary Teeth Development Chart

 

 

Upper Teeth

When tooth emerges

When tooth falls out

Central incisor

8 to 12 months

6 to 7 years

Lateral incisor

9 to 13 months

7 to 8 years

Canine (cuspid)

16 to 22 months

10 to 12 years

First molar

13 to 19 months

9 to 11 years

Second molar

25 to 33 months

10 to 12 years

 

 

 

Lower Teeth

 

 

Second molar

23 to 31 months

10 to 12 years

First molar

14 to 18 months

9 to 11 years

Canine (cuspid)

17 to 23 months

9 to 12 years

Lateral incisor

10 to 16 months

7 to 8 years

Central incisor

6 to 10 months

6 to 7 years

Teething Do’s:

  • Give your infant safe teething rings or toys to bite and chew on. 
  • Teething rings are often more soothing if they are cold, but do not freeze.
  • Often a cold washcloth to chew on or just rubbing your infant’s gums with your finger is the most effective.
  • Be sure teething toys are made of safe and non-toxic plastics or other materials.
  • If your infant is over 6 months old, infant ibuprofen is safe and can be very helpful for the pain and inflammation of the gums. 
  • Homeopathic teething tablets are likely another safe and effective option, however this is still a medication and instructions should be followed closely.   There was a recent recall of one brand of infant teething tablets due to safety concerns, which highlights the need to be cautious with any medication. 
  • As with any medication, follow the instructions closely.  There is always a risk for an allergic reaction, so call your pediatrician if you are not sure what to do or if your child has a reaction. 

Teething Dont’s

  • Don’t give your infant anything to chew on that is smaller than the hole in a toilet paper role, since they can choke on small objects.
  • Don’t use medications in an infant under 4 months old since they are more likely to have a serious reaction
  • Teething gels with benzocaine (used to numb the gums) should be avoided since they can cause a serious and potentially fatal reaction called methemoglobinemia.  Also, these gels often numb the whole mouth or wash away with saliva quickly which make them a poor choice for treatment.  Children under 2 years old seem to be at higher risk for this serious condition, so it is best to avoid teething gels altogether. 
  • Don’t use alcohol of any kind on the gums to relieve teething.  This was a common practice many years ago and again, has potentially fatal side effects. 

As always, call you pediatrician if you have any questions about teething or medications. 




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