Teething is the natural process of new teeth working their way through the gums. Sometimes bruising and swelling of the gums, and occasionally a little bleeding precede it. For some children, the teeth seem to magically pop through without any fuss or fanfare. For others, vigorous chewing, drooling, ear pulling and general crabbiness accompany teething.

Teething usually occurs between the ages of six months and one year, but you may see a first tooth as early as three months or as late as eighteen months. Usually, the two lower incisors emerge the earliest, but not necessarily. Teeth typically erupt in groups of two or four. We have yet to see a child who never developed a tooth. This is a very unusual condition and is very rare.

Many parents erroneously believe that their child is teething when they are not. It is important to remember that around 4 months of age babies have developed the ability to bring their hands midline to their mouth. Now they are able to get their hands into their mouths. With their hands in the mouth, they stimulate their salivary glands and drool (especially since they have no teeth to keep the saliva in their mouth). Your baby will discover that having their hands in their mouth provides stimulation and pleasure, so they may continue to place their hands in their mouth. This does not always mean that they are teething.

Remember that the only thing that teething causes is teeth. Contrary to popular belief, teething is not accompanied by fever greater than 100.4ºF, cold symptoms, diarrhea, diaper rash, or sleep problems. Your baby may have some teething associated pain, but this should only occur for a couple of days before a tooth erupts until a couple of days after the tooth erupts.

Here are some suggestions for dealing with teething:

  1. Gum massage with your finger for two minutes. Massage with a piece of ice may also be soothing.
  2. Give your child something to chew on like a wet washcloth or a teething ring that has been refrigerated, NOT frozen. Do not tie the teething ring around your baby’s neck since it could cause strangulation. Chilled bananas, frozen bagels or stale bagels, and teething biscuits are safe to try, with supervision.
  3. Pain medications like Tylenol, Motrin, or Advil are O.K., especially at night. We do not typically recommend teething gels (Baby Oragel or Baby Anbesol) because they may cause an allergic reaction and are usually swallowed before they can do their job.

Call your pediatrician if you think your child is ill. Remember that teething does not cause fever, congestion, or diarrhea – only teeth.