Doctors’ Notes

Teething

Teething is the process children go through as their teeth form, grow, and finally erupt through the gums.

The average age for a teething child’s first tooth to erupt is about 7 months old, but that’s highly variable. Sometimes a tooth may be present already at birth, and some kids don’t get their first tooth until well after 12-15 months. There is a genetic component to tooth eruption, so if a child’s older sibling got her teeth early or late, the younger sibling may get his early or late as well.

The order that teeth come in is also highly variable. The most common teeth to come in first are the bottom middle teeth, followed by the top middle teeth, but it can be normal if other teeth come in first. After the front eight teeth erupt, the first molars typically come next, and then the canines (or eye teeth) appear. The second set of molars, the “two year molars,” make their appearance usually after the second birthday, completing the 20 baby teeth. Again, while this is the most common pattern, it is completely normal for all sorts of variations on when teeth come in to occur.

Treatment for Teething

As a tooth starts to come in, the gums may swell and become tender. Having a baby chew on teething rings may help his discomfort. You’ll want to make sure they’re large enough that babies won’t swallow or choke on them accidentally. You can also use acetaminophen (Tylenol) to help with pain. For children 6 months and older, ibuprofen (Motrin, Advil) works well too. Topical numbing medicines (Orajel, etc.) are very popular, but are potentially dangerous when overused or used for prolonged periods.

Myths of Teething

Except for colds, there are more misconceptions and fairy tales associated with teething than anything else I can think of in pediatrics. Here are a few teething myths, and the real facts that go with them:

#1: “My baby is drooling a lot and chewing on everything, they must be teething.”

Not necessarily. Babies start drooling around 3 months, and drool even more as they get older. That happens if they’re teething or not. Same thing for chewing — babies love to chew on toys, toes, anything they can get their hands on — and they’ll do this at 4-6 months old whether they’re teething or not.

#2: “Teething causes fevers.”

Teething may make a child a little warm, but it doesn’t cause fevers; much of that is coincidence. At the age children are teething, that’s the same age their maternal antibodies are diminishing, and that they come in contact with lots and lots of germs. So teething or not, kids get sick frequently at that age, which often gets confused with teething. Also, many experts think that when teeth are coming through, babies are more susceptible to infections, because germs can get through the newly created holes in the gums. Any temperature above 100.5 F is an infection, not teething.

#3: “Teething causes diarrhea.”

Not necessarily. Because babies are salivating and drooling a lot, their stools are sometimes looser at this age. But true watery diarrhea is typically a sign of something else, not just teething.

#4: “Teeth cut through the gums as they erupt.”

Interestingly, they don’t. The body actually produces hormones that help break down the surface of the gums on top of the teeth, which then creates a hole for the erupting teeth to grow through.

#5: “Frozen teethers are soothing for a baby’s gums.”

Actually, a totally frozen rock hard object will probably be uncomfortable on those tender swollen gums. A nice cold teether will be much better. For example, a wet washcloth placed in the freezer for 15-30 minutes will get nice and cold, but will soften nicely in a baby’s mouth. (Just make sure to use clean washcloths each time!)

If you have other teething questions or concerns, you can always feel free to call the office, or post questions on our Facebook page.

Dr. Albert Wolf, a proud Kids Plus Doc since 2000, is a Senior Partner and Chief Financial Officer of the practice.