Teething
DEFINITION
- Questions about teething, the normal process of new primary teeth working their way through the gums
- Teeth come in between 6 and 24 months of age
Symptoms
- Main symptoms are increased saliva, drooling and desire to chew on things.
- Occasional symptoms: mild gum pain. Usually, not enough to cause crying or interfere with sleep.
- Does not cause fever, diarrhea, diaper rash, ill appearance or lowered resistance to infection.
- Caution: Blaming teething for fevers can lead to a delayed diagnosis of ear infections, urinary tract infections, meningitis and other infections.
- There are 2 reasons for the onset of infections between 6 and 12 months of age: The loss of transplacental antibodies and the developmental milestone of chewing on everything.
See More Appropriate Topic (instead of this one) If
- Main symptom is crying, see CRYING CHILD OLDER THAN 3 MONTHS OLD
- FEVER is also present
WHEN TO CALL YOUR DOCTOR
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
Call Your Doctor During Weekday Office Hours If
- You think your child needs to be seen You have other questions or concerns
Patient Home Care If
- Normal teething and you don't think your child needs to be seen
HOME CARE ADVICE FOR TEETHING
Reassurance:
- Teething is a natural process.
- It's harmless and it may cause a little gum pain.
- It doesn't cause fever or crying. If present, look for another cause.
Gum Massage:
- Find the irritated or swollen gum.
- Massage it with your finger for 2 minutes.
- Do this as often as necessary.
- Putting pressure on the sore gum can reduce pain.
- You may use a piece of ice wrapped in a wet cloth to massage the gum.
- Age over 12 months
Teething Rings:
- Infants massage their own sore gums by chewing on smooth, hard objects.
- Offer a teething ring, pacifier or wet washcloth that has been chilled in the refrigerator, but not frozen in the freezer.
- Age over 12 months: A piece of chilled banana may help.
- Avoid hard foods that could cause choking (e.g., raw carrots).
- Avoid ice or popsicles that could cause frostbite of the gums.
Cup Feeding: If your infant refuses nipple feedings, use a cup, spoon or syringe temporarily.
Pain Medicine: If the pain increases, give acetaminophen (e.g., Tylenol) orally for 1 day. Special teething gels are not recommended (FDA 2011). They can cause allergic reactions, choking, or bluish skin.
Call Your Doctor If:
- Develops unexplained crying
- Develops fever
- Your child becomes worse
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 1/28/2012
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

