What is teething?
Teething describes the time when your baby’s teeth are breaking through, or ‘erupting’ from the gums. These teeth are commonly called baby, milk or deciduous teeth and usually appear gradually from the age of six months up to three years. A full set comprises 20 baby teeth.
Baby teeth begin to fall out when a child is around six years of age and are replaced by permanent teeth. The last baby teeth usually fall out by around 12 years of age.
When does teething occur?
The first teeth to appear are generally the lower incisors (front teeth) at around 6-7 months. At around 12 months, the first molars will push through the gums; these are the large, flat teeth in the back pockets of the mouth that are used for chewing and grinding. Due to their size, these teeth tend to cause the most pain for babies during teething.
Canine teeth arrive at around 18 months and are recognised as the pointy teeth located between the incisors and the first molars. The second molars are generally the last to arrive at around two years of age.
However, not every baby will follow the same teething pattern. For example, some babies are born with one or two teeth already exposed, while others do not get their first tooth until one year old.
Baby teeth often appear in the following order: incisors (central and lateral), first molars, canines, second molars.
Signs and symptoms
Teething is a natural process, but it can bring discomfort and distress to babies. Some signs and symptoms of teething in your baby may include:
- Slightly red and swollen gums;
- Increased dribbling or drooling;
- Chewing on the fingers or other objects;
- A flushed face;
- Loss of appetite;
- Ear rubbing on the same side as the new tooth;
- Irritation or crying for a few days while each tooth erupts, and;
- Difficulty sleeping.
Some parents report noticing loose bowel movements in their baby during teething, which is unlikely to cause any harm. However, it is best to consult your doctor if you are concerned, or if other symptoms develop such as diarrhoea, earache, vomiting, fever or a skin rash.
At birth, a baby’s gums contain 20 hidden teeth – 10 in the upper jaw and 10 in the lower jaw. As each tooth prepares to erupt, a bluish or grey bubble, known as an eruption cyst, may be visible where the tooth is going to appear. This is generally harmless and will disappear without treatment.
Teething takes about eight days per tooth, which includes about four days before and after the tooth pushes through the gum. There can be intermittent pain during this time.
Types of treatment
To help soothe your baby at home during the teething process, you may find it helpful to:
- Massage sore gums with a soft, wet cloth or clean finger;
- Place a cool spoon on the gums;
- Provide a damp, semi-frozen face washer or chilled teething ring for your baby to chew on;
- Introduce an unsweetened teething rusk, if your baby is over six months old and eating solids;
- Give your baby paracetamol mixture for pain relief, as directed by your doctor or pharmacist, and;
- Wipe away excess drool to keep the skin dry and avoid a skin rash from developing.
It is important to avoid using teething gels that contain benzocaine, as this medication can cause a condition called methaemoglobinaemia. This is a rare and sometimes fatal condition that reduces the amount of oxygen that can be carried by the blood.
Additionally, it is unsuitable to give aspirin to children and babies, as it can cause Reye’s syndrome, a rare but serious condition that can result in brain and liver damage.
Dental care after teething
Once teeth have erupted through the gums, it is important to start cleaning them, particularly after the eight incisors have erupted. This is done by first wiping the gums with a clean wet face washer, then using a soft toothbrush with a small (rice grain-sized) amount of toothpaste. Once your baby has developed a full set of baby teeth, at around 2-3 years of age, it is recommended that you begin regular dental check-ups.
Although baby teeth fall out naturally over time, they are essential during childhood for chewing food, speech and pronunciation. They also reserve spaces in the gums for adult teeth, also known as the secondary teeth. If baby teeth are not well looked after, tooth decay can lead to pain, abscesses and problems with the surrounding teeth.
Loss of baby teeth
At around six years of age, one or more baby teeth may become wobbly and fall out as the permanent adult teeth begin to come through. This can be painful or scary for some children, and it is common for some bleeding from the gums to occur. Providing reassurance may help your child to understand this process better.
In some cases, a permanent tooth may arrive before the baby tooth has fallen out. This may require a dentist to extract the baby tooth. In most cases, all baby teeth will be lost by the age of about 12 years of age, and a full set of 32 adult teeth is usually present by age 21.
Teething is a natural process in babies that usually begins around the age of six months. Symptoms may cause discomfort and irritability, but are usually managed at home without the need to visit your doctor or dentist.
Last Reviewed: 03/10/2018
Your Doctor. Dr Michael Jones, Medical Editor.