Teething

The teething process

Most babies start teething at around six months. However, all babies are different and the timing of teething varies.
Some babies are born with their first teeth. Others start teething before they are four months old, and some after 12 months. Early teething should not cause a child any problems, unless it affects their feeding.
A rough guide to the different stages of teething is:

• bottom front teeth (incisors) – these are the first to come through, at around five to seven months
• top front teeth (incisors) – these come through at around six to eight months
• top lateral incisors (either side of the top front teeth) – these come through at around nine to 11 months
• bottom lateral incisors (either side of the bottom front teeth) – these come through at around 10-12 months
• molars (back teeth) – these come through at around 12-16 months
• canines (towards the back of the mouth) – these come through at around 16-20 months
• second molars – these come through at around 20-30 months

Most children will have all of their milk teeth by the time they are two and a half years old.

Teething symptoms

Some teeth grow with no pain or discomfort at all. At other times you may notice that the gum is sore and red where the tooth is coming through, or that one cheek is flushed. Your baby may dribble, gnaw and chew a lot, or just be fretful.

Some people attribute a wide range of symptoms to teething, such as diarrhoea and fever. However, there is no research to prove that these other symptoms are linked.
You know your baby best. If their behaviour seems unusual, or their symptoms are severe or causing you concern, then seek medical advice. You can call NHS Direct on 0845 4647 or contact your GP.
Read more about spotting the signs of serious illness.

Teething tips

There are several ways you can help make teething easier for your baby. Every child is different, and you may have to try several different things until you find something that works for your baby.

Teething rings

Teething rings give your baby something to safely chew on, which may ease their discomfort and provide a distraction from any pain.
Some teething rings can be cooled first in the fridge, which may help to soothe your baby's gums. Follow the instructions that come with the ring so you know how long to chill it for. Never put a teething ring in the freezer as it could damage your baby's gums if it becomes very hard or cold.
Also, never tie a teething ring around your baby's neck, as it may be a choking hazard.
A useful alternative to a teething ring is a cold, wet flannel.

Teething gels

For babies over four months old, you can rub sugar-free teething gel on their gums. You can get teething gel from your local pharmacy.

Teething gels often contain a mild local anaesthetic, which helps to numb any pain or discomfort caused by teething. The gels may also contain antiseptic ingredients, which help to prevent infection in any sore or broken skin in your baby's mouth.
Make sure you use a teething gel specifically designed for young children and not a general oral pain relief gel, which is not suitable for children. Your pharmacist can advise you.
You should discuss with your GP the teething gel options for babies under four months old.

Chewing

One of the signs that your baby is teething is that they start to chew on their fingers, toys or other objects they get hold of.
Try and give healthy things for your baby to chew, such as raw fruit and vegetables. For example, pieces of apple and carrot are often ideal. You could also try giving your baby a crust of bread or a breadstick. Always stay close in case they choke.
It is best to avoid rusks because nearly all brands contain some sugar. Avoid any items that contain lots of sugar as this can cause tooth decay even if your child only has a few teeth.
Make sure you always supervise your child when they are eating.

Painkilling medicine

If your baby is in pain or has a raised temperature, you may want to give them a painkilling medicine that has been specifically designed for children. These medicines contain a small dose of paracetamol or ibuprofen to ease any discomfort. The medicine should also be sugar-free.
Always follow the dosage instructions that come with the medicine. If you are not sure, ask your GP or pharmacist.
Aspirin should not be given to children under 16 years old.

Cool drinks

Cool, sugar-free drinks will help to soothe your baby's gums and may help if they are dribbling excessively. The best option is to give them cool water – just make sure it is not too cold.

Comfort

Comforting or playing with your baby can sometimes distract them from the pain in their gums. Your baby may be feeling too irritable or restless to play, but at other times, it may be a good way of getting them to concentrate on something other than their teething pain.

Preventing rashes

If teething is making your baby dribble more than usual, make sure you frequently wipe their chin and the rest of their face. This will help to prevent them from developing a rash. You may also find it useful for your baby to sleep on an absorbent sheet.

What to avoid

In April 2009, The Medicines and Healthcare products Regulatory Agency (MHRA) issued advice regarding the use of oral pain relief gel containing an ingredient called salicylate salts in children under 16.
The advice was introduced as the salicylate salts have been found to have the same effect on the body as aspirin. Aspirin should not be given to children under 16 because it can potentially increase their risk of developing a rare but serious condition called Reye's syndrome (which can cause serious liver and brain damage).
It is recommended that you check with your GP or pharmacist before buying a teething gel, to make sure that it is suitable for your child and does not contain salicylate salts.