Introduction  

Teething is an important milestone in a baby’s life, as well as in the life of the parents. Your baby will now be able to eat more solid foods and will begin exploring the many flavours the world has to offer, but the process of teething itself often brings a certain level of discomfort and challenges for both infants and parents. 

While soothing teething pain is a priority, early oral hygiene is equally important to ensure that the baby's teeth are strong and healthy in the future. Many parents often do not realise that dental care should begin even before the first tooth appears.

So in this article, we will be exploring the teething process, safe remedies to soothe the baby and the importance of establishing oral hygiene routines early in life.  

Understanding Teething  

What is Teething?  

Teething is a normal process for every baby, and it involves the cutting of the baby's primary teeth through the gums. Each baby is born with a set of 20 teeth hidden in their gums that will erupt as they get closer to their first year.¹

There are rare cases in which the kids are born with one or two teeth or have a tooth emerge within the first few weeks of life. These are known as natal teeth, and unless they interfere with feeding or pose a choking risk, it is not a cause for concern. 

While teething typically begins around 4 to 7 months of age, every baby is different, so some babies may start earlier and some may start later, but by the age of three, most children will have their full set of 20 primary teeth.²

It follows these steps:

Within the intervals of 4 to 6 months, the first teeth will usually appear, and these are the two bottom front teeth, also known as the central incisors. 

Around 4 to 8 weeks later, they are followed by the four front upper teeth, which can be called the central and lateral incisors.

A month later, the lower lateral incisors ill appear. These two will be next to the already grown bottom front teeth.

Finally, the first molar that will.be used for grinding food will break through. 

So by age three, most kids will have all 20 of their primary teeth.

Common Signs and Symptoms  

Teething can be a very discomforting experience  for some babies, and the symptoms or signs may vary, but commonly include:⁴  

• Red and sore gums where the tooth is coming through
• The baby has a higher temperature, but it is less than 38°C
• The baby has flushed cheeks
• The baby has a rash on their face
• Baby rubs  their ear
• Baby drools more than usual
• Baby  gnaws  and chews on things a lot
• The baby cries more than usual
• The baby is not sleeping very well
• The baby will lose their appetite too

But if your baby has a fever of 38C or above, along with the following symptoms: 

• Diarrhea 
• Vomiting 
• Rash

Then you should consider going to a doctor because those are not just signs of teething.¹

Safe Ways to Soothe Teething Discomfort  

It is heartbreaking to see your baby crying while being in pain, but you don't have to worry, as there are many ways to soothe the teething pain, including giving them food to eat, like watermelons or crusts of bread that they can chew on.

Teething Rings

These are rings that the baby can chew on will provide a distraction for the baby and help soothe them. You can put them in the fridge, so they are cool and give a more soothing effect, but do not put them in the freezer, as it can harm the gums.⁵

Teething Gels

While there is no concrete evidence that these gels are effective but if you use them, avoid general oral pain relief gels and use gels suited for babies and small children. These teething gels have a mild local anaesthetic and can be purchased at pharmacies. 

Paracetamol and ibuprofen for teething

If your baby is in pain, you may want to give them a sugar-free pain relief medicine. Paracetamol or ibuprofen can be given to babies and young children aged 3 months or older.

Distracting the baby

Comforting or playing with your baby can distract them from the pain and discomfort. 

Gum massages

Gently rubbing the baby’s gums can help.    

What to Avoid Using 

Although you may want to reduce your baby's discomfort, you have to be careful what you give them to do so.

• Numbing gels with benzocaine are one of those things. The FDA warns that gels with benzocaine can put your child at risk of methemoglobinemia, a serious blood disorder that reduces the ability of the blood to carry oxygen³
• Avoid teething necklaces: They pose high choking and strangulation risks³ 

Importance of Early Oral Hygiene  

Why Baby Teeth Matter

Although your baby's first teeth are temporary, they deserve as much care and attention as their permanent teeth, especially for the following reasons.⁶

• Eating: Since milk will not be a sufficient diet all their lives, your baby's new teeth allow them to chew their food and to develop proper chewing and swallowing habits
• Speech: The teeth are useful in the pronunciation of several words, so the presence and proper positioning of the baby's teeth assist them, especially during speech
• Alignment of Adult Teeth: Your baby's first teeth serve as a placeholder for what will be their adult teeth, and the loss of a baby tooth, for whatever reason, including cavities, trauma, or heredity, may cause the adult teeth to be crooked or misaligned
• Self Esteem: Children are always aware of their appearance, so crooked teeth, bad breath or ugly teeth with large cavities can reduce a child’s self-confidence

So we can see that the baby's first teeth are not just a useless accessory but very important for the health of their adult teeth and the child's welfare as well.

When and How to Start Oral Hygiene  

This is a question that many parents have, and the answer is that oral hygiene should begin even before teeth emerge.⁷

0-3 Months: Gum Care

While most babies do not have any teeth before 3 months of age, cleaning the gums daily is still a good way to preserve oral hygiene. Clean them with a washcloth or a soft-bristle toothbrush using as little pressure as possible to avoid injury.

3-6 Months: Gum Care and Tooth Brushing

Many babies may still not have any teeth at this age, so you can continue cleaning the gums with a washcloth. If any of your baby’s teeth are out by this age, still clean them with a soft-bristled toothbrush and a grain of fluoride toothpaste twice a day.

6-9 Months: Continue Gum Care and Tooth Brushing

At this age, your baby will have at least one or two teeth, so you can brush those twice a day, still with a bit of fluoride toothpaste. 

9-12 Months: Brush Those New Teeth

Your baby now has a few more teeth that growing, so brush those properly, but don't forget to clean the gums where there are no teeth yet. This is also a time when you should consider making your baby’s first dental appointment.

12-18 Months: Keep Brushing and Seeing Your Dentist

As more teeth grow, remember to keep up with the regular brushing routine, and also remember to schedule dental appointments regularly. Encourage your child to spit after brushing.

Preventing Early Childhood Cavities  

It is important that your baby's first teeth are healthy and clean so they can have good, healthy adult teeth, but to do that, we need to know what we are fighting against.

Causes of Tooth Decay in Infants  

• Eating sugar-filled food 
• Eating carbohydrate-filled food 
• Late-night feedings without brushing. 

How you may ask, well, the sugar in these foods mixes with bacteria and other things and forms plaques that stick to the teeth and ruin them.⁸

Tips for Preventing Cavities  

Preventing cavities or tooth decay is easy; all you need to do is:⁹

• Gently clean and wipe the gums even before your baby’s first teeth break through, using a damp cloth after meals
• As soon as the teeth appear, brush them gently twice a day with a small, soft-bristled brush and fluoride toothpaste the size of a grain
• Once your child has two teeth that touch, use a strand of dental floss to clean in between them, to remove leftover food between the teeth and gums
• As they get older, teach your child how to brush and floss under your supervision and make sure they reach all their teeth and all their sides
• Make sure your child drinks plenty of water, especially those who have added fluoride to help prevent tooth decay
• Watch your child’s diet carefully and reduce sugary foods and drinks, including ones you think are healthy, like fruit juice, which can lead to cavities

First Dental Visit and Long-Term Oral Care  

First Dental Visit: When and Why?  

We have already established that your baby's first teeth are very important, and while you can care for them yourself, a time comes when you will also need help. Your dentist will be the next step in your child's oral hygiene care, so when should we visit the dentist? The best time for a dentist appointment will be once your child clocks 1 year old, or six months after their first tooth erupts. Whichever date comes first is the best.

What Happens on First Visit?

The first visit is mainly to make your baby comfortable and used to future visits to the clinic. As the parent, you may be asked to hold them still while the doctor examines their mouth and teeth to make sure everything is developing as it should be.¹⁰ The dentist will check your child’s teeth for any signs of decay, examine your child’s bite, and look for any issues with their gums, jaw and oral tissues. If there is a need for it, the dentist will clean the teeth and assess the need for fluoride. 

Encouraging Lifelong Good Habits  

To maintain oral health, parents' work does not just stop at the dental visits, parents should make sure to encourage proper oral hygiene habits in their children. 

• Encourage your child to start brushing on their own from the age of 3, but always under your supervision until they are 6 years old and can do it for themselves
• Set up regular dental check-ups at least every six months¹¹
• Encourage flossing once your child has teeth that touch together

Conclusion  

Teething can be a challenging time for both the child and the parents, but parents can ease the discomfort by using safe remedies. They can also encourage early oral hygiene practices that prevent cavities and ensure lifelong dental health. By starting these oral care routines early, parents can set their child on the path to a healthy smile.