Teething is simply the process when your baby’s first teeth start showing through their gums. It is a period that every parent faces when raising a child, but no one feels quite ready for. Teething can start when an infant is as young as 4 months old, but usually happens when they are around 6 -12 months old.¹ Usually, the bottom front teeth will grow through first, followed by the two top front teeth.² Each new tooth might cause your baby discomfort for several days until the very last tooth shows up. During these times, your baby might become cranky and drooly, and when your baby is uncomfortable, no one in the household can be happy. Which is why finding effective remedies to soothe teething discomfort is so important! Not only will it calm your baby, it will also preserve your sanity and get you back to being a happy household!

Understanding teething pain in babies

What are the symptoms?

At times, teething doesn't cause any symptoms at all. However, when teething does cause discomfort, these are the symptoms to look out for:^{1,2 3}

• Cranky behaviour
• Sore or tender gums
• Drooling
• Slight temperature rise (less than 38℃, so if the baby’s temperature is above 38℃, this can be a sign of other issues, so please contact a healthcare professional
• Flushed cheeks
• Baby is not sleeping well
• Constant chewing
• Red gums
• Loss of appetite, and
• Rash on the face

What happens during teething?

The teething timeline of the order of teeth emerging has a fairly predictable pattern, but do remember, this can differ from child to child:¹ 

• Bottom central incisors (bottom front teeth):6-10 months,
• Top central incisors (top front teeth):8-12 months,
• Lateral incisors (side front teeth): upper 9-13 months, lower 10-16 months,
• Canines (pointy teeth): upper 16 - 22 months, lower 17-23 months,
• First molars: upper 13-19 months, lower 14-18 months
• Second molars (back teeth): upper-25-33 months, lower 23-31 months

The entire process is usually 2.5 to 3 years long. Leaving toddlers with 20 primary(baby) teeth in total (10 upper teeth and 10 lower teeth).¹

Non-medical remedies for teething pain

There are multiple non-medical approaches that you can take to soothe your baby's pain/discomfort. These include:

• Gum massage: gently rub the sore gums using your finger (make sure it is clean!), a wet gauze pad, a spoon or a washcloth for 2 minutes.¹ Applying slight pressure can help with the discomfort. This can be done as many times as required for your baby. Also, if the baby is above the age of 1, you can rub their gums with ice wrapped in a wet cloth²
• Cold therapies: items such as pacifiers, teething rings, or a wet washcloth can be used for cold therapies.⁴ Just put them in the fridge and make sure they do not freeze (it will be too hard for the baby), and then allow the baby to suck/chew on them to relieve discomfort. With teething rings, if you are unsure, make sure to read the instructions for how long you should put them in the fridge 
• Chew therapy: if your baby is older than 6 months, healthy, hard foods can be given for them to chew on, for example, raw fruit and vegetables.³ Try also opting for softer fruits like melons to maximise the soothing benefits of this method
• Wiping their face: facial rashes can occur from excess dribble from babies, so make sure to gently wipe their face with a wet washcloth to help prevent these rashes in the first place
• Distractions: play with your baby, distract them with their favourite things! Anything to take their attention away from their discomfort will do wonders!

Medical remedies for teething pain

Always make sure to opt for non-medical remedies before opting for medical remedies! However, if all else fails, these are some examples of medical options to treat your baby's teething pain:

• Pain relievers made for babies:
  • When your little one seems especially uncomfortable, if they are 3 months or older, medicines such as acetaminophen and ibuprofen may be given to ease their discomfort⁴
  • However, make sure to limit the use to just 1-2 days, as extended use could potentially harm your baby’s liver or kidneys²
  • Consider giving a sugar-free pain medicine if your baby is in significant pain.
  • Do not give aspirin!

• Teething gels: When shopping for teething relief gels, you will notice various options. If you decide to try one, make sure it is specifically formulated for babies and toddlers, not numbing gels for adults (as these contain ingredients that can cause adverse reactions in babies). Keep in mind that there is no research that provides concrete evidence of the beneficial effects of teething gels³

Remedies not to use

There are also a few treatment methods you should avoid. These include:

• Medication containing benzocaine or lidocaine
• Teething bracelets or necklaces are considered  choking and strangling hazards
• Homoeopathic teething tablets, as there isn't any scientific evidence. Some remedies may also contain ingredients that can cause breathing problems or seizures, such as atropine² 

Make sure to read all instructions on the packaging for any remedy found over the counter. Furthermore, if you are unsure about whether a specific type of remedy can be used for your baby, make sure to consult a medical professional first.

Preventative and long-term care for teething babies^1,2,3

• Beginning oral hygiene before emerging teeth:
  • Wipe your little one's gums using a soft, damp cloth twice a day; this will stop food particles and germs from building up
  • Do this every morning and evening!
• When teeth appear, transition to toothbrushing:
  • Brush your baby’s teeth twice a day using an infant-specific toothbrush with extra-soft bristles
  • Use fluoride toothpaste in small amounts
• Talk to a healthcare professional:
  • Discuss with your doctor or a pediatric dentist whether fluoride treatments would be good to use for your baby
  • They will recommend proper long-term care schedules tailored to your baby
• Monitor toothpaste quantities as they develop:
  • Use small amounts until your baby learns to spit out excess toothpaste
  • Progress to a slightly bigger amount of toothpaste at approximately age 3
  • When they reach age 7 and up, watch over their brushing technique
• Tooth-friendly eating patterns:
  • Minimise sweet drinks and treats to prevent cavities
  • Never allow bottle feeding with juice or sweetened drinks at bedtime
  • Check baby food labels for unexpected sugar content
• Manage pacifier use:
  • Never sweeten pacifiers with honey or other substances
  • Try to get rid of the dependency your child has built with their pacifier when they reach the age of 1, as continuous use of pacifiers can result in the teeth being in the wrong position as they grow

Summary

Teething can start at 4-12 months, which can vary from child to child, with 20 primary teeth in total. The common symptoms: drooling, sore gums and fussiness, and a mild fever below 38 °C. Some Non-medical remedies include: gum massage, cold teething rings, chewable foods for babies over 6 months, face wiping and distractions. And some Medical options include: pain relievers that are baby-specific and teething gels. Furthermore, AVOID using products with benzocaine and lidocaine, teething necklaces/bracelets/anklets, and homoeopathic tablets. Finally, long-term care options include: wiping gums, brushing with an infant toothbrush, limiting sugary foods and drinks, and discontinuing the use of a pacifier around age 1. 

FAQs

Does teething get worse at night?

Many parents notice and claim that their baby’s teething gets worse during the night; however, there is no scientific evidence for this. Many think it's because babies are more tired at night, so they are more likely to notice the pain. However, make sure not to change your bedtime routine for your baby, as they will become more dependent on you at night. 

How can I tell the difference between teething pain and an infection or other medical issues?

Infections will usually involve symptoms mainly focused around a fever above 38 °C, severe irritability, tugging at ears and extreme distress, diarrhoea, constipation, etc If any other symptoms along with these occur or you are unsure, be sure to consult a medical professional. 

Are some babies more sensitive to teething pain than others?

Yes! Some babies do not feel teething pain at all; however, if the baby does experience discomfort, it can significantly vary among different babies. 

Do teething symptoms come and go or remain constant until the tooth emerges?

Teething discomfort can change throughout the day; at times, the pain will be worse than other times, and this can go on for days or even weeks until the teeth emerge. 

How to brush baby teeth and how often?⁵

• Support your child while brushing by positioning them on your lap.
• Brush their teeth twice a day, especially before bedtime. Do this for 2 minutes each time. 
• Move the brush in small circular motions across all tooth surfaces. Make sure to teach your child to spit out toothpaste. However, you do not need to have them rinse their mouth with water, as this will just wash out the fluoride. 
• Make sure to supervise them to prevent them from licking or eating the toothpaste directly from the tube.