Introduction

Is your baby teething or keeping you awake at night? If you're a parent navigating the teething journey for the first time or seeking additional guidance, this article is made for you.

Teething is a natural milestone in a baby's development, and can bring both joy and challenges to parents. Many babies experience teething when their primary or baby teeth erupt. It mostly begins between 6 to 8 months of age. However, some babies may experience teething around 4 months of age as well. Some of the most common symptoms are gum pain, irritability, difficulty sleeping at night, loss of appetite or excessive drooling.

In this article, we'll explore what teething is and its common symptoms. More importantly, we'll delve into proven strategies and safe remedies to soothe your teething baby, to ease their discomfort. But our discussion doesn't stop there. We'll also highlight treatments to avoid during the teething phase, ensuring you're equipped with the right information to make informed decisions about your baby's care. By the end of this article, you'll have a comprehensive understanding of navigating the challenges of teething with confidence and ease.

What is teething?

Teething refers to the natural process where an infant's first set of teeth (baby teeth) begins to erupt through the gums.¹ It is medically termed or known as “odontiasis”. These 20 primary teeth, also known as baby or milk teeth, pave the way for permanent teeth later in their childhood. Below the surface of the gums within the jawbone, a tooth germ begins to form. As it develops, the emerging baby tooth exerts gentle pressure on the surrounding tissues, gradually making its way upward into the mouth. This pressure triggers a natural response in the gums, leading to inflammation, which often manifests as discomfort or irritation during the teething process.

It mostly begins when a child is between 6 and 8 months old, with the lower front teeth (central incisors) being the first to erupt.² The teething process continues until around the age of 3 years, by which time most children have their full set of primary teeth.

The sequence in which primary teeth erupt in the oral cavity:³

1. Central incisors: Front bottom incisors first erupt at 6 to 10 months of age and top incisors erupt at 8 to 12 months of age
2. Lateral incisors: Top lateral incisors come at 9 to 13 months of age, followed by bottom lateral incisors at 10 to 16 months of age
3. First molars: Back top and bottom first molars come through at 14 to 18 months of age.
4. Canines: Found between the lateral incisors and the first molars, these come through at around 16 to 20 months
5. Second molars: Back top and bottom second molars tend to come through at 23 to 30 months of age

Teething symptoms

Although not every baby experiences all the symptoms, here are some of the most common ones to be aware of:⁴

• Red and swollen gums: The inflammation caused by the emerging tooth can make the gums appear red and swollen, particularly in the area where the tooth is about to erupt
• Irritability: Discomfort and gum pain can lead to increased irritability and crying spells in babies.
• Gnawing and chewing: Babies will often seek objects to chew on, such as teething rings, toys, or even their own hands to relieve discomfort
• Mild fever: A slight increase in body temperature (typically below 100.4°F or 38°C) is possible during teething
• Excessive drooling: Excessive drooling is typical during teething, as the body produces more saliva in response to the gum irritation
• Changes in eating or sleeping patterns: Teething can disturb sleeping and eating routines. Teething may cause them to wake more frequently during the night or have difficulty falling asleep.
• Pulling the ear or rubbing the cheek: In response to gum discomfort, babies may show these behaviours

How to soothe a teething baby?

Teething can make your baby restless and irritable. Each baby is unique; what works for one may not work for another. You may try various methods to understand what works best for your baby.⁵

Here are some suggestions to soothe teething baby:

Teething rings or toys 

Give the child objects like teething rings, toys made with firm rubber or a chilled spoon. They’ll provide some relief due to pressure from chewing. Avoid any choking risks.

Gentle massage baby’s gums with fingers 

Massaging the baby’s gums gently with clean fingers or a moistened gauze pad may alleviate discomfort.

Wet washcloths

You may gently rub gums with a wet washcloth or allow the baby to chew it slowly. You can cool the cloth in the refrigerator, this may help to soothe their gums. Don’t use cloth placed in the freezer.

Offer baby cold and soft foods 

Feed your child soft foods like yoghurt, applesauce, chilled cooked vegetable puree or melon. Always give baby food under your supervision to prevent any choking hazards.

Remove the drool 

Excessive drooling is common during the teething process. Wipe the baby’s face with a clean cloth and keep it dry to prevent rash.

Over-the-counter remedy 

If your baby is experiencing pain, you can try over-the-counter pain relief options like paracetamol and ibuprofen. However, it’s important to consult the paediatrician before trying such options to ensure you understand the recommended dosage and guidelines specific to your country. Never give the baby any medications without seeking expert medical advice.

If your child is younger than 6 months old, they shouldn’t take ibuprofen without a healthcare provider’s advice. Ibuprofen is only FDA-approved for children 6 months of age and older.

Treatments to avoid

During the teething process, parents and caregivers need to be mindful of certain things to avoid to ensure the safety and comfort of the baby.⁶ Here are some key considerations:

Teething gels containing benzocaine 

Avoid using benzocaine gels or sprays and teething cream. The FDA issued a warning stating that benzocaine, a local anaesthetic, can induce a potentially life-threatening condition known as methemoglobinemia, resulting in significantly decreased oxygen levels in the blood.

Teething necklaces or bracelets 

Teething jewellery like necklaces or bracelets are used by children to relieve teething pain, but the FDA alerted parents and caregivers about the safety risks including choking, strangulation, mouth injury, and infection.

Homoeopathic remedies 

The FDA has alerted consumers that homoeopathic teething tablets and gels can pose risks to infants and young children due to higher than stated levels of the ingredient belladonna, which may lead to seizures and respiratory issues. It is recommended to consult a healthcare provider for safer alternatives.

Avoid using frozen teething objects 

Avoid using any frozen teething objects as they can pose a risk of injury to the baby's delicate gums or cause frostbite if used for too long. Also, it may mask pain causing a baby to chew more aggressively and increasing the risk of mouth injury.

FAQs

How can I ease the pain of my teething baby?

Tips to ease child’s teething pain:

• Massage the gums gently with a cool, damp washcloth, or, if the teeth are close to emerging, use a clean finger. You can chill the washcloth in the freezer beforehand but wash it thoroughly before reusing it.
• Introduce cool, soft foods like applesauce, bananas, or yoghurt (if the child has started on solid food).
• Wipe the drool from the child’s face with a clean cloth to prevent rashes.
• Offer your child a chilled item to chew on, like a solid rubber teething ring or a cold piece of apple.

What is the best soothing for teething?

Teething rings, toys made with firm rubber or a chilled spoon can be soothing for a child’s gum.

At what age does teething pain stop?

The teething process begins at 6 to 8 months of age and continues until around the age of 3 years, by which time most children have their full set of primary teeth.

How long can teething pain last?

Teething is a temporary process and the duration may vary in different children. It may last for a few days to a week. Teething pain is mild. If your child is crying too much or irritable, seek a doctor's consultation.

Why is teething worse at night?

The perception of teething pain as more severe at night is exacerbated by infants' exhaustion, making it more challenging for them to cope with discomfort. Additionally, babies do not have distractions at night as they do during the daytime.

What are signs that babies are teething?

• Swollen and tender gums
• Cranky or fussy child
• Chewing or nibbling on firm items
• Excessive drooling
• Difficulties with sleep
• Refusing food

Summary

Teething is a natural yet temporary process, but it can be uncomfortable for your little one. There are many ways to deal with a teething baby or child to ease their discomfort but be cautious while using methods which have issued warnings from the FDA.

If your baby is showing more severe symptoms and is not manageable, it is advised to consult your healthcare provider for personalised advice.