Complete Handbook on Teething

Teething, the process of a baby's first teeth breaking through the gums, is one of the initial challenges of growth and can be as stressful for parents as it is for the child. While some infants may navigate this stage with ease, others might face discomfort and irritability.

Teething can start as early as 3 months and may persist until the age of 3, by which time most children typically have all 20 primary teeth. These teeth, also known as baby teeth or deciduous teeth, are temporary and will eventually be succeeded by permanent teeth.

Primary teeth remain in place until approximately age 6, when permanent teeth begin to emerge. At this stage, primary teeth loosen and are naturally shed, or exfoliated, from the gums. The development of permanent teeth is a more extended process compared to primary teeth and can continue into adulthood, culminating with the eruption of wisdom teeth, or third molars. These molars typically appear between 17 and 21 years of age and often cause issues due to misalignment, potentially displacing adjacent teeth. As a result, wisdom teeth frequently require removal.

However, this process actually starts in the womb, where teeth undergo the initial phase of their three-stage development. The following section delves into these stages and explores the biological and mechanical aspects of teething.

Biology and Mechanics of Teething

Teeth go through three developmental phases:

The first phase, growth, commences as early as the seventh week of fetal development, when tooth buds begin to form. These buds are clusters of cells that contain the tissue responsible for eventually shaping the teeth.

In the second phase of tooth development, known as calcification, calcium and minerals accumulate in layers, hardening the tooth and forming enamel. This process is highly efficient, as enamel is the toughest substance in the human body. However, this durability has a downside: since enamel lacks living tissue, it cannot regenerate or repair itself like other bodily tissues.

Interestingly, babies are born with all 20 primary teeth already formed, though they remain hidden within the gums. The final stage, eruption, is when these teeth begin to push through the gums. This can be uncomfortable, as the tooth must navigate its way to the surface, causing persistent discomfort until it fully emerges. Since babies cannot articulate their pain, their frustration and distress can exacerbate the situation.

Genetics also influence tooth development. A child’s teething pattern may resemble that of their parents, so knowing your own teething history can provide insights when your child goes through the same process. Other factors, such as gum density and pain tolerance, also determine how challenging teething might be for a child.

Maintaining hygiene during teething is crucial, as swollen or irritated gums are prone to infection. To prevent this, keep the area around the mouth clean and dry, and gently wipe the gums with a soft, damp cloth. Additionally, since teething babies often chew on anything within reach, ensure that all teething rings and chew toys are thoroughly sanitized.

Even though primary teeth are temporary, caring for them is essential for long-term dental health. Babies can develop cavities and other oral issues, and losing primary teeth too early can cause the remaining teeth to shift, leading to crowding and misalignment of permanent teeth.

In the following section, we’ll explore some of the typical symptoms linked to teething, as well as a few less common but more serious signs to watch for.

Teething Symptoms

When teeth push through the gums, it often results in tender and inflamed gums, which can heighten a child’s irritability. This is why teething is frequently blamed whenever a baby is fussy, even if teeth aren’t actually emerging. To check if teething is the cause, gently run your finger along the gums to feel for any teeth breaking through.

Another frequent symptom is increased drooling, which is one of the most noticeable signs of teething. The urge to chew, triggered by teething, stimulates the salivary glands [source: Cohen]. While drooling might seem minor, it can lead to other complications. Constant moisture can irritate the skin, causing rashes or inflammation, and excessive saliva can even result in a cough.

The desire to chew can also lead to biting, another common teething symptom parents should monitor. As teeth push through the gums, they can cause soreness, and biting provides counter pressure that eases the discomfort. Babies often chew on anything they can grasp, so keep an eye on what they put in their mouths.

These symptoms can escalate into more noticeable side effects, such as reduced appetite, difficulty sleeping, and even gum bruising.

A sore mouth might make babies reluctant to eat, particularly solid foods. Liquids can help ensure they stay nourished, but it’s wise to track their food intake during this phase. Discomfort from teething can also disrupt sleep, making it harder for babies to settle. Additionally, teething can sometimes cause gums to bruise or bleed, which might look concerning but is usually not very painful for the child. If this occurs, gently clean the area to confirm the source of the bleeding.

Remember, these symptoms can also indicate illness, so if there’s any uncertainty, parents should seek medical advice. Now that we’ve covered the symptoms, let’s explore some ways to ease teething discomfort.

Teething Remedies

Teething can be stressful for both children and parents, but knowing a few simple calming techniques can make this phase easier for everyone. Most teething babies find comfort in a parent’s touch, and something as straightforward as cuddling or rocking can help soothe both the child and caregiver.

Since teething babies have a strong urge to chew, parents can gently press their finger against the gums to provide counter pressure and relieve pain. Another effective option is a teething ring, a specially designed toy for teething infants. These rings come in various shapes and sizes, typically made from durable rubber to withstand a toddler’s biting.

A popular variation is water-filled teething rings that can be chilled in the refrigerator. Similar to applying ice to an injury, a cold teething ring can soothe sore gums. While ice cubes are another common remedy, they pose a choking risk. To reduce this danger, place the ice cube in a plastic bag and wrap it in a washcloth. This allows the baby to suck on the cloth safely, though supervision is still necessary to ensure the bag doesn’t come loose. Cold foods like applesauce or yogurt can also help ease discomfort.

For ongoing pain, over-the-counter teething medications are available. Teething gels, which are topical anesthetics applied directly to the gums, provide immediate relief. However, they should be used sparingly, as overuse can occur if teething symptoms are mistaken for other issues. Some pediatricians are cautious about recommending them. Infant ibuprofen, an anti-inflammatory, can also reduce pain from swollen gums [source: Greene]. Always consult a pediatrician before giving any medication.

As an alternative remedy, clove oil, a natural anesthetic long used by dentists for toothaches, can be effective. However, it should not be used for infants under 6 months and must be diluted for older babies and toddlers [sources: Medline Plus, Pitman]. The eugenol in clove oil, combined with gentle gum massage, can provide significant relief for teething discomfort. Some also suggest using pure vanilla extract, known for its calming properties and ability to create a soothing, warm sensation [source: Nature Moms].