Baby teething is an exciting milestone! As a parent or caregiver, it can be both exciting and worrisome to see those little teeth poking out for the first time. But when do babies start teething? The answer may surprise you.
In this article, we will explore every exciting detail about baby teeth.
Age of First Tooth
Babies are born with all of their baby baby teeth hiding inside of their gums. For most babies teeth will begin to erupt between the ages of 6 and 12 months old. However, there is significant variability when the first tooth may appear. It is important to note that this timeline is not set in stone, and some infants may experience delayed teething.
Delayed teething refers to the situation where a baby does not have any teeth after 12 months or later. This can be a cause for concern for some parents, but it is still within the range of normal development. You may be wondering if it’s possible that your baby will never get teeth, but have no fear.
The American Academy of Pediatrics recommends making an appointment with a board-certified pediatric dentist if your baby has no teeth at 18 months old. Delayed teething does not necessarily indicate a problem, but it is important to seek professional advice at this age for a work up.
What About Fluoride?
In February of 2014, the American Dental Association (ADA) recommended new fluoride guidelines for children in order to decrease early dental decay. They recommend the use of a grain of rice size or smear of fluoride toothpaste beginning after the eruption of the first tooth. Put the toothpaste on a soft-bristled toothbrush and gently brush that little tooth. Studies have shown that using this small amount of toothpaste will not lead to fluorosis, even though your baby will swallow some toothpaste. In addition to brushing with fluoride toothpaste, you need to add fluoride to your child’s diet around 6 months of age. Most municipal water supplies are supplemented with fluoride. Be sure to ask your pediatrician about fluoride supplements for your baby if your family has well water.
Tooth decay is a common problem among young children, and it can have long-term effects on their oral health. By incorporating fluoride into their diet and tooth brushing routine early on, you can help protect their teeth and establish good dental hygiene habits from a young age.
In recent years, fluoride has gotten a bad rap from the “natural” community. Parents have called into question the safety of fluoride, especially in public water supply. Thankfully, studies have shown that fluoride is safe and works to prevent dental decay in kids and adults.
Fluoride from toothpaste doesn’t stay on teeth for very long. However, fluoride varnishes stay on the tooth for several months. Varnishes can be applied by your child’s pediatrician or dentist. It is important to protect baby teeth or primary teeth as they are placeholders for your child’s permanent teeth.
Ways to Relieve Teething Pain
Teething can be a challenging time for both babies and parents. The process of teeth erupting through the gums can cause discomfort and pain for infants. Some babies are very bothered by the teething process while others don’t show many signs of teething pain. However, there are several methods that can help soothe a baby’s teething pain. One effective method is massaging sore gums with a cold washcloth.
Another method to ease this pain is to offer other cold items such as a liquid-filled teething ring. Cold temperatures numb the gums, providing temporary relief. Ensure that the teething ring is specifically designed for this purpose and does not contain any substances that could harm your baby. Avoid using sharp objects or frozen items as they may cause injury. Supervise your child to prevent choking and remove any objects that become damaged.
If the pain persists or causes your baby to be fussy, you can administer pain relievers. Babies under 6 months old can have acetaminophen while babies over 6 months can have either acetaminophen or ibuprofen. Be sure to follow the directions carefully and give your baby the appropriate dose. You can consult your child’s pediatrician for their weight based dose.
Things to Avoid
While no one wants to see their baby in pain, it is important to avoid certain teething pain remedies. These things are ineffective and often dangerous. These include teething tablets, gels with benzocaine, homeopathic teething gels or tablets, and amber teething necklaces.
Homeopathic teething products like teething tablets are potentially dangerous. There was a popular brand of these tablets that was recalled in recent years. This was due to these homeopathic teething tablets containing belladonna. This substance leads to serious side effects, including seizures, difficulty breathing, and even death. Due to these risks, the U.S. Food and Drug Administration (FDA) has issued warnings against using this unregulated product.
Additionally, parents should avoid gels containing benzocaine. This medication is a local anesthetic that numbs the gums to provide temporary relief from teething pain. However, it has been associated with a rare but potentially fatal condition called methemoglobinemia. This condition affects the oxygen-carrying capacity of red blood cells. The FDA advises against using benzocaine gels in children under 2 years old.
As a resident pediatrician, I had to administer medication to a baby in the hospital who came in with methemoglobinemia from teething gel. She came to the ER because her parents noticed that she was blue.
Lastly, please avoid amber teething necklaces. They may seem like a natural solution to pain during the teething period, but they are ineffective and potentially dangerous. Parents have been told that they release a substance called succinic acid which has analgesic effects. Unfortunately, this substance is not released until the amber is heated to really hot temperatures. Even then, there is no scientific evidence that this helps with any kind of pain, let alone teething pain. There are many other reasons why pediatricians hate amber teething necklaces.
Brushing Tiny Teeth
The minute that you see your baby’s tiny tooth, you should start their oral care routine. Make your goal to brush that tooth with a soft toothbrush with a bit of fluoride toothpaste twice daily. In general, your baby’s first tooth will be two bottom central incisors (front teeth), followed by the upper central and lateral incisors a month or two later.
Children frequently fight you when you are trying to brush their teeth. However, it is really important to win that battle at least once per day. As the parent, you want to do a good tooth brushing in the evening before they go to bed. You need to do the brushing because you are much better at getting their teeth clean. In the morning, you can allow your child to brush their teeth on their own while you supervise.
Pediatric dentists recommend that the parent does the child’s tooth brushing until 8 years of age. Children don’t have the dexterity or attention to detail to properly brush their teeth on their own. It is important for parents to be in charge of this task. Teach your child proper brushing techniques. This includes gentle circular motions and reaching all surfaces of the teeth. This will help maintain healthy teeth and good oral hygiene.
Signs of Teething
Around 4 months of age, babies start to drool a lot as well as put their hands in their mouth. Often, parents believe that this is a sign that their baby is teething. And while teeth can appear at this age, more often than not, your baby won’t get their first tooth until 6 months old. Excess saliva at this age is a normal developmental milestone. When your child’s teeth actually begin to erupt, you may note flushed cheeks or a low-grade fever or elevated body temperature. True fever is 100.4 degrees Farenheit or higher. Teething does not cause a true fever, but babies who are teething are more likely to pick up germs because they are putting their hands in their mouths more often.
Fluoride Varnish
It is important for parents to discuss their baby’s teeth and fluoride varnish with their pediatrician. Your pediatrician will monitor your baby’s pearly whites. We will ensure that your child has good oral health from a young age. During well-child visits, the pediatrician will not only check the baby’s overall growth and development but also examine their teeth.
Regular dental check-ups are essential, even for infants, as tooth decay can occur as soon as teeth erupt. By assessing the baby’s teeth, your pediatrician can identify any signs of tooth decay early on.This preventive approach can help avoid more severe dental issues in the future.
One effective prevention method that pediatricians recommend during well-child visits is the application of fluoride varnish. Fluoride varnish is a protective coating that is applied to the teeth to strengthen the enamel and prevent tooth decay. This procedure is safe and effective, especially when started early.
The process of applying fluoride varnish is quick and painless. The pediatrician or dentist will apply a small amount of varnish onto the surface of the teeth using a brush. The varnish hardens quickly and forms a protective layer. This can be repeated every few months.
First Dentist Visit
The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) recommend that children visit a pediatric dentist within six months of their first tooth erupting, or by their first birthday at the latest.
This early dental appointment is important because it establishes a dental home for your child. A board certified pediatric dentist plays a vital role in monitoring your child’s tooth development as well as monitoring for decay. This is just one of the reasons well child care is important. In general, kids under age 3 years old have a “happy” visit where the dental hygienist goes over good oral hygiene habits. Additionally, they examine your child’s teeth to get them acquainted with the process. Regular dental visits from a young age also familiarize children with the dental setting. This reduces their anxiety and promotes a positive attitude towards oral health.
Celebrate Every Moment
Childhood is such a whirlwind of milestones for both parents and kids alike. While teething is an important part of those milestones, it does need to be stressful for families. Hopefully, this article will equip you with ways to prioritize your child’s dental health and what to avoid when it comes to teething. Before you know it, your child will start to lose all of those hard earned baby teeth.
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© 127 Pediatrics; December 2023
This article exists for informational purposes only and should not be construed as medical advice.
Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house-calls-only concierge pediatric practice in Colleyville, TX. She is also the owner and operator of the 127 Pediatrics Online Breastfeeding Medicine and Education Center.
