Teething is a rough time for the pediatric population. In this review, you will learn about the teething process that includes the teething sequence, symptoms, and remedies to help the child who is teething.

Teething can be separated into two stages: stage one is for the cutting of the 20 primary teeth and stage two is the cutting of the 32 permanent teeth.

The eruption of the primary teeth affects young babies and extends into toddlerhood. This is typically the most difficult stage of teething for the child. The eruption of the permanent teeth starts once the primary teeth begin to shed, which is around 5-7 years of age (school-age) and ends around adulthood.

This review will concentrate on the primary teething process for the young child.

When do most babies start and end teething?

Each baby is different in the time they teethe and the sequence for how they cut teeth. Some babies can start teething and have teeth erupt as soon as 3-4 months (or even earlier), while some may not cut a tooth until they’re one. The teething process is an on and off cycle and happens overtime.

The teething process for the primary teeth tends to end by 2-3 years of age.

How do the primary teeth typically start to cut through the gum line (the sequence)?

Typically, it goes like this according to the American Dental Association (ADA):

Lower central incisors (green): 6-10 months
Upper Central Incisors (green): 8-12 months
Lateral Central Incisors (pink): 9-13 months
Lower Lateral Incisors (pink): 10-16 months
Upper Canines (red): 16-22 months
Lower Canines (red): 17-23 months
Top First Molar (blue): 13-19 months
Lower First Molar (blue): 14-18 months
Lower Second Molar (brown): 23-31 month
Upper Second Molar (brown): 25-33 months

How do you Know if a Baby is Teething?

Signs and symptoms of teething occur before a tooth actually cuts through the gums and increases with intensity as the tooth is cutting through the gums. Once the tooth cuts through the gums the signs/symptoms will decrease.

The signs and symptoms may catch you off guard each time because you don’t know when the baby is cutting the tooth. All of the sudden you may notice your baby is extremely cranky and clingy….not content at all and they need to be held and cuddle constantly (like during the newborn stage).

If you have an older baby, it may seem like the child is regressing in development. However, this can vary among children.

Signs and symptoms vary from child to child (some it doesn’t bother while others can experience severe symptoms):

–Gum line changes: gums are swollen, tooth buds may be present, or white areas on the gum line where the tooth is putting pressure or even the presence of a tooth that has broken the gum line.
–Drooling
–Biting on everything (fingers, toys, nipples during breastfeeding)
–Whiny/fussy
–Clingy
–Sleep problems
–Not wanting to eat (may start refusing solids)
–Pulling at the ear (why? the pain they are feeling in the gums is radiating to the ears due to the nerves that branch out from the teeth to the ears. **However, confirm the baby doesn’t have an ear infection…has the baby been sick with a cold, has a high fever, runny nose, productive cough…the baby may not be teething but is sick).
–Red cheeks

Teething Remedies

• Teethers (here some examples of teethers)
  • Put them in the freezer to get cold
  • Teethers help relieve pressure in the gums and the coldness will help soothe the inflammation

• Self feeders with frozen fruit or veggies
  • example: frozen blue berries, bananas, strawberries, breast milk: helps with providing the child with nutrition, helps them learn to self feed, and helps with teething

• Teether Foods (confirm baby is ready for this)
• Sucking (nursing helps)
• Medication per the doctor’s recommendation
  • Acetaminophen
  • If over 6 months, Ibuprofen

• Lots of cuddling and patience
• Once they cut through: brush them regularly

References