Teething

Pediatric HouseCalls Online

DEFINITION

• Questions about teething, the normal process of new primary teeth working their way through the gums.
• Teeth come in between 6 and 24 months of age.

Symptoms

• Main symptoms are increased saliva, drooling and desire to chew on things.
• Occasional symptoms: mild gum pain.  Not enough to cause crying or interfere with sleep.
• Does not cause fever, diarrhea, diaper rash, ill appearance or lowered resistance to infection.
• Caution: blaming teething for fevers can lead to a delayed diagnosis of ear infections, urinary tract infections, meningitis and other infections.

See More Appropriate Topic (instead of this one) If

• Main symptom is crying, see CRYING CHILD OLDER THAN 3 MONTHS OLD.
• FEVER is also present.

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick

Call Your Doctor During Weekday Office Hours If

• You think your child needs to be seen.
• You have other questions or concerns

Parent Care at Home If

• Normal teething and you don't think your child needs to be seen.

HOME CARE ADVICE FOR TEETHING

1. Reassurance:  
   • Teething is a natural process.  
   • It's harmless and it causes little if any pain.  
   • It doesn't cause fever or crying. If present, look for another cause.
2. Gum Massage:  
   • Find the irritated or swollen gum.  
   • Massage it with your finger for 2 minutes.  
   • Do this as often as necessary.  
   • You may use a piece of ice wrapped in a wet cloth to massage the gum.
3. Teething Rings or Teething Biscuits: Infants massage their own gums by chewing on smooth, hard objects.
   • Offer a teething ring, pacifier or wet washcloth that has been chilled in the refrigerator, but not frozen in the freezer.  A piece of chilled banana may help.
   • Avoid hard foods that could cause choking (e.g., raw carrots).
   • Avoid ice or popsicles that could cause frostbite of the gums.
4. Cup Feeding:  If your infant refuses nipple feedings, use a cup or spoon temporarily.
5. Pain Medicine:  If the pain increases, give acetaminophen (e.g. Tylenol) orally for 1 day. Special teething gels are unnecessary and we do not recommend them. They can cause allergic reactions or choking.
6. Call Your Doctor If:
   • Develops unexplained crying
   • Develops fever
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.