Written by Claire Burgess, Family Consultant

Teething can be one of the most difficult times with the under twos.  It is horrible to see your little one uncomfortable, in pain and not understanding what is happening to them or why they are feeling like they do.  If you have ever experienced pain with wisdom teeth pushing through I am sure that you can empathise with what your little one is going through. However, some babies and toddlers can breeze through teething and you only notice when you put your finger in their mouth and get a surprise nip! 

Teething can very often be attributed to babies and toddlers being unsettled and it can sometimes feel that it is going on for months on end! Typically this is not the case though and often you will see the common symptoms 2-3 days prior to the tooth/teeth coming through. 

Signs and symptoms

You may notice that your baby suffers from none, one or several of the symptoms below:

• Red and / or sore gums where a tooth is coming through. Often when you feel the gums they can feel hot.

• Red cheeks (one or both).

• Rubbing or pulling at one ear.

• Dribbling more than usual. *

• Gnawing and chewing on things more than usual.

• Generally being more unhappy / unsettled than usual.

• Loss of appetite.

• Trouble sleeping.

* Don’t confuse teething with a developmental stage.  It is very common for babies around 2-3 months old to start chewing on their hands or dribbling and this typically lasts until a child reaches 12-15 months.  Researchers believe that a baby’s excess dribble production is connected to a developing digestive system, it means your baby’s salivary glands are starting to fire up after not being needed as much when eating easy-to-digest milk.  Because of this it can sometimes feel that your little one has been teething for months with no sign of any teeth!

When do teeth come through?

Some babies are born with their first teeth. Others start teething before they are 4 months old, and some after 12 months. But most babies start teething at around 6 months. Most children will have all of their milk teeth by the time they are 2 1/2 years old.

What order do baby teeth appear in?

Here's a rough guide from the NHS about how babies' teeth usually emerge:

• Bottom incisors (bottom front teeth) – these are usually the first to come through, usually at around 5 to 7 months. 

• Top incisors (top front teeth) – these tend to come through at about 6 to 8 months. 

• Top lateral incisors (either side of the top front teeth) – these come through at around 9 to 11 months. 

• Bottom lateral incisors (either side of the bottom front teeth) – these come through at around 10 to 12 months. 

• First molars (back teeth) – these come through at around 12 to 16 months. 

• Canines (towards the back of the mouth) – these come through at around 16 to 20 months. 

• Second molars – these come through at around 20 to 30 months .

How to Help a Teething Baby

• Teething rings / toys – these are liquid filled and can be placed in the fridge (never the freezer - it makes them too cold which can hurt the sensitive gums and can even harm the gum) for baby to chew on. The cold may help to soothe sore gums.  There are also wooden teethers which are more environmentally friendly as well as various teething toys such as those from Gummee and teething jewellery, worn by the parent or carer, which baby can chew on, like these from Nibbling  or HEXNEX. Amber teething anklets / bracelets and necklaces worn by baby have become very popular, however information from The Royal Society for the Prevention of Accidents has raised concerns about these bracelets – read more here.

•  A wet flannel, that has again been chilled in the fridge, may offer some comfort for baby to chew on. Try to keep one section of the flannel dry so that this can then be held by you or your baby without getting cold hands.  You could also look at soaking the flannel in chamomile tea as a natural remedy.

• Pressure on the gums may help so try rubbing your clean finger along baby’s gums.

• If your baby has already started solids, cold pieces of fruit may offer comfort for baby to chew on. Ensure these are big enough that they won’t cause a choking risk. This is only if your child has started solids and is over the age of 6 months.

• Distraction – anything that might help to take baby’s mind off of their discomfort. Try games, reading stories, going out for a walk or a drive in the car. 

• Teething gels are available from pharmacies which contain a mild local anaesthetic. There is no evidence these can help, so always ask for advice from a pharmacist.  If you do decide to use a gel, make sure you use a teething gel that is specially designed for young children as general oral pain relief gels are not suitable for children. 

• There are homeopathic powders and gels available but again there is no evidence that these actually help. If you do decide to try these, the NHS advises that you should make sure it's licensed for use in the UK as some unlicensed homeopathic gels advertised on the internet have been linked to serious side effects. 

• If your baby is in a lot of pain and the tips above haven’t helped, you may want to try a sugar- free painkilling medicine such as Paracetamol or Ibuprofen which are suitable for babies from 3 months. The NHS warns however that Ibuprofen is not suitable for some children. Check with your pharmacist or doctor if your child: has had an allergic reaction to ibuprofen or any other medicines in the past; has asthma; has liver or kidney problems; has a health problem that means they have an increased risk of bleeding; has an inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis or is small or big for their age, as a lower or higher dose may be better. You should also never give your child Ibuprofen if they have Chickenpox (unless recommended by a doctor) – it can cause a serious skin reaction.  Always follow the instructions and, if you’re unsure, speak to your doctor or pharmacist. 

  Some babies will suffer from a ‘teething rash’ which is where they are dribbling/drooling more than normal and makes the skin around their mouth sore.  Putting a barrier cream on this area can help to protect against it getting more red and sore. Avoid using a wet wipe as this adds to the moisture, try using a soft flannel to dry the area as not to make it more sore.

Looking after your baby’s teeth

It is recommended that parents and carers should take babies to the dentist as soon as their first teeth come through, or before their first birthday.  This gets them off to a healthy start and used to visiting the dentist from an early age.  See the Dental Check by One website for more information. You can also start brushing your baby's teeth as soon as they start to come through. Use a baby toothbrush with a tiny smear of fluoride toothpaste.  More information about caring for your child’s teeth can be found on the NHS website here.

Teething varies between all babies, no two babies are the same.  Hopefully the hints and tips above will help you and your little one through this stage.  Just remember cuddles work wonders too! ;-) 

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