teething

New parents sometimes anticipate their baby's first tooth with a mixture of excitement and worry. While reaching a new developmental milestone is always a cause for celebration, this particular one can come with considerable discomfort. However, teething is different for each baby, and need not be painful at all; plus, there are steps you can take to make the process easier for your baby — and yourself.

Teething refers to the process by which primary (baby) teeth emerge through the gums and become visible in the mouth. This usually begins between six and nine months of age, though it may start as early as three months or as late as one year. Usually, the lower front teeth erupt first, followed by the ones directly above. Most children have all 20 of their primary teeth by the age of 3.

Common signs that your baby is teething include:

• Irritability
• Biting and gnawing
• Drooling
• Chin rash (caused by excessive salivation)
• Swollen gums
• Ear rubbing
• Decreased appetite
• Disrupted sleep patterns

You are most likely to notice any of the above from about four days before the tooth breaks through the gums up until three days after the tooth appears.

A less common teething issue is the formation of an “eruption cyst,” a small bubble-like swelling filled with fluid that covers an erupting tooth. Eruption cysts usually do not require treatment as the tooth will simply pop the cyst when it comes through.

While there has been some disagreement as to whether diarrhea, rashes and fever are signs of teething, these are more likely to be associated with an unrelated illness and should be reported to your pediatrician.

Teething babies get the most relief from cold and/or pressure on the affected area. This can be applied with:

• Chilled teething rings
• Cold, wet washcloths
• Chilled pacifiers
• Massaging baby's gums

Make sure not to actually freeze your baby's teething ring or pacifier because this could burn if left in the mouth for too long. The outmoded “remedy” of rubbing whiskey or other alcohol on the gums is neither effective nor appropriate. Over-the-counter medication may be helpful, but always check the correct dosage with your pediatrician or pharmacist. These, too, should not be rubbed on the gums because they can burn. Numbing agents shouldn't be used on babies under age 2 unless directed by a physician.

The Food and Drug Administration recommends that parents and caregivers not use benzocaine products for children younger than 2. “We are also warning that benzocaine oral drug products should only be used in adults and children 2 years and older if they contain certain warnings on the drug label," the FDA said in a May 2018 statement. "These products carry serious risks and provide little to no benefits for treating oral pain, including sore gums in infants due to teething.” Benzocaine is an over-the-counter anesthetic, which the FDA notes are usually under the product names Anbesol, Hurricaine, Orajel, Baby Orajel and Orabase. Benzocaine has been associated with a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood stream is greatly reduced.

The FDA also urges parents not to use – and dispose of homeopathic teething tablets – after lab testing found “inconsistent amounts of belladonna, a toxic substance, in certain homeopathic teething tablets, sometimes far exceeding the amount claimed on the label.”

“The body’s response to belladonna in children under two years of age is unpredictable and puts them at unnecessary risk,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research.

Homeopathic teething products have not been evaluated or approved by the FDA for safety or effectiveness, and the agency says it is unaware of any proven health benefit of the products.

"Consumers should seek medical care immediately if their child experiences seizures, difficulty breathing, lethargy, excessive sleepiness, muscle weakness, skin flushing, constipation, difficulty urinating, or agitation after using homeopathic teething tablets or gels," the FDA states.

Finally, If you have any questions about how to relieve your child’s teething symptoms, talk to your dentist or pediatrician.  Remember, it's best to start dental visits by your child's first birthday to establish this lifelong health-promoting routine. We look forward to meeting your little one!