So your little angel has turned into an unsettled, drooling vampire – unsettled at night, poor
feeding, fingers in the mouth, biting everything in sight and generating a tsunami of saliva.
‘Could it be teething?’ you ask, and ‘how would you know?’ Well, these eternal questions
are right up there with ‘what is the meaning of life?’ and ‘how to fix pandemics?’
When baby teeth erupt First, let’s go back to the basics. At birth, all babies have all their primary teeth, hidden
under their gums, just waiting to burst out and wreak havoc. They usually start erupting
between 4 to 7 months. By now I’m sure all you new parents would agree that the Golden
Rule about anything to do with pregnancy, childbirth and babies is that there are no Golden
Rules. Some sprogs start teething anywhere from 3 months of age through to well over a
year, and the occasional newborn even arrives on day one with a tooth or two on display.
The two lower central incisors usually arrive first, followed by the four upper central fangs,
the lower side incisors, then the molars (the grinders) and finally the pointy upper eye teeth
- 20 little baby teeth all up, usually by the third birthday. (Not that anyone is having big
birthday parties just now.) Then around three years later, those milk teeth start to shed and
the 32 permanent pearly whites begin to come through, nothing to it. Piece of cake, really. (Well, not too many pieces of cake.)
How do you know your little one is teething?
You won’t be surprised to hear that they all do it differently. Some babies just wake up one morning with a bright shining tooth. Happy as Larry. Others seem to absolutely sweat out each one with uber drama and great distress. In theory each teething episode takes around 8 days i.e. 4 days painful lead up, then the great eruption and another 3 days of misery after. However some babies go for the long slow build up for some weeks before the big day. All the signs are there but nothing to see.
Most teething babies get a little cranky and fussy, don’t feed as well, have more dirty
nappies, don’t sleep as well (it’s harder to ignore your aching gums lying in your cot at night
with no distractions), might pull the ear on the same side of the tooth coming through, stick
their fingers in the mouth, drool excessively and chew on anything they can get their hands
Do they get a temperature? Answer, no. Well not much. Some babies do seem to develop a
low-grade fever when they are teething, but anything over 37.5 or 38 is likely to be due to
an infection, viral or bacterial. What about rashes? Sure, some little ones get a bit rashy
especially on the face and chin and upper chest but teething usually doesn’t cause more
generalised rashes. Lethargic and floppy? Certainly not. Teething bubs are more likely to be
annoyed and agitated. So if your baby has a high temp, persistent vomiting/diarrhoea, an
odd rash or seems flat and out of it, don’t blame it on those toothy pegs - time to seek
How to you soothe teething? No simple solution. Best to wipe the face with a cloth to mopup the drool, rub your baby’s gums with a (clean) finger, give him/her something to bite on, like a cold teething ring or toothbrush, something firm to suck on, like a (sugar free) rusk and prepare mushier foods. If your bub still seems pretty unhappy and teething is the obvious cause, then it’s worth a dose of paracetamol, or ibuprofen (if over 6 months).
We medicos are not crazy about teething gels because we feel they don’t really help and
usually contain aspirin, which we avoid in young children, and local anaesthetic which doesn’t absorb well via the gums. Also any benefit rarely justifies the trauma of trying to rub
it on! Ditto about the ubiquitous amber bead necklaces, which are supposed to release a
soothing oil when in contact with warm skin. They can be dangerous if babies chew on them
or get them tangled up, ie. there is a small risk of choking. So, don’t let your baby sleep with
one of these necklaces on.
Do you need to look after baby teeth?
I mean the Tooth Fairy is going to end up with them anyway, right? Answer, course you do. It’s important to get into the habit of cleaning them from the start. Mum or dad needs to brush these new teeth twice a day with water and a small soft toothbrush. After 18 months you can start using a small amount of appropriate toothpaste. From around 2, kids can start holding the toothbrush themselves, but need adult supervision until they are 8 or so. And, of course, we love flossing and fluoride and we don’t love sugary snacks and going to
sleep with a bottle in situ. Even baby teeth can develop decay, which can result in other
health problems and early loss of those teeth can result in overcrowding when the
permanent teeth arrive.
So, the bottom line is, the main thing that teething produces is …teeth.
This article was written by Mama You've Got This GP and Shared Care Expert Dr Bill Batman, who features in Mama You've Got This Expert Videos as part of the Experts On Demand Video Series
Image credit - Leah Born on a Wednesday / Sophie The Giraffe