Baby’s first tooth: A parent’s guide to teething

  • Published
  • By 1st Lt. Amanda Peter
  • 23rd Medical Operations Squadron
MOODY AIR FORCE BASE, Ga. --  Most parents want to know when their baby will get their first tooth. Because every baby develops at a different rate, their first tooth can arrive as early as three months to as late as 14 months. The stages in which a baby's first tooth grows in vary from infant to infant. 

Tooth development is also based upon a baby's hereditary patterns, but for the most part, teeth appear in the following stages: at six to seven months old, babies will grow the two lower middle teeth (incisors); followed by the two upper middle teeth (incisors). Between seven and nine months old, two more incisors typically will develop. When a child is 10 to 14 months old, the first molar will begin to grow, followed by the canine teeth at 15 to 18 months old. Finally, at two to three years old a child's second molars will grow. 

Teething is the first sign that an infant's teeth are growing. Since every infant is different, there are various symptoms that they may or may not experience during teething. 

The following symptoms are typical and usually occur when an infant is teething. 

- Irritability - As a tooth grows closer to the surface of the gums, it becomes sore and the infant will likely become irritable, especially at night when there are fewer distractions.
- Drooling - Excessive drooling can indicate teething, but it is also a normal developmental stage of infancy and some babies are just prone to this type of behavior.
- Chin rash - Irritation from saliva can cause a chin rash. To prevent this, wipe gently and try not to irritate the area.
- Gnawing/chewing - Babies can begin gnawing or chewing to relieve the pain associated teething.
- Fever - A low-grade fever may be present during an infant's teething stage.
- Swollen gums - The pushing of a new tooth beneath the surface causes the gums to swell, become red and sometimes appear bruised.
- Pulling at ears - This action can indicate pain in the jaw from the growth of molars. The development of molars can be more painful due to their larger size.
- Change in eating habits - This will vary with each infant. Some prefer to eat more due to relief of food on their gums and others refuse food due to pain.
- Loose stools - Infants may or may not experience slightly looser stools with teething, which is thought to be caused by the increased swallowing of saliva. 

There are several options to easing a baby's teething pains during this developmental stage. Just like varied symptoms, each baby is going to have different responses to treatment. It is suggested to try more than one treatment before finding something that works for an infant. Creativity might also be useful such as combining two or three different treatments. 

Treatments can include: 

- Gum massage - Massage the gums using a finger for two minutes. Apply counter pressure gently to the swollen or irritated area.
- Teething rings/pacifier/frozen washcloth - Allow infants to chew on them to provide relief.
- Infant acetaminophen - Use as directed for age and weight.
- Cup feeding - Use a cup, spoon or syringe for temporary feeding during teething. 

Parents are reminded that the following treatments are not recommended during teething. 

- Do not rub any kind of alcohol on the infant's gums because it is very dangerous to the infant.
- Do not give aspirin to children because of risk of Reye's syndrome.
- Do not give ibuprofen to infants under six months of age.
- Use caution when giving infants frozen food to chew due to choking hazards.
- Over-the-counter teething gels are not recommended due to the potential for allergic reactions and potential choking from numbing of the lips and tongue. 

For infants who are teething, parents should seek immediate medical assistance when the child experiences a fever greater than 101 Fahrenheit degrees, has unexplained crying or the infant develops symptoms other than previously listed.