Teething and What to Expect

Baby teeth appear at different ages for different babies and can sometimes take quite some time before they appear. By three years of age most children will have all of their primary teeth. If by the time your baby reaches twelve months of age he does not have his first tooth, you should consult your dentist.

There are 20 primary or “baby” teeth that every child has during their lifetime: ten in the upper jaw and ten in the lower. Typically, the appearance of baby teeth is as follows: the upper and lower incisors come first, then the upper lateral incisors come in a few months later, followed shortly thereafter with the bottom lateral incisors. The top and bottom molars are the next set to come through, usually right around 18 months. The cuspids, or eyeteeth, usually follow soon after the molars. At approximately two, to two and a half years, the second set of molars will appear.

The order in which baby teeth appear can vary and no two children will necessarily be alike in their teething schedule. Although occasionally it occurs that a child does not get an entire set of baby teeth, it is still very rare that a child doesn't get all twenty.

Occasionally a baby is born with a front tooth (about 1 in every 2000 babies are born this way). If this happens a pediatric dentist should see your baby. Until you and your baby adjust this can interfere with breastfeeding so it’s best to see a pediatric dentist as soon as possible, especially if you intend to breastfeed.

If you are wondering if your baby is teething here are a few surefire signs that your little one is about to get his first set of choppers:

• Increased fussiness.
• Nighttime crying.
• “Clingy" behavior.
• Excessive dribbling (drooling).
• Chewing on fingers, teething rings, and other objects.
• Swollen, red, inflamed gums.
• Increased demand in breast or bottle-feeding.
• Rejection of breast or bottle because sucking hurts the gums.
• Poor appetite.
• Interrupted sleep.

Although you may have heard otherwise from well meaning friends and relatives, teething does NOT cause significant fever (over 100 degrees rectally), sleep problems, diarrhea, diaper rash, or lowered resistance to any infection.

To help soothe your baby's teething discomfort, follow these guidelines:

• Gently massage the swollen gums with one of your fingers (be sure to wash your hands thoroughly).
  
• Take a clean, soft washcloth and soak it in apple juice. Wring it out, tie the cloth in a knot, and place it in the freezer for 30 minutes (it will not freeze hard like water does, rather, it will get very cold and nearly frozen). When frozen, give it to your baby, placing it first in his mouth, then his hands. You will see almost immediate results. Your baby will love the apple juice and most doctors approve it for even very young infants. The combination of the cold and the texture of the washcloth will begin to ease your baby's pain right away.
  
• Give your child something cold to gnaw on like a Popsicle or a chilled teething ring (not a frozen one), or a frozen banana.
  
• Do not use lotions or ointments that are supposed to reduce teething pain in a baby less than four months. They wash out of the baby's mouth within minutes. They may contain an agent that could numb the throat and cause the baby to choke.
  
• NEVER, under any circumstances, place alcohol into your baby’s mouth. Many well meaning friends and relatives (there sure are a LOT of those “well meaning friends and relatives”) may suggest a “dab of whiskey”, but this is NEVER ok. Alcohol can act like a poison to a young baby.
  
• Acetaminophen may be used for a few days if your baby is uncomfortable.
  
• Baby Advil (ibuprofen) can be used as well and can be more effective than acetaminophen because ibuprofen contains an anti inflammatory component and acetaminophen does not.

Though your baby will eventually replace his primary teeth with permanent teeth they are still important for his development right now and are not just there for appearance. Primary teeth enable children to chew and speak properly, and these "baby" teeth reserve space in the jaw for permanent teeth. The proper care of baby teeth can be very important to the proper development of adult teeth.

Once the new teeth are in place clean them with a soft baby toothbrush or wipe them with gauze.

Be sure to never allow your baby to fall asleep with a bottle. This will lead to tooth decay. Whether a baby is bottle fed or nursed, he will be vulnerable to “baby bottle tooth decay”. Such decay occurs when freshly sprouted baby teeth are exposed to liquids containing sugars (basically, anything other than water) for long periods of time. Bacteria in the mouth will grow in the sugar, which attack the tooth enamel and cause cavities. The best treatment for “baby bottle tooth decay” is prevention. Don't let your baby use a bottle as a pacifier or fall asleep with a bottle containing anything but water. Also, be sure to gently clean his teeth and gums after each feeding.

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