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Dentition or teething in babies starts around 5-9 months of age. The initial set of dentition is temporary in nature and it is replaced later by permanent teeth at around 6 years of age. Babies may feel uncomfortable when they are teething.

Teething in babies starts around 5-9 months of age

As new teeth grow, the gums may get inflamed and sensitive. The babies may become irritable during this process. The response to this discomfort varies and some babies get used to it very quickly.  Mother should be able to recognize this issue of teething pain and take appropriate steps to calm the baby.

Eruption of teeth

The primary, temporary, deciduous or milk teeth set has 20 teeth.  These include 8 incisors, 4 canine and 8 molars. The teeth in the upper jaw erupt earlier than those in the lower jaw except for lower central incisors.  The first tooth, the lower central incisor appears by 5-9 months. By one year of age 6-8 teeth are present. All the 20 teeth are present by around two and half years.

Symptoms during teething

The signs and symptoms of teething may not be the same in all the babies. It varies from one baby to another. Though mothers often associate drooling and babies putting fingers in their mouth as symptoms of teething, these symptoms may not be necessarily those of teething and they may be just part of normal developmental process and coincidental with teething. The specific sign of teething include:

  • Eruption of tooth itself
  • Swollen gums

The other symptoms which may be seen during teething and which may sometimes be a mere coincidence are:

  • Drooling
  • Increased biting
  • Decreased appetite
  • Putting fingers in the mouth
  • Rubbing the gums
  • Irritability
  • Poor sleep

The symptoms may be seen about 3-4 days before the eruption of tooth and may persist a few days after it has erupted. These will not persist for weeks as wrongly believed. These symptoms may recur when a new tooth erupts.

Teething may be accompanied by other symptoms like low grade fever. Though low grade fever can occur during teething most of the times it may be due to some other cause and proper evaluation should be done. Similarly diarrhea is also wrongly believed to be a symptom of teething. Diarrhea though can occur during teething is not a symptom of teething but just a coincidence. At around the same time when teething is seen, hand mouth coordination occurs. This leads to another developmental milestone called mouthing. The baby starts putting in the mouth whatever he/she able to grasp with the hands. This exposes the baby to germs which may result in diarrhea.

Teething pain varies from child to child

The lower central incisor is the first tooth to erupt at around 5-9 months of age. The erupting tooth exerts pressure on the surrounding tissue. As the tooth erupts, the gum surrounding it becomes inflamed and sensitive. The gum reddens, becomes swollen and may be painful to touch. The baby feels uncomfortable and may become irritable.

The tooth that causes pain varies from child to child. But most often it is the first tooth that causes much discomfort. Sometimes it could be due to the molars. Molars are quite big when compared to the first appearing central incisors.

Read More: Baby Colic (Abdominal Pain in Infants) - Symptoms and Treatment

How to deal with teething pain?

The following steps may be taken to deal with teething pain in babies:

  • When the baby cries or is irritable, the mother can hold the baby and comfort him/her.
  • Baby may be distracted by patting, talking or rocking gently
  • Baby can be allowed to suck a pacifier.
  • Nursing the baby more often provides relief from teething pain.
  • Babies may be seen put the fingers in the mouth and rubbing the gums during teething. This is similar to massaging. If it is done by another person it will be more soothing to the baby. The mother can rub the gums of the baby gently to comfort him/her. But proper precaution like washing her hands well should be taken.  A clean finger should be used to gently rub the gums around the erupting tooth. Though initially it may be a little uncomfortable, it becomes more soothing for the baby as massaging is continued.
  • Allowing the babies with teething pain to chew is another good option. Most doctors suggest mothers of allowing the babies to chew wet washcloths or terrycloth toys taken fresh from the refrigerator. Alternatively food can be given for chewing if the baby is more than 6 months. Sugar free biscuit, unsweetened rusk, bread slices may be given. These should be given under supervision as these carry the risk of choking if the baby bites off larger pieces.  Cold food can numb the gums and can be given to relieve teeth pain. Chilled yoghurt or unsweetened apple puree can be given.
  • A dose of acetaminophen can be given to reduce pain. Ibuprofen is another option. These medications are analgesic medications which provide adequate relief from teething pain and discomfort. These medications not only provide relief from teething pain but also bring down the temperature if the baby is having fever. But if the temperature is very high, then the baby should be taken to the doctor to find the cause of fever as high fever is not caused by teething.
  • Topical anesthetics can be used to relieve teething pain. Topical Benzocaine can be used. Benzocaine is an anesthetic medication.  This medication makes the gum go numb and reduce pain. But a numb swollen gum may sometimes be causing discomfort similar to the teething pain. This medication only provides transient relief and the effect may last for about 30 to 60 minutes.  Moreover it also carries a small risk of allergic reaction in susceptible babies.
  • Teething gel like Bongela teething gel can be used to relieve teething pain. The teething gel is applied gently on the gums around the erupting teeth with a clean finger.  In addition to the teething gel, the procedure of applying the gel also will give the effect of massaging and will provide good relief.