Arrival of Primary Molars – A Walkthrough for the Parents

We often see behavior changes like irritability and anguish in a toddler during primary molars eruption. The major discomfort is due to red and swollen gums around the area of eruption. Some children also suffer from mild fever due to pain. As parents, you can ease this discomfort for your child by just altering their food habits and maintaining proper oral hygiene.

We all have a distinct memory of our teeth coming in for the first time. The reason for this distinct memory is the pain associated with teeth eruption. Children have a hard time going through pre-eruption pain and discomfort.


Front teeth come in early, so they don’t feel much discomfort. The tricky part of the eruption process is molar teeth or back teeth coming in later at the age of 1 to 2 years.

The age of molar eruption is also the transition time for a child from the stage of infancy to toddler. Toddlers are the fussiest when it comes to handling them while teeth eruption.

Let’s walk through this guide that might help your child through primary molars eruption.

What are the primary molars and when do they come?

Primary teeth or milk teeth are the first teeth to appear in a child’s mouth. Primary molars are the back teeth that appear in your child’s mouth.

Baby teeth start erupting in your child’s mouth since the age of 6 months. The first primary teeth to erupt are lower front teeth and the last ones to erupt are upper 2nd molars.  (1)

Primary teeth help your child to chew before the permanent teeth erupt. Baby teeth are important because they give time for the permanent teeth to develop underneath fully. Therefore, taking care of milk teeth is as important as permanent teeth.

First molars appear in the upper jaws at the age of 18 to 19 months and in the lower jaws around 14 to 16 months of age. Be prepared for erupting molars, as soon as you see your child biting his toys from the back of his mouth.

Gums become irritable and swollen during an eruption, so your child tries to bite down on things to ease the discomfort. There are few specific signs to look out for when your child is teething.

You can take a few measures to relieve the pain. So let’s dive into the details.

Signs and symptoms of erupting primary molars

Your child might have the following symptoms during the eruption of primary molars.

  • Pain in the gums around the erupting molar
  • Inflammation of the gums
  • General malaise like fever and flushed face
  • Disturbed sleep due to pain
  • Facial flushing if there is fever
  • Drooling
  • Gum rubbing/biting/sucking
  • Stomach ache and loose stools
  • Loss of appetite

If your child has these symptoms and you don’t see a tooth coming in, immediately call your pediatrician. These symptoms may also be due to a systemic problem when not associated with teething. (2)

Why your child might be in pain during a primary molar eruption?

Teething is always hard for your toddler, especially while molars erupt. Molars are comparatively larger, and they erupt when your child is around two years old. At this age, your toddler becomes well aware of the pain and how to express it.

An apprehensive toddler while teething is in his absolute worst because of moderate pain in the gums when molars erupt.  Why is molar eruption painful, you may ask?

The primary reason is the broad size of the tooth. Also by the age of 2, the gums are more developed and fibrous. So when molars start busting out of your toddler’s gums, it creates pressure on the gums.

All eight molars might start erupting in quick succession to one another, making the process all the more painful for your child.

In this case, visit your dentist. He/she may be able to help you through this phase. Dentists often prescribe mild analgesic gels if there are severe teething symptoms and pain.

Easing pain and discomfort

It is difficult to reassure or control a toddler in pain. But with the following minor dietary changes and methods, we can ease out the pain.

Home remedies

The following can be done by you at home to ease your child’s teething discomfort-

  • Give chilled teething rings
  • Frozen fruit and vegetables or sugar-free smoothies help soothe the pain
  • Give chilled pacifiers
  • Reassure your child that the pain will subside in sometime
  • Rub the gums with a chilled spoon
  • Brush around the area with a soft brush and toothpaste (3)

When to see a dentist? Conventional therapy

If your child is too irritable, refuses to eat or sleep to the point where it might have started affecting his health, see a dentist. Many methods exist for teething treatment.

Pain-relief medicines can be given including ibuprofen or acetaminophen to dull the pain. The dentist may administer numbing compounds containing topical benzocaine and lignocaine in your child’s gums.

Usually, dentists advise us to use soft bristle toothbrushes with smaller heads for our children. Teething pain can be controlled by helping your child brush twice daily with this kind of a brush in small circular motion.

Maintaining oral hygiene while teething

Maintaining good oral health is essential during teething because the gums are tender and susceptible to infection. Brushing twice every day with a soft bristle brush and mild toothpaste is very important.

Make small circular motion while brushing your child’s teeth. This method of tooth brushing is called Fon’s technique. Tooth brushing and gum massage increase the blood flow in the gums.

Increased blood flow to the gums leads to reduced pain and discomfort. Repeat the whole process twice or thrice in a day and avoid putting your or your child’s dirty fingers in his mouth.

Over to you

Every child has to go through teething. As parents, you can assist your child while tooth brushing and help reduce the discomfort associated with teething.


Molars are the last primary teeth to erupt. They erupt in the back of the jaws, and hence your child becomes even more irritable. Cleaning or being able to see this area is difficult for you.

Maintain pristine oral health while teething, make a few dietary adjustments and apply numbing gels over the irritated gingiva.

With a little patience and care, you and your child will quickly get through this phase. If your child’s discomfort continues or becomes unbearable, visit your dentist for further assistance.


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