Teething in Babies – An Overview of the Biggest Baby Milestone

The eruption of the first baby tooth is one of the milestones that parents celebrate. However, as new parents, it is essential to understand that this event is not always a comfortable one. Teething is a process of tooth eruption which often can make the baby irritable, anxious, fuzzy, and hyperactive. You cannot avoid this natural process; you can only treat its symptom.

Typically, the process of teething in infants begin from six months of age. This is the time when the first set of primary teeth start to erupt in the mouth. Usually, lower front teeth are the first set of teeth that erupt in babies. The duration of teething may vary from a few months to one year of age. By this time, all the primary teeth erupt in the mouth. During this process, the baby may experience a broad range of symptoms like drooling, fever, swollen, and tender gums.


It is essential to follow soothing methods to comfort your baby through the process of teething. There are several professional as well as home management techniques that can soothe the symptoms of teething. Today’s article will highlight the various symptoms of teething and different treatment modalities to manage the signs of teething.

What is teething?

Teething is typically defined as a natural process of tooth eruption commonly experienced by infants. This is the period when the primary teeth prepare to break and cut through the gums. Teething is also considered as one of the most significant milestones in a child’s life. Moreover, it is believed as a sign of proper health and development of the child. During this period, the baby transitions from a liquid diet to eating a solid food diet. (1)

However, teething is not an easy process for the baby. Often, it makes the baby irritated and fuzzy. The baby usually cries out loud and becomes restless during the day. Such situations can make baby management a difficult task, especially for new parents. It is essential to understand the reason behind teething and correct management techniques that can ease this process for the child as well as the parents.

What causes teething in babies?

As mentioned above, teething is a natural process of tooth eruption. Typically, babies are born with a full set of developed primary teeth embedded in the jaw bone and covered by gums. Each tooth has a specific rate of the eruption. Usually, tooth eruption in babies begins during the first years of life.

The teeth often cut through the gum tissue and get exposed to the oral environment. The first set of teeth to erupt in the mouth are the lower front incisors. Often the event of teeth breaking through the gums can cause mild pain and discomfort characterized as teething. Furthermore, during this stage, the baby tends to bite on hard objects.

What are the signs and symptoms of teething?

Teething usually brings a wide range of symptoms to the baby. However, every child is unique and can experience none or few symptoms to all the symptoms of teething. Some of the common signs and symptoms of teething are listed below –

  • Excessive drooling from the mouth
  • Mild irritability and cranky behavior
  • Fussiness (2)
  • A slight rise in temperature associated with facial flushing
  • Swollen and tender gums
  • Pain and discomfort in the mouth
  • Loss of appetite
  • Stomach pain associated with loose stools
  • Disturbed sleep pattern
  • An urge to bite or chew on hard objects
  • Sometimes the baby may also try to rub the gums

These are the typical signs and symptoms of teething. Some of the extreme symptoms like diarrhea, vomiting, or development of body rash, high fever, cough, and congestion may indicate an underlying health problem. (3)

It is essential to gather as much information as you can about teething. The best way is to contact a dentist or a pediatrician for advice. Persistent symptoms should be immediately addressed by a health care professional.

When do babies start teething?

Teething typically begins at the age of six months when the lower front incisors start to erupt in the mouth. The process of teething can, after that continue until a few months to several years until all the primary teeth have erupted in the oral cavity. The eruption sequence or teething schedule can be tracked as follows –

  • Around the age of six months, the lower front incisors erupt as the first set of primary teeth in the mouth. Followed by them, the upper front incisors erupt between the age of 8-10 months. Usually, lateral incisors erupt at a later stage in life which may take up to one-year time.
  • Next, in line are the primary first molars which erupt between the age of 13-19 months. Both the upper and lower first molars erupt simultaneously together during this timeline.
  • Following this timeline, the primary canines erupt between 16-22 months of age. (4)
  • Lastly, the second molars erupt at 23-25 months of age in both the upper and lower jaw.

The first set of teeth does not constitute premolars. The teething period ends when all the 20 primary teeth have erupted in the mouth of the child.

What can you do to manage the symptoms of teething?

There are several ways you can soothe the symptoms of teething in a bay. Some of the conventional treatments are listed below –

  • Cold objects work wonders in numbing the affected area and healing the swelling of the gums. You can use a chilled pacifier, spoon, teething toy, clean washcloth, or a small piece of carrot. Do not freeze the objects mentioned above. Keep them in the refrigerator to cool for some time and give it to your child to chew on it. (5)
  • Gently massage the gums of the baby. Do not rub it vigorously as it may aggravate the pain. An excellent way to soothe the pain through massage is to dip your fingers in cold water before you touch the gums. For more effectiveness, you can use an extra-soft toothbrush and gently massage the gums with the toothbrush.
  • Switch the child’s diet from liquid to solid food. Start by giving cold fruits and vegetables as it allows the baby to develop a taste for different food items gradually. Chewing on fresh cold fruits and vegetables is also a great way to soothe the teething pain and discomfort.
  • Always reassure your child that the pain is temporary and it will subside with time. Emotional support often works well and treats the fuzziness of the child. (6)
  • The most common type of teething toys that help to relieve the pain is teething rings and teething biscuits. Most people use a teething necklace. However, it is better to avoid the use of teething necklace as it may strangle the baby.

Teething toys come in a variety of shapes, size, and material. It is best to choose a toy which is slightly bigger than your child’s mouth. This prevents unnecessary choking on the toy. Single piece teething toys are better than teething toys with multiple parts.

Avoid teething toys that have a liquid gel inside them. Clinical studies have shown that the chemicals in the gel can be hazardous to the health of the baby. Silicone teething toys are often recommended as the best type of teething toys.

Pain relievers

Pain medications to soothe the symptoms of teething can be categorized into two categories –

  • Topical pain relievers come in the form of a teething gel. Most of the teething gel contains benzocaine as an active ingredient. However, benzocaine is not ideal for the health of the child. Sometimes, it can also pose a threat to the life of the child. Therefore, It is better to avoid teething gels that contain this active agent.

The Food and Drug Administration has declared benzocaine containing teething gel as harmful for children below two years of age. If you want to go for topical pain relievers, it is better to get professional recommendations from a dentist.

  • Oral medications can also be administered for children. Tylenol is a mild form of acetaminophen which is usually preferred for children. Tylenol is helpful against the pain as well as feverish symptoms that may occur during teething. Ibuprofen is often not considered safe for children under six months of age. Aspirin is also a dangerous pain medication that can be life-threatening to the child.

While using pain medications, you must take care of the dosage and frequency of the drug being administered. Never overmedicate the teething symptoms. At the same time, switch to the use of pain relievers when all other home remedies have been unsuccessful.

An ideal period for the use of pain medication is generally two days. If you wish to continue the use of pain relievers, it is best to take the advice of a dentist or a medical professional. Moreover, contact the health care professional immediately if the symptoms persist for a long time or when the swelling and redness increases aggressively. (7)

  • A new trend to relieve teething symptoms is the use of teething tablets like belladonna. Teething tablets are best used under a doctor’s supervision. Most of the teething tablets can have adverse effects on the health of the baby. This is because most of the times, parents are not aware of the ideal ingredient, dosage, and frequency of teething tablets that may be safe for the baby. (8)

A note on infant oral care

A healthy mouth is a portal to healthy growth and development of the baby. It is essential to take proper oral hygiene steps for your child and ensure that the baby has clean teeth and gums. Some of the common ways to take care of your child’s oral hygiene are as follows –

  • As soon as the first set of teeth start to erupt, get on a routine schedule of brushing the teeth. Use a small soft-bristled brush, for example, a finger brush for infants and clean the teeth twice a day.
  • A regular strength fluoride toothpaste works well for children. For babies, it is recommended to take an amount equivalent to the size of a rice grain.
  • Modify your child’s feeding habits as he grows older. It is best to train your child to drink from a sippy cup after six to eight months of age.
  • Make sure you’re your child is not sleeping with a bottle in the mouth. Sipping milk or sweet drinks while sleeping can potentially cause tooth decay. Switch the bottle with a pacifier to help your child sleep.
  • For infants below six months of age, it is essential to clean the gums. To do this, you can use a damp clean cloth and gently wipe the gums to remove the plaque. Make sure you are not rubbing the gums.

The first set of teeth will help your baby to eat and speak. It is, therefore, essential to take proper care of the teeth and prevent them from tooth decay.

Take away message

Teething is a natural process that an infant experience during tooth eruption. There is nothing you can do to stop the infant from teething. However, you can manage the symptoms to ease the process of teething. Usually, babies start the process of teething around five to six months of age which can prolong till one to two year of age. Some of the common symptoms of teething include pain and discomfort, anxiousness, and irritability. However, the symptoms pass eventually as the child’s primary teeth erupt.


Moreover, during teething, the child may tend to bite on hard or cold things to soothe the discomfort. Teething toys are one of the safest and best options for the baby to chew on. They are specially made from soft silicone or plastic material that does not hurt the oral tissues of the baby.

The parents can help to soothe the symptoms of teething by following professional recommended techniques or home remedies. In case of persistent pain and discomfort or development of new symptoms, immediately contact the dentist or a pediatrician to address the problem.


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