Teething begins before a child's first tooth breaks through the gums. It is a natural process, but causes sore gums. Teething can make your child uncomfortable and cranky. Teething lasts from 6 months to 3 years.
The first teeth start to come in when your baby is 6-12 months old. The first teeth are most often the two bottom front teeth. Other teeth will quickly follow. The pressure on the gums can make them swollen and tender.
Many babies do not experience any problems or pain. When symptoms do occur, they generally last for several days before and a few days after the tooth comes through the gums.
If the baby is feverish and acts sick or very upset, seek medical care. Something else may be causing the symptoms.
A doctor will diagnose teething by the baby's age, symptoms, and appearance of the gums. A teething baby's gums appear swollen and are tender. Sometimes small, white spots appear on the gums just before a tooth comes through. There may be some bruising or bleeding.
Most children will only need basic comfort measures. Your doctor may recommend pain-numbing gels and medications, but they are rarely needed.
Bring your child to a dentist when the first tooth comes in. Make sure to visit the dentist by one year of age. The dentist will perform an exam. You will be shown how to care for your child's teeth.
Teething babies usually like to chew on a wet washcloth or teething ring. Guidelines for teething rings include:
Note: Avoid using amber teething necklaces. Current evidence does not show that they help relieve pain. They are also a strangulation and choking hazard.
Other general tips include:
Healthy Smiles, Healthy Children—American Academy of Pediatric Dentistry
Mouth Healthy—American Dental Association
Canadian Dental Association
The Canadian Dental Hygienists Association
Amber teething necklaces: a caution for parents. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Amber-Teething-Necklaces.aspx. Updated October 19, 2016. Accessed December 8, 2016.
Teething: 4 to 7 months. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Teething-4-to-7-Months.aspx. Updated December 3, 2013. Accessed February 17, 2014.
Teeth and teething. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/kids/eating-nutrition/teeth-teething.html. Accessed February 17, 2014.
Teething tots. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/general/teeth/teething.html. Updated November 2011. Accessed February 17, 2014.
2/17/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014;145(2):190-191.
Last reviewed January 2015 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.