It is only a matter of time before my baby George starts teething.  I remember when Madi was teething, there were times she was crying and inconsolable because of the discomfort.  

When do babies usually start teething?

Teeth actually start forming in utero!  However, they usually do not start making their first appearance until babies are 6 to 10 months of age.  

You can expect your baby to have their first full set of teeth by around 2.5 years old.

What are the symptoms of a teething baby?

The most common symptoms of teething are gum irritation, irritability, and increased drooling.  Symptoms of teething usually are the worst the day the tooth breaks through, or 1 to 2 days before.  Symptoms generally go away within 3 days of the tooth coming through the gums.  

Other symptoms that parents report during teething include: a decrease in appetite for solid foods, an increase in thirst, nose congestion, ear rubbing, or loose stools. 

Sometimes babies can have a mild increase in body temperature up to 37.7 °C.  Do not confuse this with a true fever, which is when the temperature is greater than 38 °C measured rectally.

physician should evaluate signs and symptoms of teething that appear severe before attributing them to teething.  Do not ignore a fever.

How can parents help ease teething discomfort?

There are a number of things parents can do to help ease the symptoms of teething.  Some ideas are:

  • Rub the gums with a clean finger
  • Rub the gums with the back of a small, cooled spoon
  • Allow the baby to chew and bite on a frozen face cloth 
  • Allow the baby to chew on a cooled teether or teething ring (do not freeze these)

Do not dip teething devices in anything to encourage chewing.  This promotes dental cavities.  

Amber necklaces are marketed as a non-drug way to manage teething pain.  These are NOT recommended due to lack of evidence and the inherent risk of strangulation.  

What about medicine to treat teething pain?

Teething pain that isn’t relieved by the above can be treated with analgesic medicines.  

Acetaminophen or ibuprofen can be used at the usual doses to help with pain.  Ibuprofen can only be used if the baby is at least 6 months old.  These medicines should be swallowed by the baby and not rubbed on the gums.

Unfortunately there are products marketed for teething pain in infants that are NOT recommended and may be unsafe.  Do NOT use the following:

  • Topical numbing agents containing benzocaine (Orajel or Anbesol): These can increase the risk of the child choking.  There is also a rare side effect called methemoglobinemia that affects how oxygen is delivered to body tissues.
  • Homeopathic teething products (Hyland’s teething tablets): Some of these products have been found to contain elevated levels of belladonna, which can cause seizures, difficulty breathing, and agitation.  

This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

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