Baby development

Tooth truths

What you need to know about teething and your tot

By Cheryl Embrett
Tooth truths

You’ve probably heard it said that “teething produces nothing but teeth.” But, as parents, we know that’s not always true. When those first little nubbins start to appear, sore gums and a cranky disposition can be close companions. We asked the experts for answers to common teething questions, as well as their best tips on how to soothe tiny teethers.

Q: When can I expect baby to sprout his first tooth?

A: Between four and seven months of age, you’ll probably notice two little red swellings at the front of your baby’s bottom gums — a sign that he’s “cutting” his first teeth. Baby teeth usually come in pairs: The bottom front two teeth typically show up first, followed by the top ones. By age three, your child should have all 20 primary teeth, which fall out usually around kindergarten. If your child shows no signs of teething by 12 months, check with your doctor or dentist, advises Mia Lang, an assistant professor of paediatrics at Edmonton’s Royal Alexandra Hospital. Teething patterns tend to be hereditary, so if you were late teething, junior might still be flashing that gummy smile as late as 18 months.

Q: My tot is chewing on everything in sight. Does that mean she’s teething?

A: Teeth marks on baby’s crib are definitely one of the telltale signs of teething. Your normally cheerful tyke may also have occasional crankiness and crying (tender, swollen gums can cause pain and irritability), although some children will sail through teething with nary a whimper, says Lang. Other symptoms may include increased drooling, loss of appetite and disrupted sleeping.

Q: Does teething cause diarrhea and fever, or is that an old wives’ tale?


A: Although sore gums could cause baby’s temperature to be a little higher than normal, teething as a rule does not cause a fever higher than 38°C (100.4°F), or diarrhea. “Be careful of what you’re blaming on teething because you might be missing something more serious,” cautions Jeremy Friedman, chief of paediatric medicine at Toronto’s Hospital for Sick Children and co-editor of Caring for Kids: The Complete Canadian Guide to Children’s Health. “Young babies who have a high fever or uncontrollable crying need medical attention.” You should also see your paediatrician if baby is vomiting, lethargic or has ear-infection symptoms (a cold, persistent fever, ear pulling) — all things that can be mistakenly associated with teething.

Q: How can I make teething easier on my child?

A: One of the best ways to ease teething pain is to massage baby’s gums firmly and gently with a clean finger for a minute or two, says Lang. You can also offer a cold washcloth or teething ring (chill in fridge, not freezer), as they have a numbing effect. Once teeth erupt, avoid liquid-filled teething rings, especially ones with little objects floating inside, as baby’s new teeth may puncture them. Also avoid teething rings with rough edges that can abrade an infant’s soft gums, and store away any toys with breakable parts or that are smaller than the circumference of a toilet paper roll — they could be choking hazards.

Older tots may enjoy chewing on a partly frozen banana or Popsicle, but don’t give them hard foods, such as raw carrots, that they could choke on. If your child is having a rough go of it, talk to your paediatrician about using a non-aspirin baby pain reliever. “If a child is really uncomfortable, I’m not averse to giving them one dose of acetaminophen or ibuprofen, but I wouldn’t give it to them on a regular basis,” says Friedman. “If they need it regularly, teething isn’t the problem and they should see their doctor.” Q: Do topical treatments work?

A: Some parents swear by the pain-relieving effects of teething gels such as Orajel. However, they contain benzocaine — an anaesthetic that numbs the gums and could interfere with your baby’s swallowing. They also carry a small risk of allergic reactions. “You have to weigh how mild and short-lived the relief is against possible side effects,” says Friedman. If your child is miserable and you choose to use a topical gel, don’t apply it more than four times a day (check the packaging for instructions).


Q: Why is my baby drooling so much?

A: All that saliva helps cool off inflamed and tender gums and speeds up the healing process, says Lang. To help prevent dry, chapped skin and rashes on cheeks and chins, keep them dry (pat with a soft cloth or tissue; don’t rub) and apply a simple barrier cream such as fragrance-free Zincofax or petroleum jelly.

Q: When should I take my child for his first visit to the dentist?

A: The Canadian Dental Association recommends children visit the dentist within six months of getting their first tooth, or by one year old. “There are typically a lot of questions parents have at this age and there could be problems such as early childhood tooth decay,” says Ian McConnachie, a paediatric dentist and president of the Ontario Dental Association. Choose a dentist who’s comfortable with kids — that could be your family dentist or one who specializes in children’s dentistry.

Q: Why all the fuss about taking care of baby teeth when they’re going to fall out anyway?


A: Baby teeth are important for chewing, speech, appearance and for healthy development of adult teeth, says McConnachie. “If they’re not cared for carefully, they can decay, and that can affect the spacing of the permanent teeth.” Start good dental care early by wiping baby’s gums with gauze or a clean damp cloth after each feeding. Once that first tooth appears, use a soft infant-sized toothbrush and plain water. After age two, a pea-sized amount of toothpaste will do (you may want to use just non-fluoridated until she’s old enough to spit it out, usually around age three or four). By the time your child can print her name, she can likely brush her teeth with your guidance. She should brush twice a day for a minimum of two minutes (try singing “Twinkle, Twinkle, Little Star” and encourage your little one to brush until you’re finished). Don’t offer food or a drink of anything besides water after the evening tooth-brushing, advises McConnachie.

Q: My baby’s teeth are quite gappy. Should I start saving for braces?

A: The spacing of baby teeth doesn’t necessarily reflect how permanent teeth will appear, says McConnachie. “If anything, when I see a child with general spacing between his teeth, I’m happier because I know there’s a slightly improved chance that the adult teeth are going to come in nice and straight. But if I see baby teeth with no spacing at all between them, I usually advise the parent to be prepared because, in all likelihood, their child will need orthodontics down the line.” Don’t rub alcohol on your baby’s gums. Even a small amount can be harmful since there’s no predicting how your baby will react, says Mia Lang, an assistant professor of paediatrics at Edmonton’s Royal Alexandra Hospital. Medications, such as ibuprofen or acetaminophen, should never be applied directly to baby’s gums either since they can cause further inflammation and irritation.

Don’t dip your tot’s pacifier in honey to try to distract her from teething pain. “Honey is not advised in the first year of life because of the risk of botulism,” says Jeremy Friedman, chief of paediatric medicine at the Hospital for Sick Children in Toronto and co-editor of Caring for Kids: The Complete Canadian Guide to Children’s Health.

Do limit chewy, sticky snacks, such as raisins and granola bars. “They may be healthy, but they’re the worst kinds of food for growing teeth,” says paediatric dentist Ian McConnachie, president of the Ontario Dental Association. If you do give them to your child, make sure she brushes well immediately afterwards.


Do give your child a bottle or sippy cup with water for comfort or to fall asleep. Letting her walk around or drift off with a bottle of juice, milk or formula can lead to tooth decay.

Don’t share food utensils with your child or lick off a dirty pacifier and put it back in her mouth (yes, some parents do this). Bacteria can be passed from parent to toddler and cause tooth decay.

This article was originally published on Mar 12, 2007

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