Teething
When Does Teething Happen & How Long Does It Last?
While first teeth erupt at 6-12 months on average, it can happen as early as 3 months. The lower teeth usually appear first. Teething typically lasts for 1 week, and you can often see mild gum inflammation and swelling before the tooth is visible (sometimes a bluish-purple lump, called an eruption cyst, occurs). If teething doesn’t happen until after 12 months, don’t fret! Until 18 months is still normal. If there are still no teeth at 18 months, talk to your dentist to see if ruling out genetic, nutritional, or hormonal conditions is necessary.
What Can I Use To Treat Fussiness?
Gum Massage: You can use either a silicone finger brush to gently massage your infant’s gums, or offer a teether with textured end that can do the heavy lifting for you.
Cold Washcloths: Take a clean newborn washcloth and tie it into a knot at one end, then run that knotted section under cold water (leave the tail dry, so that it’s a safe temperature for your infant to handle). You can leave the washcloth in the refrigerator for 15 minutes to chill prior to offering to your infant. It’s cheaper than a teether and often just as effective.
Teething Rings or Toys: I recommend a silicone (BPA-free) material, since it’s durable, flexible, and chills easily. Teethers come in a variety of different shapes and sizes, and often have a handle or opening so that the child can hold onto it while they insert the gum massaging end in their mouth. You can leave these toys in the refrigerator or freezer for a few minutes, test the handle’s temperature for safety, and then offer it to your infant. While I tend to opt for toys without a gel filling, this is often what keeps the toy cold for longer durations. If you do use one, just make sure there’s no holes or leaks in the outer coating, and this’ll ensure that it’s safe to use.
Quality Time / Snuggles: If you think about any time you’ve had a toothache, it hurts. Often, extra attention and care makes a huge difference. If your child likes to nurse, you can sneak in extra sessions to help with comfort.
Breastmilk Popsicles: If you’re breast/chest-feeding and your child is >4 months, these can relieve symptoms while offering extra nutrition.
Use a BPA-free, silicone mold and freshly expressed breast milk, then place in the freezer until solid. Make sure to let these thaw for a few minutes after you remove them from the freezer, so that they don’t cause damage to the gums.
Never use breast milk that has already been thawed.
If your child has started solids, an alternate to breast milk is pureed fruits and vegetables (such as bananas, mangoes, strawberries, avocados). Giving them in a pureed form minimizes risk of choking.
Medication: Infant Tylenol or Motrin (for 6+ months) can be used as needed for moderate to severe teething discomfort. Talk to your PCP regarding appropriate dose for your infant’s age and weight.
Product Recommendations:
Should I Refrigerate Or Freeze Teethers?
Chilling teething toys (and washcloths) in the refrigerator is recommended over the freezer, since extreme cold can cause frostbite and affect gum development. If using the freezer, make sure the item isn't in there for more than 10-15 minutes, and touch it yourself first to make sure it isn’t too cold to offer to your child.
What About Cleaning Teethers?
Since teethers are exposed to saliva, they’re at risk for attracting germs and mold, which can cause stomach viruses or other health issues. The cleaning technique depends on the material of the teeth (e..g, hard plastic teethers can be sanitized with boiling water, while silicone teethers may require hand washing with a vinegar and water solution that’s then rinsed and left to air dry), so check the instructions on your specific toy. I recommend cleansing at least nightly.
What Are Some Teething Misconceptions?
What Products Should I Avoid?
Teething Gels: As tempting as they are, medicated options often contain lidocaine or benzocaine (numbing agents that can make it hard for infants to swallow their saliva). Though homeopathic options seem safer, sometimes they can contain unsafe ingredients (e.g., belladonna), so I would use these with caution or speak to your Pediatrician first.
Necklaces: The string can cause a strangulation risk, and the tiny beads can pose a choking hazard if the necklace accidentally gets torn or falls apart.
Gel- Or Fluid-Filled Teethers: If these somehow break, the gel inside can be unsafe, so it’s best to stick with solid teethers if you’re able!
While teething is a frustrating stage to get through, remember that it’s temporary.
What About All That Drool?
In teething infants, excess saliva and drooling is common. It’s a good idea to keep a washcloth on hand at all times to wipe away secretions and prevent rashes around the mouth, chin, and neck. Avoid ointments in this area unless instructed by a provider.
