Teething can make babies (and parents) miserable for a while. Some popular remedies, including numbing gels and teething necklaces, carry real risks. This guide covers what’s normal, what isn’t and how to soothe a teething baby safely, based on the American Dental Association (ADA) and MedlinePlus from the National Library of Medicine.
When teething happens
Babies are born with all 20 primary teeth below the gums. The ADA says they typically start coming through between 6 and 12 months, though timing varies. MedlinePlus says teething generally begins between 6 and 8 months, and that teeth showing up later than 8 months is usually normal. The ADA says children usually have all their baby teeth by age 3. MedlinePlus notes the two bottom front teeth often come in first, then the two top front teeth. See the baby teeth timeline.
Normal teething signs
From the ADA and MedlinePlus:
- fussiness or irritability
- trouble sleeping
- drooling more than usual
- biting or chewing on hard objects
- swollen, tender gums
- loss of appetite or refusing food
Signs that aren’t from teething
MedlinePlus says teething does not cause fever or diarrhea. The ADA lists fever, diarrhea and rash as reasons to call your pediatrician.
Safe ways to soothe
- Gently rub the gums with a clean finger, a small cool spoon or a moist gauze pad (ADA), or a cool, wet washcloth (MedlinePlus).
- Offer a clean, solid rubber teether. Avoid liquid-filled teething rings and plastic objects that could break. Always watch your child with a teether so they don’t choke (ADA).
- If your child eats solids, cool, soft foods such as applesauce or yogurt may help (MedlinePlus).
- Wipe drool from the face to prevent a rash (MedlinePlus).
- If using a bottle, MedlinePlus says to fill it only with water, since formula, milk or juice can cause tooth decay at bedtime. See baby bottle tooth decay.
MedlinePlus says acetaminophen or ibuprofen can help a very uncomfortable child. Follow the package instructions and ask your child’s provider if you’re unsure.
What to avoid
- Teething necklaces and bracelets. The ADA says the FDA has received reports of deaths and serious injuries, including strangulation and choking, from teething jewelry such as amber necklaces.
- Benzocaine or lidocaine numbing gels. The ADA says the FDA warns against them for children under 3: they offer little to no benefit and are linked to serious risks. Benzocaine can cause methemoglobinemia, a serious and sometimes fatal condition that reduces the blood’s ability to carry oxygen.
- Homeopathic teething tablets. The ADA says the FDA urges against them because they haven’t been evaluated or approved for safety or effectiveness. MedlinePlus also advises against homeopathic remedies.
- From MedlinePlus: don’t tie anything around your child’s neck, don’t place anything frozen against the gums, never cut the gums, avoid teething powders, never give aspirin or put it on the gums, and don’t rub alcohol on the gums.
Caring for new teeth
Once teeth appear, start brushing. Our baby bottle tooth decay guide covers the ADA’s toothpaste amounts by age. Plan your child’s first dental visit too. See your child’s first dental visit.
Frequently asked questions
Does teething cause fever?
MedlinePlus says no. Call your child’s provider about a fever or diarrhea.
Are amber teething necklaces safe?
No. The ADA cites FDA reports of deaths and serious injuries from teething jewelry.
Can I use a numbing gel?
The ADA says the FDA warns against benzocaine and lidocaine products for children under 3.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Teething” by Daniel Schwen, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.