Teething

Authored by Dr Mary Harding, 10 Jun 2016

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Laurence Knott, 10 Jun 2016

Teething occurs when the teeth emerge through the gums. It can be a frustrating time for many parents, as babies and children can become unsettled when they teethe. There are measures which you can take to improve symptoms of teething in your baby or child. These include using cooled teething rings and also some teething gels.

Teething is a normal part of growing for babies: it’s when the baby teeth push through the gums as they’re growing. It usually happens at 6 to 9 months of age. Your baby may be more unsettled than usual, dribbling or want to chew on something more than usual.

Although the milk teeth develop when the baby is growing in the womb, the teeth only start to grow throughout the gums when the baby is 6-9 months old (although it can be before or after these ages). When the teeth grow, special chemicals are released by the body, which causes part of the gums to separate and so allows the teeth to grow through.

The teeth grow throughout the gums in stages. Usually the lower front teeth come through first, followed by the top middle teeth. Other teeth follow over the following months. A child is usually aged around 2½ or 3 when they have their full set of first teeth.

Babies and children can vary greatly with the symptoms they can have when they are teething. For many babies, teething leads to mild symptoms that just last a few days. However, for others, teething is painful and can last much longer.

Symptoms of teething often occur a few days (or even weeks) before the tooth comes through the gum. Common symptoms and signs include:

  • Red and swollen gums.
  • Red flushed cheek or face.
  • Rubbing their ears on the same side as the tooth which is coming through.
  • Dribbling more than usual.
  • Waking more at night and generally being more unsettled.
  • Inconsistent feeding.
  • Rubbing their gums, biting, chewing or sucking more.

Although there is little evidence that diarrhoea is caused by teething, there often seems to be a change in the poo (stools) at this time. A very mild rise in temperature may possibly be a symptom of teething. Teething should not cause your child to become unwell. If your baby or child has a fever, diarrhoea or other symptoms and is unwell then you should see your doctor to check for another cause of their symptoms. (For example, an ear infection, chest infection or urinary infection.)

Many babies and children will have minimal or no symptoms when they are teething so will not need any treatment.

However, the following may be useful for those who are having symptoms:

General advice

Gently rubbing over the affected gum with your clean finger may ease the pain. Many children find that biting on a clean and cool object is soothing (for example, a chilled teething ring or a clean, cold, wet flannel). Chewing on chilled fruit or vegetables may help. However, teething biscuits (or rusks) should be avoided as they contain sugar.

Medicine to help the pain

If your child is in pain with his/her teething, then giving paracetamol or ibuprofen may help. These should be given at the recommended doses for their age.

There is no evidence that complementary treatments are of any benefit for teething - for example, herbal teething powder.

Teething gels

There are teething gels available which contain a local anaesthetic or mild antiseptic (for example, Bonjela® or Calgel®). The local anaesthetic is usually lidocaine. Experts advise against using these gels for teething pain. This is because there is not much evidence that they help for very long and there is evidence that they can cause harm. There have been a number of cases where a baby has accidentally swallowed too much of the anaesthetic and had serious consequences, including death. If you do choose to use a teething gel, follow the manufacturer's instructions closely to be sure it is safe.

There is no evidence that using gels which contain choline salicylate is of any benefit for teething. In addition, there is a risk of the salicylate leading to a liver condition, called Reye's syndrome, in children (aged under 16 years). So, gels which contain choline salicylate should also be avoided.

Further reading and references

  • Teething; NICE CKS, May 2014 (UK access only)

  • Massignan C, Cardoso M, Porporatti AL, et al; Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Pediatrics. 2016 Mar137(3):1-19. doi: 10.1542/peds.2015-3501. Epub 2016 Feb 18.

  • Kakatkar G, Nagarajappa R, Bhat N, et al; Parental beliefs about children's teething in Udaipur, India: a preliminary study. Braz Oral Res. 2012 Mar-Apr26(2):151-7.

  • Plutzer K, Spencer AJ, Keirse MJ; How first-time mothers perceive and deal with teething symptoms: a randomized controlled trial. Child Care Health Dev. 2012 Mar38(2):292-9. doi: 10.1111/j.1365-2214.2011.01215.x. Epub 2011 Mar 6.

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