If you’ve just felt a sharp little gum with your finger or spotted a fresh flash of white when your baby smiles, then you’ll be thinking, ‘Ah! She’s started teething!’ Says Claire Stevens, consultant in paediatric dentistry and a mum of two, toothfairyblog.uk. But this process started months and months ago, when your baby was just a tiny dot in your womb.
And once you understand what’s happening, you can help her cope with this big change.
When do babies start teething?
Six weeks after conception, the cells that will eventually become your baby’s teeth started to form underneath her jaw. And, as she grew in your womb, these gradually became more solid and structured so, when she was born, she had a full set of teeth buds sitting in her jaw. These continue to grow until they’re right underneath her gum line at the grand old age of around four months, which is when teething symptoms normally start. So, don’t be surprised if your baby is grumbling way before you see the first sign of a tooth: before they break through, her teeth are already putting pressure on her gums and causing her mouth to ache. Gums have the same nerve pathways as cheeks and ears, so it can lead to discomfort in other areas of her face – for example, you might spot her pulling her ear or rubbing her cheek.
The buds for different types of her teeth grow at different rates. First to emerge at around six months will be her bottom two front teeth, followed a month later by her upper middle teeth, her central incisors. At nine to 12 months, she’ll get four more, one on either side of these central teeth, and these are her lateral incisors. They usually emerge in pairs: two on one side, then the two on the other. Around 14 months, her first molars – bigger and with a flat surface to crush food – will appear top and bottom, leaving a gap between them and her incisors.
At 18 months, four sharper canine teeth fill this top and the bottom: these are used to tear food. At around 26 months, two pairs of second molars will emerge at the back of her mouth, with broad flat surfaces to grind up her food. Of course, the age when teeth come through varies a lot, just as some babies talk early and others walk early, although if she reaches her first birthday without any teeth emerging, then it’s a good idea to visit your dentist.
It’s good to know where the next tooth is likely to pop up too, so you can look for signs while you’re cleaning her teeth. When a tooth is ready to come through the gum, you’ll be able to see its white tip just underneath your baby’s gum line. Her body releases a chemical that causes her gum to become less dense, so the tooth can push through easily. But the tooth still must break through the top layer of her gum, which can cause some discomfort.
It’s good to be on the watch for early symptoms, so you’re ready to ease a tooth’s arrival. Irritability as that budding tooth presses on her gums will be your first clue, and a single flushed cheek is a clear sign that a tooth is about to pop through on that side. You’ll also usually be able to see a bulge in her gum and a translucent film or grey bubble over the area. Teething stimulates saliva production, so a flood of dribbles heralds an imminent arrival: to stop this causing chapping, soreness or a teething rash, use a smear of Vaseline or nipple balm around her mouth and on her chin to form a moisture barrier, and pop on a bib.
But by the time she’s around two and a half, she’s likely to have her full set of 20 baby teeth. You’ll find that she reacts differently to these teeth types coming through – what soothes an incisor might not work so well on a molar, which is why it’s great to have lots ways to help your baby. Her front teeth have flatter, thinner edges and tend to slide through her gums so are usually the easiest to cut.
So, although she may grumble with these first teeth, it’s because the discomfort is a new sensation for her. It will take around eight days for the tooth to push through the gum and a few months to continue growing to full size, at a rate of 1mm a month. With some teeth, she might not feel up to feeding, as the suction can make her sore gums feel worse, and if she’s weaning, she might also refuse solid foods.
Be persistent as hunger usually wins out, but if she’s reluctant to feed a few days give your doctor a call to check everything’s OK. Your baby may also bite to relieve the pressure in her gums, so receiving a nip on your fingers or while you’re breastfeeding can indicate a tooth is well on its way.
Some babies might have all these symptoms, while others may sail through without a sign. And some teeth might cause a run of restless nights, while others will pop up one morning without warning. Whichever you find, there are lots of ways that will help your baby when she needs it, and the secret is to experiment and mix and match your methods with each new tooth to find what really works.
To numb your baby’s gums, give her a teether that’s been chilled in the fridge for half an hour. Or if she’s over six months, offer her some cold water in a cup. Depending on her age, feed her chilled fruit purées or pop a chunk of frozen banana or plums in a baby feeder mesh bag for her to gnaw on safely.
Experiment with teething toys to find one that offers just the right pressure to ease discomfort. And have a selection of different shapes too: circular teethers are best when she’s cutting her front teeth but she’ll need a longer, thinner design to reach her molars.
The crook of your little finger makes a great teether – but do wash your hands first. And, if she’s restless at night, gently press on her gum with your little finger – it’s a great way to soothe her without waking her up. A teething necklace can also be a great option for on the go.
The nobbly bits on teethers can provide extra relief and will give your baby’s gums something to grasp onto. Buy one with a range of textures so she can experiment for herself.
You can give your baby paracetamol from two months and ibroprofen from three months but whichever brand you choose, make sure it is suitable for babies.
Paracetamol is best for relieving mild to moderate discomfort before a tooth comes through. When she is actually cutting a tooth, ibroprofen is more effective as it helps reduce inflammation. Always give the recommended dosage and check with your doctor if you’re not sure.
Teething granules contain a natural pain reliever to ease discomfort and easily dissolve in your baby’s mouth.
6) Topical gel
Teething gels can help ease discomfort as they contain a small dose of antiseptic which will help numb her gums, but make sure you use one that is suitable for babies.
Give your baby a clean flannel soaked in warm water to suck on as the warmth can ease aching gums and help teeth break through the gums.
Give your baby lots of extra cuddles and kisses as teething can be a really unsettling time and she’ll need lots of love and reassurance.
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Lorna is the digital executive and regular contributor for Mother&Baby. After running the Yours magazine website which specialises in content about caring for kids and grandchildren, she has now brought her expertise to the UK's #1 leading pregnancy and parenting magazine. Lorna specialises on a range of topics from potty training and nutrition, to everything and anything that will keep your tot occupied!
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