When should I be concerned about my child’s teething?

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Many parents are concerned with teething pain associated with the teeth as they first come into the mouth (tooth eruption). As the new tooth gets closer to the surface, the gum tissue becomes stretched until the tooth finally breaks through and enters the mouth. This of course is what causes the child’s discomfort.

There is a lot of variability from child to child as to when the teeth start erupting; but usually the first baby tooth to erupts occurs when the child is around six months old.  Quite commonly, however, tooth eruption is delayed; sometimes for several months. THIS SHOULD NOT BE CAUSE FOR CONCERN!

Typically, the lower front central incisor is the first tooth to appear.  After that, the order varies but usually the four upper and lower incisors come in before the back teeth. By the time the child turns two – three years old, all twenty baby teeth are present in the mouth. There are five teeth in each quadrant: the central incisor, then the lateral incisor, followed by the canine (or eye tooth), then the first molar, and then finally the second molar.

Most commonly, the first adult tooth to erupt is the adult first molar; frequently called the six year molar because of its common time of eruption. This tooth will start to eruption behind the baby second molar. The first baby tooth to be lost is usually the first one in; the central incisor on the lower jaw to be followed closely by the adult central incisor.

Frequently baby teeth erupt into the mouth without any discomfort or without much ado. However, there are times when teething can be associated with quite a lot of discomfort. In young babies who can’t really communicate, this may be difficult if not impossible to discern. Some children may drool more than usual or just be more irritable or cranky; but there is by no means no way to definitely say that this is due to teething unless we actually see a tooth that is erupting. More serious symptoms such as diarrhea, constipation, or fever may be associated with teething; but are most often a sign of coincidental viral or bacterial infections; so please check with your pediatrician. A fever of more than 100 should never be ignored!

The best thing to relieve this discomfort is a cold teething ring or something that can safely be put in their mouth to help them to feel better.  Please be careful to only use topical anesthetics such as Baby Oragel (benzocaine) very sparingly, especially in younger babies.  These creams or gels will “numb” the gum tissue where it is applied. Orally administered pain relievers such as Tylenol (acetaminophen) should be also used very sparingly; consult with your pediatrician before giving any medications.

THE MOST IMPORTANT THING TO REMEMBER IS THAT THESE TEETHING SYMPTOMS ARE ONLY TEMPORARY AND MOST OFTEN ALL YOUR BABY NEEDS IS SOME COMFORTING AND TLC.

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