Teething

Overview

Teething
Teething

Baby teething symptoms

When it comes to teething, all babies are different. But your baby will probably get their first tooth some time during their first year.

When do babies start teething?

Some babies are born with their first teeth. Others start teething before they are four months old, and some after 12 months. Early teething should not cause a child any problems, unless it affects their feeding.

Teething symptoms

Baby teeth sometimes emerge with no pain or discomfort at all. At other times, you may notice that:

  • your baby's gum is sore and red where the tooth is coming through
  • one cheek is flushed
  • your baby is dribbling more than usual
  • they are gnawing and chewing on things a lot
  • they are more distressed than usual

Some people think that teething causes other symptoms, such as diarrhoea and fever, but there's no evidence to support this.

You know your baby best. If they have any symptoms that are causing you concern, then seek advice from your GP or 111.

What order do baby teeth appear in?

Here's a rough guide to how babies' teeth usually emerge:

  • bottom front teeth (incisors) – usually the first to come through, at 5 to 7 months
  • top front teeth (incisors) – 6 to 8 months
  • top lateral incisors (either side of the top front teeth) – 9 to 11 months
  • bottom lateral incisors (either side of the bottom front teeth) – 10-12 months
  • first molars (back teeth) – 12-16 months
  • canines (third teeth back) – 16-20 months
  • second molars – the last to come through at 20 to 30 months

Most children will have all of their milk teeth by the time they are two and a half years old.

Tips for helping your teething baby

  • Keep the teeth clean using a toothbrush and a small smear of fluoride toothpaste. For children under 3 years old, use a toothpaste with a Fluoride level of 1000ppm (parts per million)
  • If your baby is over 6 months old and chewing on toys or their fingers, try giving them raw fruit or vegetables such as a piece of apple or carrot to chew on. Always stay close when your baby is eating in case they choke
  • Teething rings are safe for babies to chew on and can provide some relief. Some can be cooled in the fridge (do not use the freezer)
  • There is not much evidence that teething gels are effective
  • If your baby is in pain, try giving them Calpol, following the instructions on the packet

Arrange for your baby to see a dentist after their first teeth come through and take them as regularly as your dentist recommends.

Treatment

A pharmacist can help with Teething 

Teething is one of the conditions covered by the Common Ailments Scheme which is an NHS service that patients can access for free advice and free treatment and is available from 99% of pharmacies in Wales. 
Find your nearest pharmacy here
Find more information on the service here

Teething tips

Teething can be distressing for some babies, but there are ways to make it easier for them.

Every baby is different, and you may have to try a few different things until you find something that works for your baby.

Teething rings

Teething rings give your baby something to safely chew on, which may ease their discomfort and provide a distraction from any pain.

Some teething rings can be cooled first in the fridge, which may help to soothe your baby's gums.

The instructions that come with the ring should tell you how long to chill it for.

Never put a teething ring in the freezer, as it could damage your baby's gums if it gets frozen.

Never tie a teething ring around your baby's neck, as it may be a choking hazard.

If your baby is chewing

One of the signs that your baby is teething is that they start to chew on their fingers, toys or other objects they get hold of.

If your baby is 6 months or older, you can give them healthy things to chew on, such as raw fruit and vegetables. Soft fruit like melon can soothe gums.

You could also try giving your baby a crust of bread or a breadstick.

Always watch when your baby is eating in case they choke.

It's best to avoid rusks because nearly all brands contain some sugar.

Avoid any foods that contain lots of sugar, as thie can cause tooth decay, even if your child only has a few teeth.

Teething gels

There's a lack of evidence that teething gels are effective. It's recommended that parents try non-medical options for teething first, such as a teething ring.

If you do decide to use a gel, make sure you use a teething gel that's specially designed for young children.

General oral pain relief gels are not suitable for children.

Teething gels contain a mild local anaesthetic and are only available from pharmacies. Speak to a pharmacist for further advice.

There's no evidence that homeopathic teething gels are effective. If you use a homeopathic gel, make sure it's licensed for use in the UK.

Some unlicensed homeopathic gels advertised on the internet have been linked to serious side effects.

The Medicines and Healthcare products Regulatory Agency has a list of licensed homeopathic gels.

Painkilling medicine

If your baby is in pain, you may want to give them a sugar-free painkilling medicine.

Paracetamol or ibuprofen can be given to relieve teething symptoms in babies and young children aged 3 months or older.

Children under 16 years old should not have aspirin.

Always follow the instructions that come with the medicine.

If you are not sure, ask your GP or pharmacist.

Comforting a teething baby

Comforting or playing with your baby can distract them from the pain in their gums. 

Gently rubbing their gums with a clean finger may also help.

Preventing teething rashes

If teething is making your baby dribble more than usual, gently wiping their face may help prevent a rash. 

Caring for your baby's new teeth

You'll need to register your baby with a dentist when their teeth start coming through.

Find a dentist near you

Start brushing your baby's teeth with fluoride toothpaste as soon as their first milk tooth breaks through.  

 

Recommendations

Looking after your baby's teeth

You can start brushing your baby's teeth as soon as they start to come through. Use a baby toothbrush with a tiny smear of fluoride toothpaste.

Don't worry if you don't manage to brush much at first. The important thing is to get your baby used to brushing their teeth as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.

Tooth brushing tips for babies

  • Use a tiny smear of toothpaste for babies and toddlers up to 3 years old, and a pea-sized amount for children aged 3 to 6 years.
  • Gradually start brushing your child's teeth more thoroughly, covering all the surfaces of the teeth. Do it at least twice a day: just before bed and at another time that fits in with your routine.
  • Not all children like having their teeth brushed, so you may have to keep trying. Make it into a game, or brush your own teeth at the same time and then help your child finish their own.
  • The easiest way to brush a baby's teeth is to sit them on your knee, with their head resting against your chest. With an older child, stand behind them and tilt their head backwards.
  • Brush the teeth in small circles, covering all the surfaces, and encourage your child to spit the toothpaste out afterwards. There's no need to rinse with water, as this will wash away the fluoride.
  • Check to make sure your child gets the right amount of toothpaste and they're not eating or licking toothpaste from the tube.
  • Carry on helping your child brush their teeth until you're sure they can do it well enough themselves. This will normally be until they're at least 7.

Taking your baby to the dentist

Take your child with you when you go for your own dental appointments so they get used to the idea.

NHS dental treatment for children is free, but not all dentists will take on new NHS patients.

To find a dentist go to NHS 111 Wales - Services Near You: Dentists

Sugar and tooth decay

Sugar causes tooth decay. It's not just about the amount of sugar in sweet food and drinks, but how long and how often the teeth are in contact with sugar.

Lollipops and sweet drinks in a formula bottle are particularly damaging, because they bathe the teeth in sugar for long periods of time. The acid in drinks like fruit juice and squash can harm teeth as well.

The sugars found naturally in whole fruit and milk are less likely to cause tooth decay.

Sucrose, glucose, dextrose, maltose, fructose and hydrolysed starch are all sugars. Invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado sugar and concentrated fruit juices are also sugars.

How to cut down sugar in your child's diet

These tips will help you reduce the amount of sugar in your child's diet and prevent tooth decay:

  • Avoid sugar-sweetened drinks – the best drinks for young children are plain milk and water.
  • It's OK to use bottles for expressed breast milk, formula milk, or cooled boiled water. But using them for juices or sugary drinks can increase tooth decay.
  • From 6 months old, you can offer babies drinks in a non-valved free-flowing cup.
  • When your baby starts eating solid foods, encourage them to eat savoury food and drinks with no sugar. Check if there's sugar in pre-prepared baby foods (including the savoury ones), rusks and baby drinks. Read more about food labels.
  • If you choose to give your child sweet foods or fruit juice, only give them at mealtimes. Remember to dilute 1 part juice to 10 parts water. Your child should have no more than 1 drink of fruit juice (150ml) in any 1 day as part of their 5 A Day.
  • Don't give your child biscuits or sweets – ask family and friends to do the same. Offer things like stickers, hair slides, crayons, colouring books and bubbles instead. They may be more expensive than sweets, but they last longer.
  • At bedtime or during the night, only give your child breast milk, formula or cooled boiled water.
  • If your child needs medicine, ask a pharmacist or GP if there's a sugar-free option.

Should I give my baby a dummy?

It's fine to give your baby a dummy but avoid using them after 12 months of age. Using dummies after this can encourage an open bite, which is when teeth move to make space for the dummy. They may also affect your child's speech development.

Discourage your child from talking or making sounds with a dummy or their thumb in their mouth, and don't dip dummies in anything sweet, such as sugar or jam.



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 16/03/2023 12:15:34