Among your baby's developmental milestones, cutting their first teeth is perhaps the most bittersweet. Yes, your little one looks adorable as they flash their brand-new pearly whites at you. But for most babies, teething is uncomfortable, and fussiness and sleeplessness can accompany the arrival of each new tooth.
To help, we asked experts for their best teething tips. From when you can expect your baby's first tooth to feeding and brushing advice, here's what to know about baby teething and advice for nurturing a happy, healthy smile.
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Don't Stress If Teething Starts Later Than Expected
Most babies start showing signs of teething around 4 to 6 months. They may start putting their fingers in their mouth more and producing more saliva. (The drooling is usually unrelated to teething and stops once teeth start to grow in and create "dams" for the saliva.)
That very first pearly white often pokes through between ages 5 and 12 months. The average age babies get their first tooth is around 7 months. The bottom incisors emerge first, followed by the top incisors.
By their first birthday, babies have about six teeth on average. A toddler usually has a full set of teeth by around 2 years of age, explains Edward Kulich, MD, of New York.
Some babies start developing teeth later than others, and most of the time, there's no issue. But if you haven't seen the tip of a first tooth begin to poke through as they approach their first birthday, bring it up with your doctor, who may recommend a dental visit with X-rays. There are a few very rare medical conditions where the body fails to form teeth.
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Don't Panic If Your Baby Sprouts Teeth Early Either
Some babies are super early with teeth. About 1 in every 2,000 to 3,500 babies are born with "natal teeth." Others cut them very soon after. "I get worried calls from parents who see teeth within a week or so after their baby is home," says Megan Chin, DDS, attending pediatric dentist at Mount Sinai Hospital in New York City.
It's understandable if the idea of a newborn with little chompers freaks you out, especially if you plan on nursing. Though unusual, natal or newborn teeth aren't usually a cause for concern. However, if your baby is born with any pearly whites, it's important to visit a pediatric dentist, says Dr. Chin.
The pediatric dentist may recommend smoothing the sharp edges of natal teeth, or occasionally, extracting a tooth. You wouldn't want to remove them unless necessary, since natal teeth are typically your child's primary teeth, not an extra set, Dr. Chin notes. However, if a tooth is excessively loose because the root hasn't fully formed, extraction may prevent your baby from choking if it falls out on its own.
White Bumps Aren't Always Teeth
Not all white bumps in your baby's mouth are budding teeth. Small, round, white cysts called Epstein pearls can form on the gums or the roof of the mouth in as many as 4 out of 5 newborns. They're actually harmless pockets of skin cells, and you should leave them alone, says Elliott Maser, DDS, clinical associate professor of pediatric dentistry at the University of Pennsylvania in Philadelphia. Epstein pearls go away on their own and aren't a choking hazard.
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Don't Delay or Stop Offering Solid Foods During Teething
There is no need to delay starting solid food if your baby has not started developing teeth yet. Just cut everything into small pieces and keep it on the soft side—nothing you can't mash between your thumb and first finger, Dr. Bowden says. All toddlers gum their food until they get their molars anyway. "Their little gums are very tough," he says.
Is your baby suddenly refusing solid foods they enjoyed before? Check in their mouth for white spots, which could indicate thrush—an overgrowth of yeast in the mouth that requires a trip to the doctor. If they don't seem to have thrush or show signs of sickness generally, teething could be the issue.
For these suddenly picky teething babies, continue to offer solids at least once a day and try different textures of foods and types of spoons (those with a coating like a teething ring may be preferable). If they reject solids for 3 to 4 weeks straight, talk to a doctor.
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Ask Your Pediatrician About Safe Pain-Relief Medications
Teething can be uncomfortable as little teeth poke their way through sensitive gums. For babies older than 2 months, "I recommend giving an appropriate dose of acetaminophen along with a cool teething ring," says Tanya Remer Altmann, MD, of Los Angeles, co-editor of Caring for Your Baby and Young Child. Wait until 6 months to give your baby ibuprofen, however.
Acetaminophen Dosage Chart for Babies and Kids
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Try Natural Soothers With Caution
There haven't been many studies on what remedies (natural or otherwise) are truly effective for the pain associated with teething, says Dr. McKenna. "For most infants, non-medicinal therapies such as chewing on cool washcloths, frozen teething rings, and other such items is usually enough to ease the pain."
You should never give your teething baby food or food-based teething products to gnaw, as they can be choking hazards. (For toddlers, popsicles can be an exception and are a fun treat, says Dr. Altmann.) Teething necklaces or beads are also choking hazards to avoid.
Take caution with "natural" teething remedies as well. Our experts advise that you never give your baby alcohol of any kind, even topically. Also avoid rubbing their gums with clove oil, as it can burn your baby's gums and skin.
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Treat Painful Teething Rashes With Petroleum Jelly
If your little one drools so much that their lips and skin are irritated from the constant contact with saliva, there are things you can do to help soothe the rash. "Apply some Vaseline (white petroleum jelly) to reduce the contact of the saliva with the tender skin. Also, do not rub the saliva off the chin—just pat dry gently to avoid a friction-induced, worsening rash," says Gaurav Gupta, MD, pediatrics expert at JustAnswer.
Does Teething Cause Diarrhea as a Side Effect?
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Some Low Fevers May Be Linked to Teething, But High Fevers Aren't
Teething can make a baby cranky and even cause a mild fever. "Research seems to confirm that some symptoms, including fever around 101 degrees Fahrenheit, may be associated with teething," says Michael McKenna, MD, a pediatrician at Indiana University School of Medicine.
However, any temperature above 101 degrees is likely from an infection rather than teething. "If an infant has a temperature, excessive irritability, decreased eating, increased sleeping, or other symptoms such as vomiting, a cough, or a rash, it is unlikely that teething is the culprit," says Dr. Kulich.
"If your baby is experiencing such symptoms, or the irritability is excessive, you should touch base with your pediatrician," he adds.
Why Teething Symptoms Feel Worse at Night
Many parents notice an increase in teething symptoms and discomfort during evening hours, but there's no specific medical reason for this. "It seems worse at night because they are tired, and during the day they are awake and playing and have things to distract them from the pain," says Dr. Gupta.
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Start Dental Hygiene Even Before That First Tooth Pokes Through
Experts advise starting a dental hygiene routine early—even before your baby gets a tooth. Start by cleaning your baby's gums with wet gauze pads, a clean damp washcloth, or a very small soft toothbrush. As soon as you see teeth sprout, start gently brushing them with a soft brush. For children under age 3, use a smear of kid-friendly fluoride toothpaste about the size of a rice kernel.
Some training toothpastes don't have fluoride—which has been proven to help prevent decay in young children—because young children can't spit it out. But ingesting a small amount isn't harmful. "A child would have to swallow tubes and tubes of toothpaste per day for it to be dangerous," Dr. Maser says.
It's easy to be lax about brushing and flossing when there are more immediate battles to fight, but early dental hygiene is crucial. Kids rely on teeth for eating—a vital job for a growing body—and some kids are more prone to plaque buildup, which leads to cavities. Your hard work to polish those tiny teeth will set the stage for a lifetime of healthy habits and lead to a healthy, beautiful smile in the long run.