Check out the PedsDocTalk YouTube Video: Teething in Babies for more information and guidance, including how to manage discomfort caused by teething, common myths surrounding teething, and a review of safety infoormation with certain teething devices.
Do you think your baby is teething? Maybe they’re drooling more or seem more fussy, and you wonder if teething is the cause. Many parents have questions about teething – does it cause a fever or diarrhea? Does it cause a rash? What are the best ways to help my baby when they’re teething? It’s helpful to know the signs of teething, common myths, and remedies when they’re teething.
Signs of teething
One of the most common signs of teething is an increase in drooling from their baseline. It’s important to note that many babies start drooling when they begin to put everything in their mouths, often as early as three to four months. This is because they go through an oral phase of exploration where everything goes in their mouth for sensory learning.
Most infants don’t start teething until four to six months, and some don’t get their first tooth until closer to 12 months! Therefore, not all drooling indicates teething, but an increase in drooling from their baseline associated with other symptoms may be a sign of teething.
Gums can appear swollen or slightly red as the teeth break through. Some irritability or decreased appetite is common as the teeth erupt, but it should be short-lived and not severe enough to affect their hydration status. You may also notice your baby rubbing their cheeks or ears. This is because the nerves to the gum travel close to their ears, causing babies to feel discomfort all the way up to their ears when teeth erupt.
Common Teething Myths
You may have heard that teething can cause a fever, but this is false. There may be a slight increase in temperature; however, any temperature above 100.4 degrees indicates something else is going on. Children who are teething commonly put their hands in their mouths, making them more susceptible to germ exposure, meaning a fever could result from a concurrent virus.
Many parents hear this and still believe their child gets a fever of 100.4 degrees or above with teething – this can be concerning because you could miss something else, like an ear infection or another illness that requires treatment. Therefore, it’s essential to seek medical attention if your child has a persistent fever, is dehydrated with a fever, or is inconsolable with a fever – even if they are teething!
Another common myth is that teething causes diarrhea. Teething can lead to more drool, and more drool can be swallowed, which leads to looser poop. Remember, a child’s poop is constantly changing. Children of teething age are also eating new foods, which often causes changes in their poop. If your child has persistent diarrhea and you are worried about dehydration, see your child’s clinician to make sure it’s not something more.
The idea that teething causes a rash is another myth. However, it’s important to clarify – if their stool is looser, that can result in a diaper rash. That can be treated with an ointment containing zinc oxide, but seek medical care if you notice any worsening symptoms. The drool from teething can also cause a rash around the mouth, but teething will NOT cause a full-body rash.
Another common myth is that all teething gels are safe. It’s important to be aware that teething gels on the market are not always regulated for safety or efficacy. Gels with lidocaine, benzocaine, or belladonna have all been noted to have adverse side effects for children when swallowed.
Lastly, it is a myth that amber necklaces are safe. Amber necklaces and bracelets have small pieces that can break off, and babies can choke on those small pieces. Also, the necklace itself can lead to strangulation. Amber necklaces are not recommended because of safety concerns and insufficient evidence to support their efficacy. If you and your family believe strongly in amber necklaces, it’s important to know the risk and proceed accordingly.
Best Teething Remedies
Everybody has different pain thresholds, and some babies may be really uncomfortable while teething, while other babies may show no symptoms at all. Come up with a pain management plan that works best for your baby. Here are a few common remedies.
- Make your own teething toy – tie a clean, wet washcloth to a ring and stick it in the freezer. You can also roll the wet washcloth into muffin tins and stick it in the freezer. Your baby can hold this, gnaw on it, and put it directly where they feel discomfort.
- A teething ring or pacifier dipped in water and placed in the freezer can also effectively relieve discomfort. Make sure they are not too hard once they come out of the freezer, as they need some softness for your baby to chomp down on them. You can move them from the freezer to the refrigerator before using them.
- You can also gently massage their gum line with your clean finger. This can help when the tooth is just starting to erupt. If they have multiple teeth, watch out for biting!
- Introduce silicone teething toys around the age a baby begins to drool and put their hands in their mouth. This doubles as a teething aid and a toy to explore during this oral phase.
- Once a baby starts solids, you can place their favorite frozen fruit in a fruit feeder and allow them to gnaw on it. If breastfeeding, try making a breast milk popsicle by freezing breast milk in a fruit feeder.
- Think cold, cold objects that aren’t frozen solid to allow them to gnaw on and alleviate their gum pain.
- Give extra snuggles and comfort as needed. Remember, having the teeth come through the gum line doesn’t feel great – there is likely to be discomfort or pain. Some extra snuggles with some go-to remedies are the best combination.
- Patience and empathy go a long way in teaching them to cope with discomfort. If it’s an extra rough night when that tooth is really breaking through the gum line, you can consider ibuprofen, acetaminophen, or paracetamol, but do not administer this around the clock.
Keep in mind…
Many people are quick to blame teething for everything. They’re fussy or not sleeping – they must be teething. Yes, teething can cause irritability, but this irritability and other symptoms are around the time of the eruption of the tooth. Fussiness, sleep changes, and meal intake changes are typical in the infant and toddler years – even when they’re not teething!
My best advice with teething is don’t make a big deal about it. If you start crying with them or get worried or stressed, our babies sense this energy. Keep these remedies in mind, be a calm presence, and be empathetic.