Teething

When will my baby start getting teeth?

The vast majority of babies sprout their first teeth when they're between 4 and 7 months of age. An early developer may get his first white cap as early as 3 months, while a late bloomer may have to wait until he's a year old or more. (In rare cases, a baby's first tooth is already visible at birth.) Whenever the first tooth makes its appearance, celebrate the milestone by taking pictures and noting the date in your child's baby book.

Teeth actually start developing while your baby's in the womb, when tooth buds form in the gums. Teeth break through one at a time over a period of months, and often — but not always — in this order: First the bottom two middle teeth, then the top two middle ones, then the ones along the sides and back. They may not all come in straight, but don't worry — they usually straighten out over time.

The last teeth to appear (the second molars, found in the very back of the mouth on the top and bottom) have usually begun coming into place by your baby's second birthday. By age 3, your child should have a full set of 20 baby teeth, which shouldn't fall out until his permanent teeth are ready to start coming in, around age 6.

What teething symptoms will my baby experience?

Experts disagree about whether teething actually causes symptoms — like fussiness, diarrhea, and fever — or whether these common symptoms are not related to teething at all and just coincidentally appear at the same time as emerging teeth. Regardless, many parents maintain that their teething babies do experience discomfort (though some babies get through the process with no problems at all). The symptoms most likely to trouble a teether include:

• Drooling (which can lead to a facial rash)
• Gum swelling and sensitivity
• Irritability or fussiness
• Biting behavior
• Refusing food
• Sleep problems

Though many parents report that their babies have loose stools, runny noses, or a fever just before a new tooth arrives, most experts don't think teething is to blame for these symptoms. One who does is William Sears, pediatrician and author of The Baby Book. Sears believes that teething can cause diarrhea and a mild diaper rash because your baby's excessive saliva ends up in his gut and loosens his stools. Inflammation in the gums, he thinks, may cause a low fever (under 101 degrees Fahrenheit).

On the other hand, child development experts such as Penelope Leach assert that teething cannot cause fever, diarrhea, vomiting, or loss of appetite and that these are signs of illness that should be checked out. Noted pediatrician T. Berry Brazelton says such symptoms are probably due to an infection unrelated to teething, but that the stress associated with teething could make your child more vulnerable to infection right before a new tooth appears.

The one thing experts agree on is that you should call your child's doctor if your baby has symptoms that worry you or a rectal temperature of 101 degrees F or higher (100.4 degrees F or higher for babies younger than 3 months). The doctor can help determine whether your baby is showing signs of a problem that needs medical attention, like an ear infection. If your baby has loose stools — but not diarrhea — don't worry. The condition will clear up on its own.

What can I do to ease my baby's discomfort?

Give your child something to chew on, such as a firm rubber teething ring or a cold washcloth. If your baby is old enough to eat solids, he may also get some relief from cold foods such as applesauce or yogurt. Giving him a hard, unsweetened teething cracker such as zwieback to gnaw on is another time-honored trick. (Avoid carrots, as they can be a choking hazard.) Simply rubbing a clean finger gently but firmly over your baby's sore gums can ease the pain temporarily, too.

If these methods aren't working, some doctors recommend giving a teething baby a small dose of children's pain reliever such as infants' acetaminophen — but check with your doctor before giving your baby any medication. (Never give your baby aspirin or even rub it on his gums to ease the pain. The use of aspirin in children is associated with Reye's syndrome, a rare but potentially life-threatening condition.)

Rubbing the gums with topical pain relief gel is also an option, but you may want to ask your baby's doctor before trying it. If you use too much, it can numb the back of your baby's throat and weaken his gag reflex (which helps prevent him from choking on his saliva). The gels are generally safe to use, but in rare cases can cause an allergic reaction.

If drool causes a rash on your baby's face, wipe, but don't rub, the drool away with a soft cotton cloth. You can also smooth petroleum jelly on his chin before a nap or bedtime to protect the skin from further irritation.