Family doctor

Overview:

• Teething usually starts at around six months but many babies begin cutting teeth earlier or later than this
• Most babies find teething painful and will be grizzly for a few days
• Teething symptoms include dribbling, rashes on their face or chin, pain in the gums
• Symptoms like fever and prolonged crying should not be put down to teething; a medical check up is advised if in doubt
• Give babies a teething ring to chew on or use a teething power or gel to numb the area

Teething:

Most babies will begin teething at around six months. However, some babies are born with teeth and others may not start teething until they are 12 months.

Teething usually begins with the lower middle teeth, but some babies cut their upper or side teeth first.

Most children have 20 teeth by two and half years.

If no tooth appears by 12 months, a dental examination is advised.

First teeth are necessary to help children eat and speak properly. They are also important for the development of second teeth.

If your baby bites you while breastfeeding, take them off the breast, have a break and then try again. This should help to teach your baby not to bite while feeding.

What are the symptoms?

Babies are often grizzly for a few days before a new tooth appears. They are likely to have painful or swollen gums and dribble more than usual.

Other possible symptoms are:

• Changes in bowel motions
• Changes in feeding patterns or loss of appetite
• Waking during the night
• A rash on the face or chin
• Chewing on toys and fingers

Be careful not to put too many other symptoms such as fever and prolonged crying down to teething; other conditions should be excluded by a medical examination.

What can be done to help?

A teething powder or gel available from pharmacies can help to numb the area.

Give paracetamol once every four hours if your baby has a fever. Do not use aspirin because this has been linked to Reye's syndrome.

Teething rings that have been chilled in the fridge are useful. But avoid those filled with fluid because these can sometimes rupture.

Try wrapping some cold fruit or vegetables in muslin and give them to your baby to chew.

Dental care:

Baby teeth should be regularly clean with a soft cloth.

Teeth brushing is not necessary until your child is 12 months.

Start with a small, soft-headed brush and teach your child to clean their teeth in the morning and at night.

Use just a small smear of toothpaste on the brush because most children will swallow it before they learn to spit it out.

Fluoride tablets are not recommended if you live in an area without fluoride in the water. But make sure you use a toothpaste which contains fluoride.

Try to limit sugary drinks or fruit juice because these can cause dental caries (holes), and don't let babies fall asleep with a bottle of milk or juice in their mouth.

Getting help

It is sometimes difficult to distinguish between teething and illness. See your doctor if you are concerned the symptoms could be a sign of illness.