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Our Baby's First Two Years
by Robert M. Selig, M.D., FAAP & Joann C. Cozza, D.O., FAAP

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Teething is another new and exciting experience for you and your baby. Your baby will display his individuality during this sometimes difficult time. There is a wide range of normal dental development. Eruption of your child's first tooth may occur around 6 months, however it is not uncommon to see a tooth as early as 4 months and as late as 15 months. Your baby's primary teeth are already developing by the time your baby is born, however you just cannot see them. Be patient and they will come.


Usually the lower middle teeth (incisors) appear first, followed by the upper middle teeth. However, any tooth can erupt in any order. Teeth may appear one at a time or come in groups. There is no set pattern, but many babies average one tooth a month between 6-12 months, or 6 teeth by a year.


By 2 to 2 1/2 years, your baby's full set of 20 teeth should be complete. They are only temporary teeth and will fall out between 6-10 years of age. Permanent teeth will replace these over the next several years until the full set of 32 teeth is complete.


Some babies have no problem with teething. In fact, you may not even know that they are teething until one morning you discover a tooth. Other babies are extremely uncomfortable. Parents always ask me if their baby's crying and irritability is from teething. The only way to know for sure if your baby's behavioral change is from teething is see your baby return to normal after a tooth has erupted. I may ask to see your baby in order to be sure that there is no other problem going on which may need to be treated.


Every mother asks me, "Is my child's drooling due to teething?" Drooling is a normal developmental stage for your baby. Saliva is produced by the salivary glands in the mouth, and these begin to function at birth. Saliva production increases between 4-6 months normally. Many babies will have excessive drooling beginning around 4 months and yet no teeth will come through for months. Be patient.


What other things can teething cause? Almost anything! Babies are not usually sick with teething, but just uncomfortable. They may cry more than normal or wake up in the middle of the night more frequently, but will still be comforted with some TLC. They are often more irritable and restless, but otherwise playful. Many babies develop a bad diaper rash right before a tooth comes in and once in, the rash disappears.


Your baby may have looser, greener bowel movements. The green color is the saliva and/or mucus that your baby has swallowed. When your baby is drooling , he/she is also swallowing more saliva, which travels through his/her intestinal system and out through his/her bowels.


Around 4 months of age, your baby has reached a developmental stage where he/she is able to pick up objects and place them in his/her mouth. This is his/her way of exploring his/her environment. You will find that rubbing your baby's gums, or letting her bite on soft objects, will bring some relief to her discomfort. Teething rings (cold, not frozen) are also very soothing for sore gums. A pacifier may be the answer for your baby. Baby Oragel, Ambesol or similar generics are anesthetics which can be applied directly to the gums and may help teething pains. These are available over the counter.


When you rub your finger across your baby's gum, you may feel a raised area. This is his/her tooth getting ready to erupt. Once eruption has occurred, your baby's disposition will return to normal. Be patient and please remember that your baby may be uncomfortable during this time.


The fact that your child is suddenly chewing everything in sight, may be a sign of teething or just a normal stage in his/her normal development.


What about fever and teething? Babies can develop a low grade temperature (99-100 degrees F) around the time a tooth is about to erupt. However, I never attribute fever, especially over 101 degrees, to teething, unless I am sure your baby has no other illness causing the fever. It may be necessary to see your baby in the office. Never blame a fever on teething, especially if your baby appears sick.



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