Teething

Q:When do the primary (baby) teeth form?

A: The cells which form the hard structures of the teeth begin their work about midway through pregnancy.  The crowns of the front teeth are completed at about 2 months of age, molars at about 11 months.  The roots are still forming during tooth eruption and provide the force to push the teeth through the gums.

Q: When will my child get teeth?

A: Most children begin getting teeth around six months old, but there is a large variation.  Some children start getting teeth soon after they are born and some are toothless until they are 18 months old.

Q: Is very early or very late tooth eruption a sign of any medical problems?

A: No. There is a wide range of eruption times that fall within the normal limits.

Q: What is the usual sequence of eruption?

A: The middle front teeth (central incisors) usually erupt first with the lower typically preceding the upper.  Then the lateral incisor, first primary molar, cuspid (“eye tooth”), and second primary molar erupt.

Q: Is it true that babies get sick in different ways from teething?

A: All kinds of problems from colds to rashes to diarrhea have been blamed on teething.  The safest approach is to think of these problems as just coincidentally occurring at the same time as the eruption of the teeth.  If your child has a fever or actually seems sick, consult with your pediatrician.

Q: Are children ever born with teeth?

A: Occasionally. They are called natal teeth if they are present at birth and neonatal teeth if they erupt during the first month of life.  There is a wide variation in natal teeth.  Some are just barely through the gums and will develop normally.  Others are attached by a strand of gum tissue, will never develop normally, and should be removed as soon as possible to avoid the possibility of becoming loose and being aspirated or swallowed by the child.

Q: How can I make teething easier for my child?

A: Teething rings are important to help the teeth work through the gums.  As soon as the teeth penetrate the gum tissue, the discomfort begins to go away.  Try cooling the teething ring in the refrigerator.  If you put it in the freezer compartment, don’t give it to your child immediately when you take it out because it is possible to get a “cold burn” on the sensitive mouth tissues.  Ask your pediatrician’s advice about whether to give Tylenol, and how much and how often to give it.  A surface anesthetic preparation like Ora-Gel (not indicated for before the age of two years old) for teething may be useful at bedtime or when the baby is particularly upset; however, it washes away in a short time.  Be sure to use it only according to the directions.  There is no perfect solution, so just give extra love and the problem will resolve itself. 

Q: What are “eruption cysts?”

A: An eruption cyst is a soft, bluish dome of gum tissue over an erupting tooth caused by a small blood vessel being broken and the fluid filling up the gum tissue.  It is not really a cyst.  Usually no treatment is needed, but be sure to contact your dentist if concerned.