Teething is the natural process where a baby’s first set of teeth, known as primary or deciduous teeth, begins to push through the gum tissue and become visible in the mouth. This milestone often begins around six months of age and can cause discomfort for both the child and the parent. Understanding the physical signs and symptoms helps caregivers provide appropriate support and distinguish between normal teething discomfort and other health concerns.
Visual Changes in the Gums
The most direct indication of eruption is a change in the appearance of the gums. Parents often notice localized swelling and puffiness, as the tissue becomes slightly raised over the emerging tooth. This pressure causes the gums to become tender and sore.
The color of the gum tissue may shift from a healthy pink to a mild, inflamed redness (erythema) directly above the developing tooth. The gum may also look pale or white just before the tooth breaks through, signifying the stretching of the tissue over the underlying structure.
Sometimes, a small, fluid-filled bubble known as an eruption cyst may form on the gum surface. If this cyst contains blood, it is called an eruption hematoma and can appear blue, purple, or dark red. These cysts are harmless and disappear on their own as the tooth cuts through the gum line. The final confirmation is the distinct white edge of the tooth crown visible beneath the stretched tissue.
Accompanying Physical Symptoms
The physical act of a tooth pushing through the gums is accompanied by several behavioral and systemic changes. One noticeable symptom is excessive drooling (sialorrhea), which leads to persistent wetness around the mouth and chin. This constant moisture can irritate the skin, resulting in a facial rash or chapping.
The discomfort often translates into increased fussiness and irritability, which tends to worsen during the night. Babies instinctively seek to relieve pressure by gnawing or biting down on anything they can reach, including fingers, toys, and clothing. The pain can sometimes radiate, causing some babies to rub their ears or cheeks.
Teething can also cause a temporary change in feeding habits. Some babies refuse to feed because the sucking motion puts pressure on their sore gums, while others may want to feed more for comfort. Although a slight rise in temperature is possible, teething does not cause a high fever. A temperature over 100.4 degrees Fahrenheit (38 degrees Celsius) is usually a sign of an unrelated illness and requires medical attention.
General Timeline for Tooth Eruption
The timeline for tooth eruption is highly variable, but the process generally begins when a baby is between 6 and 10 months old. The first teeth to appear are typically the two lower central incisors, followed shortly after by the four upper central and lateral incisors.
The remaining primary teeth emerge in a specific sequence over the next two years, with the entire set of 20 baby teeth usually complete by the child’s third birthday. The first molars typically erupt between 13 and 19 months, providing the first grinding surfaces for solid foods. The canines appear after the first molars, followed by the second molars, which are the last to arrive.
Soothing Discomfort
Parents can safely manage their baby’s discomfort using several practical, non-medicinal approaches. Applying gentle pressure to the gums can temporarily ease the pain, which can be done by massaging the sore spots with a clean finger or a damp, sterile gauze pad.
The use of cold is also highly effective, as the low temperature dulls the nerve endings in the inflamed tissue. Offering a chilled, but not frozen, teething ring or a damp washcloth that has been refrigerated provides a safe chewing surface. Deeply frozen items should be avoided, as they can be too hard and potentially damage the delicate gum tissue.
If non-medicinal methods are not providing adequate relief, age-appropriate over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be given after consulting a pediatrician. Parents should avoid certain products that pose risks to the baby. Topical teething gels containing benzocaine are not recommended due to the risk of a rare but serious blood disorder. Products like amber teething necklaces or bracelets carry strangulation and choking hazards and should not be used.