Teething

When does teething take place?

Teeth start to develop in the jaw before a baby is even born, but the first tooth usually appears at about six months of age. However, this will vary from child to child, and a very few children are even born with one or more teeth already visible. The final tooth has usually come through by the age of two and a half years.

Teeth usually come through in the same order, although the age at which they appear may vary:

  • The first to show, usually at 5 - 7 months, are the two lower central incisors (front teeth), followed by the two top central incisors at 6 - 9 months.
  • The upper two lateral incisors (either side of the central incisors) are usually next, from 9-12 months, followed by the lower lateral incisors, again between 9-12
  • From 12-16 months, the molars (back teeth) appear, most often beginning with the two upper first molars, and then the two lower first molars.
  • Sometime between 15-20 months the gaps are filled, first by the upper canines (eye teeth), one on each side, and then usually the lower canines.
  • At 24 - 30 months, the second molars emerge.

What is teething?

Teething is the term used to describe the period when each of a baby's 20 first, or milk, teeth appear.

What are the signs of teething?

You may notice that your baby's gum is sore and red over the emerging tooth, and the child may dribble more than usual. When a molar is coming through,

the corresponding cheek may be warm and flushed. Some babies are more irritable and clinging than usual when cutting their teeth and try to chew on their hands, fingers or any other hard object to relieve the discomfort.

You may also spot the emerging tooth itself as a small whitish bump in the gum, which feels sharp when you touch it. It can take several days for each tooth to emerge and the symptoms usually come and go over this time.

What can I do myself?

As the teeth are formed before birth, you can help to ensure that they will be strong and healthy by eating a good balanced diet during pregnancy, containing plenty of calcium (from dairy products) and vitamin D (from margarine, and oily fish, such as herrings and sardines).

Once the baby is born, try to minimize the amount of sugar in the child's diet. Above all, do not let the baby suck on a sweetened dummy or a bottle of sugary drink as the gums and teeth will then be bathed in sugar for long periods, which can cause severely decayed teeth.

Do not give sweets to babies.

If at all, young children may be given sweets at the end of a meal, or encouraged to eat them in one go, rather than making them last, as the teeth will then not suffer a prolonged acid attack.

If your baby shows signs of discomfort while a tooth is coming through, offer something hard to chew on, such as a sugar-free rusk, toast crust, or a teething ring.

The baby may also find it soothing if you gently rub the gum with your (clean) little finger. Try to avoid using teething gels containing a local aesthetics as, on rare occasions, they may cause an allergic reaction in some babies.

Fluoride strengthens teeth and reduces decay. If your water supply does not contain the recommended level of fluoride (ask your local dentist), you may prefer to give your child fluoride drops, available from the dentist, chemist, or health center. You will be given advice on the correct dose.

Supplements are usually given from birth until about 13 years old. Never give more than the recommended dose as an excess can cause mottled teeth. Brush the baby's teeth with a fluoride toothpaste, but tell your dentist or health visitor that you are doing so as they may recommend reducing the dose of supplements.

As soon as the first tooth appears, get into the habit of regular cleaning. Although these first teeth

will fall out from the age of about six years to be steadily replaced with the second or permanent set, they still need to be looked after carefully.

If any first teeth have to be removed early because of decay, the other teeth may move to fill the gaps, and the permanent teeth may not come through in the correct positions.

At first it is often easier to use a piece of gauze to clean the baby's teeth, before progressing to a baby-size toothbrush and a pea-size blob of toothpaste. Toddlers will be keen to try to clean their own teeth, however children are likely to need supervision, until the age of at least seven years.

Advice on Teething

  • Offer the baby something firm to chew on, such as a crust, teething biscuit or slice of carrot.
  • Offer the baby a water-filled teething ring, cooled in the refrigerator (never cool a teething ring in the freezer).
  • Gently rub the baby's gums with your little finger.
  • If the baby is not very hungry, offer frequent drinks or pureed food.
  • Give the baby lots of cuddles and extra attention.
  • Cold can make teething pain worse; dress your baby in a hat and scarf for outings.

When should I see my doctor?

Some discomfort is normal while the baby's teeth are emerging and it is quite likely that the child will be a little unwell. However, teething does not cause high fever, or persistent diarrhoea, or vomiting.

If your baby has these or any other symptoms of illness, consult your doctor.

WARNING

If potentially dangerous symptoms are attributed to teething and ignored, this can lead to a baby becoming seriously ill.

Always see your doctor if you are worried about your child.

tony
 

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