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Teething

Advancement in the speciality of Paediatric Dentistry

Introduction

Children get their first teeth around the age of 6 months, and their last baby tooth around 30 months.  Around the time that they are teething, their immune systems are also changing.

Most kids this age also like to pick things up and put them in their mouths.  The change in the immune systems and the tendency to put things in their mouths make them more prone to feeling unwell.  Symptoms like fussiness, rash, drooling, runny nose, diarrhoea, and changes in sleeping and eating patterns are often blamed on teeth.  If your child has these symptoms, make sure that they are not suffering from other bacterial, viral or middle ear infections.  

Teeth development in children

Baby teeth form while the baby is still in the womb.  By the time the baby is born, all 20 baby teeth have formed and are hidden under the gums.  Baby teeth are also known as milk teeth, primary teeth or deciduous teeth.

Normal teething process

Most children get their first teeth between the ages of 4 to 15 months.  Teething takes about 8 days, which includes 4 days before and 3 days after the tooth comes through the gum.

erupting tooth

Sometimes you may see a blue-grey bubble on the gum where the tooth is about to come out.  This is called an eruption cyst and will usually go away without treatment.

eruption cyst second primary molar
eruption cyst adult lateral incisor

First set of teeth

Children have 10 teeth in the top jaw and 10 teeth in the bottom jaw.  Most kids get the full set of 20 baby teeth by the time they are 3 years old.  The four top and four bottom front teeth are called "incisors".  The pointy teeth on either side, two in the top jaw and two in the bottom jaw, are called "canines".  The four top and four bottom back teeth with flat chewing surfaces are called "molars".

primary anterior teeth maxillary primary teeth mandibular primary teeth

Tips for soothing sore gums

  • Massage
    Gently massage the sore gum with clean fingers or a soft, wet cloth.
  • Chilled (not frozen) teething rings or rusks
    The cold and the pressure from teething rings or rusks can make the gum feel better.  Unsweetened teething rusks or sugar-free teething biscuits can be given to children older than 6 months who have started eating solids.

    It is important not to put plastic teething rings into boiling water or the dishwasher unless suggested by the manufacturer.
  • Pain medicines
    Paracetamol (e.g. Children's Panadol®) can be useful for pain relief.  Ibuprofen (e.g. Nurofen® for Children) may be more effective at relieving pain, but it is best to talk to your doctor before giving this to your child.
  • Dry the drool
    The skin around the mouth and the chin can become irritated when saliva pool around the area for a long time, and this can add to your child's discomfort.  Gently wipe this away with a soft cloth throughout the day.
  • Teething gels
    Common teething gels like Bonjela® can help with teething pain.  Before use, wipe the sore gum with soft cloth then rub the gel on 3-4 times a day, but no more often than 6 times a day. 

    Teething gels containing the ingredient "benzocaine" are not recommended for use in children.
  • Teething necklaces
    Amber teething rings or necklaces have become popular in recent years.  Amber beads are believed to release healing oil when they touch the skin, and this is thought to have a soothing effect when worn around the neck, wrist or ankle.  Unfortunately many are bought for children to chew on.  These products can be dangerous as your child can choke on the beads if they fall out from the string.  The necklaces can also cause strangulation.