# Teething and First Teeth

> When teeth come, what helps the sore gums, what to skip, and brushing from the first tooth.

Stage: baby - Topic: Everyday care - Page: https://www.askcladle.com/guides/baby/teething

Grounded in: AAP HealthyChildren guidance on teething and on baby teeth and fluoride, and FDA safety communications on teething gels, tablets and jewelry.

## TLDR

- First teeth usually come around 6 months (anywhere from 4-15 months is normal). Drooling, chewing and fussiness are typical.
- Teething doesn't cause real fever (100.4°F+), diarrhea or a rash; look for another cause.
- Use a chilled teething ring or gum rub. Skip numbing gels and amber necklaces. Brush from the first tooth with a rice-grain smear of fluoride toothpaste.

## When teeth come

- Most babies get their first tooth around 6 months, but anywhere from about 4 to 15 months is
  normal. A few are born with one.
- The bottom front teeth usually come first, then the top front ones. All 20 baby teeth are usually
  in by about age 3.
- Molars, around 13 to 19 months and again around 2 years, are often the uncomfortable ones.

## What you may see

- Drooling, chewing on everything, swollen or tender gums, fussiness and lighter sleep for a few
  days before a tooth comes through.
- Teething can make a baby a little warm, but it does **not** cause a real fever (100.4°F / 38°C or
  higher), diarrhea, a runny nose or a rash. If you see those, look for another cause.

## What helps

- Rub the gums with a clean finger, or let your baby chew a firm rubber teething ring or a clean
  wet washcloth that has been chilled in the fridge (not frozen solid).
- Extra cuddles and patience; it passes in a few days per tooth.
- If your baby is very uncomfortable, ask the pediatrician about acetaminophen, or ibuprofen from
  6 months, dosed by weight.

## What to avoid

- Numbing gels or liquids with benzocaine or lidocaine. The FDA warns against them for teething.
- Homeopathic teething tablets.
- Amber teething necklaces, bracelets and other teething jewelry: they can choke or strangle.
- Teething biscuits that break into hard chunks, and anything frozen solid.

## Caring for new teeth

- Brush twice a day from the first tooth with a soft brush and a smear of fluoride toothpaste the
  size of a grain of rice. Move to a pea-sized amount at age 3.
- Plan a first dental visit by the first birthday. The pediatrician may also paint on fluoride
  varnish at checkups.
- No bottle in bed, and no juice in a bottle, to protect against tooth decay.

## When to check in

- Any fever in a baby under 3 months: call right away, whatever you think the cause is (see the
  newborn red flags guide).
- At any age, a high temperature, diarrhea, a rash, refusing to drink, or a baby who seems ill: these aren't
  teething, so check with the doctor.
- No teeth at all by about 18 months: mention it at the next visit.