Teething Symptoms

The vast majority of babies sprout their first teeth when they're between 4 and 7 months of age. An early developer may get his first white cap as early as 3 months, while a late bloomer may have to wait until he's a year old or more. (In rare cases, a baby's first tooth is already visible at birth.) Whenever the first tooth makes its appearance, celebrate the milestone by taking pictures and noting the date in your child's baby book.

Teeth actually start developing while your baby's in the womb, when tooth buds form in the gums. Teeth break through one at a time over a period of months, and often — but not always — in this order: First the bottom two middle teeth, then the top two middle ones, then the ones along the sides and back. They may not all come in straight, but don't worry — they usually straighten out over time.

The last teeth to appear (the second molars, found in the very back of the mouth on the top and bottom) have usually begun coming into place by your baby's second birthday. By age 3, your child should have a full set of 20 baby teeth, which shouldn't fall out until his permanent teeth are ready to start coming in, around age 6. 

The symptoms most likely to trouble a teether include:

• Drooling (which can lead to a facial rash)
• Gum swelling and sensitivity
• Irritability or fussiness
• Biting behavior
• Refusing food
• Sleep problems

Though many parents report that their babies have loose stools, runny noses, or a fever just before a new tooth arrives, most experts don't think teething is to blame for these symptoms. One who does is William Sears, pediatrician and author of The Baby Book. Sears believes that teething can cause diarrhea and a mild diaper rash because your baby's excessive saliva ends up in his gut and loosens his stools. Inflammation in the gums, he thinks, may cause a low fever (under 101 degrees Fahrenheit).

On the other hand, child development experts such as Penelope Leach assert that teething cannot cause fever, diarrhea, vomiting, or loss of appetite and that these are signs of illness that should be checked out. Noted pediatrician T. Berry Braselton says such symptoms are probably due to an infection unrelated to teething, but that the stress associated with teething could make your child more vulnerable to infection right before a new tooth appears.

The one thing experts agree on is that you should call your child's doctor if your baby has symptoms that worry you or a rectal temperature of 101 degrees F or higher (100.4 degrees F or higher for babies younger than 3 months). The doctor can help determine whether your baby is showing signs of a problem that needs medical attention, like an ear infection. If your baby has loose stools — but not diarrhea — don't worry. The condition will clear up on its own.

Drooling. You might find that your baby's shirts are suddenly soggy. Fasten on a bib to keep her more comfortable (and cleaner), and gently wipe her chin throughout the day to stave off chapping (if that doesn't work, ask your doctor about a mild moisturizer such as Aquaphor or even Lansinoh nipple cream). Pooling saliva may also cause a slight cough or even trigger the gag reflex. If she's otherwise healthy, you can safely ignore both.

Gnawing: She's not trying to be naughty. Little nips at your fingers, breast (ouch!), or her spoon help relieve the pressure she feels from under her gums.

Crying: Some babies breeze through teething with nary a whimper, while others suffer from a good deal of pain — which they feel compelled to share with you in the form of whining or crying. Talk to your doctor about when to administer pain relievers such as infant acetaminophen or ibuprofen.

Fasting: Since sucking movements can worsen teething pressure or pain, your baby may refuse to nurse or eat, or may nurse briefly and then turn away. Keep at it, and call your pediatrician if the strike lasts more than a few days.

Waking: Especially when she's working on cutting that very first tooth, your baby may fuss during the night as well as during the day, so be prepared for a little extra crib-side duty for a while.

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