Teething takes place when an infant's tooth begins to come through the gum tissue. The first tooth usually becomes visible when an infant is between the ages of 5 and 6 months but may not be visible until the child is age 12 months or older. The gums may be swollen and sore in the spot where the tooth is coming into the mouth. If there are symptoms, they begin about 3 to 5 days before the tooth erupts and usually disappear as soon as the tooth breaks through the gum.

Some infants and children do not show any signs of discomfort from teething, but others may experience irritability, crying, tender or bleeding gums, excessive drooling (which can lead to a rash on the chin, face, or chest), or a desire to chew on something hard. Infants and children who are teething may also have symptoms such as pulling their ears and refusing to eat and drink because of tender gums.

Over-the-counter gels and numbing remedies should not be used on infants and children unless a physician or dentist has given specific directions to use them. Such remedies tend to wash out of the mouth and may cause choking. To ease the soreness, give the infant or child a clean teething ring, cool spoon, or cold wet washcloth, or simply rub the gums with a clean finger.

Pain relievers that contain aspirin should not be given to infants, children, or adolescents under age 20, because they have been associated with Reye's syndrome, a rare and deadly illness that can affect the brain and the liver. Pain relievers that contain aspirin should never be applied directly to the gums.

Teething does not usually make an infant or child sick. If the infant or child appears particularly uncomfortable, has diarrhea, or has a fever of 101 degrees Fahrenheit or higher, the cause is probably something other than teething, Severe or ongoing symptoms should be closely watched and discussed with a physician.

Performance Standards

1304.40(f)(2)(iii)

References

American Academy of Pediatric Dentistry. Dental Care for Your Baby. Chicago, IL: American Academy of Pediatric Dentistry. http://www.aapd.org/publications/brochures/babycare.asp.

American Academy of Pediatrics. Dental Health. Elk Grove Village, IL: American Academy of Pediatrics. http://www.aap.org/pubed/zzzkryyxa7c.htm?&sub_cat=11.

Casamassimo P, Holt K, eds. 2004. Bright Futures in Practice: Oral Health—Pocket Guide. Washington, DC: National Maternal and Child Health Oral Health Resource Center. http://www.mchoralhealth.org/PDFs/BFOHPocketGuide.pdf.