Teething: Facts & Fiction

Teething frustrates many parents. You want to provide relief for your little one when their incoming teeth are bothering them, but it is difficult to know how to do this safely and effectively.

You may have read articles or talked to family members about this subject, but sometimes that information isn’t necessarily correct. Here’s some factual information so that you can provide practical, safe, and evidence-supported care to help your child.

Fiction: Teething gels and tablets are a safe option for teething discomfort.

Fact: The FDA warns against products such as Oragel, Cepacol, or Topex that contain local anesthetics like benzocaine and can cause a serious condition in infants called methemoglobinemia, which can be fatal. A plant compound called belladonna has been found in some teething tablets and can also be toxic.

Fiction: If my baby is teething, I should give him or her Tylenol around the clock.

Fact: Liquid Tylenol (acetaminophen) is a safe and effective medication for teething, but teething is often not painful. Don’t misinterpret chewing behavior for pain. The urge to gnaw may mean your baby has “itchy teeth” but is not uncomfortable. Don’t reach for the Tylenol until you’re sure they’re uncomfortable.

Fiction: Increased drooling always means my child is teething.

Fact: Drooling does not necessarily mean your child is teething. Drooling increases in infants around 3–4 months of age as a result of your baby’s increased exploration by mouth (gnawing, putting hands in mouth) and to facilitate digestion. Most children start teething around 6 months of age; you may see swollen/tender gums and increased drool at this point as teeth appear.

Fiction: My child’s runny nose/diarrhea/fever is just because they’re teething.

Fact: While low-grade fevers and runny noses are often blamed on teething, be on the lookout for other causes, like viral infections or ear infections. Research has not found any strong links between diarrhea, vomiting, fevers, and teething. If your baby’s temperature is over 100F, call or visit your doctor for help.

Fiction: Teething necklaces and bracelets are good non-medicinal options for teething relief.

Fact: The FDA released a new warning in December 2018 against teething necklaces, bracelets, and other jewelry due to a risk of serious injury (including strangulation and choking) or death. There’s also no evidence to support the effectiveness of such jewelry, regardless of whether it’s made of amber, wood, marble, or silicone. If parents choose to use these products anyway, the child should never be unsupervised or sleeping while wearing them.

Fiction: I should be worried if my baby has no teeth by their first birthday.

Fact: Most babies will develop teeth between 4 and 12 months of age, but there’s a wide range of variability. No teeth by 14–15 months is more concerning and should be discussed with your doctor. The lower front teeth (the lower central incisors) are usually first to appear. Most children will have all of their baby teeth by age 3. For children with genetic syndromes (for example, Down syndrome), teeth may appear in a different order or later than average.

 Safe Options for Teething Relief

Try providing symptom relief without medications first, using the options listed below. If your child still seems uncomfortable, then try Tylenol (acetaminophen). Check with your pediatrician to make sure you’re giving the right dose for your child’s size.

1.      Find something that’s cool to touch but tough to chew on, such as:

·         A wet washcloth or rolled up cotton sock chilled in the freezer for 15–30 minutes

·         A frozen banana or frozen bagel (if the child is safely eating solids)

·         Solid teething rings chilled in the fridge or freezer but not frozen solid. (There have been several recalls in the past due to the potential for bacteria growing in the liquid of liquid teething rings and the solid ones can be too hard when frozen completely.)

·         A silicone, rubber, or latex chewy toy

2.      If your baby doesn’t have any teeth yet, let them gnaw on your fingers or massage their gums with your fingers for comfort. Make sure your fingers are clean first.

Resources:

·         American Academy of Pediatrics/ healthychildren.org

·         FDA.gov

·         https://seattlemamadoc.seattlechildrens.org

-Sara Williams, MD
Developmental Pediatrics Fellow
University of Colorado