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Teething

By Christopher P. Raab, MD, Associate Professor of Pediatrics;Attending Physician, Diagnostic Referral Division, Sidney Kimmel Medical College at Thomas Jefferson University;Nemours/Alfred I. duPont Hospital for Children

A child's first tooth usually appears by 6 months of age, and a complete set of 20 primary or first teeth usually develops by 2½ years. Before a tooth appears, the child may cry, be fussy, and sleep and eat poorly. The child may drool, have red and tender gums, and chew constantly on objects like toys and crib rails during tooth eruption.

Tooth Eruption Times for Baby Teeth

Teeth

Age at Eruption*

Lower front teeth (lower central incisors)

5–9 months

Upper front teeth (upper central incisors)

8–12 months

Upper side teeth (upper lateral incisors)

10–12 months

Lower side teeth (lower lateral incisors)

12–15 months

First back teeth (first molars)

10–16 months

Eye teeth or cuspids (canines)

16–20 months

Second back teeth (second molars)

20–30 months

*The age at eruption for baby (deciduous) teeth varies greatly. Children have a total of 20 baby teeth.

Teething does not cause fever (temperature of 100.4° F or 38° C or higher). Children who have fever and who are especially fussy should be evaluated by a doctor for an infection because these symptoms are not caused by teething.

Did You Know...

  • Despite popular belief, teething does not cause fever.

Teething infants get some relief from chewing on hard objects (such as teething biscuits) or cold objects (such as firm rubber or gel-containing teething rings). Massaging the child's gums with or without ice also may help. If a child is extremely uncomfortable, weight-based doses of acetaminophen or ibuprofen are usually helpful.

Teething gels are not recommended because they are not any more effective than other measures of pain relief, and some contain a potentially dangerous substance called benzocaine. Benzocaine can rarely cause a serious condition called methemoglobinemia, which affects the ability of the blood to carry oxygen.

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