Teething
Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
What is teething?
Teething is the process by which an infant's teeth erupt, or break through,
the gums. Teething is also referred to as "cutting" of the teeth. Teething is
medically termed odontiasis.
When do babies start teething?
The onset of teething symptoms typically precedes the eruption of a tooth by
several days. While a baby's first tooth can present between 4 and 10 months
of age, the first tooth usually erupts at approximately 6 months of age. Some
dentists have noted a family pattern of "early," "average," or "late" teethers.
A relatively rare condition, "natal" teeth, describes the presence of a tooth
on the day of birth. The incidence of such an event is one per 2,000-3,000 live
births. Usually, this single and often somewhat malformed tooth is a unique event
in an otherwise normal child. Rarely, the presence of a natal tooth is just one
of several unusual physical findings which make up a syndrome. If the
possibility of a syndrome exists, consultation with a pediatric dentist and/or
geneticist can be helpful. The natal tooth is often loose and is commonly
removed prior to the newborn's hospital discharge to lessen the risk of
aspiration into the lungs.
What are the signs and symptoms of teething?
Teething is generally associated with gum and jaw discomfort as the infant's
tooth prepares to erupt through the gum surface. As the tooth moves beneath the
surface of the gum tissue, the area may appear slightly red or swollen.
Sometimes a fluid-filled area similar to a "blood blister" may be seen over the
erupting tooth. Some teeth may be more sensitive than others when they erupt.
The larger molars may cause more discomfort due to their larger surface area
that can't "slice" through the gum tissue as an erupting incisor is capable of
doing. With the exception of the eruption of the third molars (wisdom teeth),
eruption of permanent teeth rarely cause the discomfort associated with eruption
of "baby" (primary or deciduous) teeth.
Teething may cause the following symptoms:
- increased drooling,
- restless or
decreased sleeping due to gum discomfort,
- refusal of food due to soreness of
the gum region,
- fussiness that comes and goes,
- bringing hands to the mouth,
- mild rash around the mouth due to skin irritation secondary to excessive
drooling, and
- rubbing the cheek or ear region as a consequence of referred pain
during the eruption of the molars.
Importantly, teething is not associated with the following symptoms:
- fever
(especially over 101 F),
- diarrhea, runny nose and cough,
- prolonged fussiness, or
- rashes over the body.
Next: What is the order of tooth eruption in infants? »
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