Ask the Experts: Teething timeline

I think my 4-month-old daughter is in the beginning stages of teething. How can I be sure?

A: Teething is the natural process of tooth eruption in babies. Symptoms usually begin about two to five days before a tooth appears, and most often stop once the tooth emerges through the gums. However, in some babies, symptoms can persist off and on for up to two months after the tooth has broken through.

The most common symptoms of teething are discomfort, soreness and swelling of the gums where a tooth will erupt, as well as drooling from increased saliva flow. These symptoms tend to be worse at night.

The experience of teething varies greatly among babies. The fortunate ones have almost no issues while others will experience a fairly rough time getting teeth in. Other reported symptoms that may be teething related are cough and congestion, runny nose, sleep disturbance, decreased appetite, loose stools, vomiting and low-grade fever. However, if these symptoms persist beyond a few days or worsen, then it is advisable to have other possible causes ruled out.

Timing of eruption also varies, but usually the two lower front teeth (central incisors) make an appearance by 6 months of age. There are some babies born with these teeth, and others may not get them until closer to a year. It is definitely possible that a 4-month-old female would be in the beginning stages of teething.

Baby teeth tend to erupt in a symmetrical pattern, with the lower teeth emerging before upper teeth and front teeth coming in before back teeth. The complete arrival of all 20 baby teeth can take up to three years, with the typical pattern being central incisors (6-12 months), lateral incisors (9-16 months), first molars (13-19 months), canines (16-23 months) and second molars (23-33 months).

Treatment for teething pain most often includes gently massaging gums with a clean finger, gauze or washcloth. Cool fluids and other cold items such as ice cream, yogurt and pudding can also help soothe teething pain. If teething rings or pacifiers are used, try chilling them to help numb the gums.

Teething is a normal part of your baby’s growth and development, and as with most phases that can be difficult, remember that it too shall pass.

—Robert L. Delarosa, DDS, president of the American Academy of Pediatric Dentistry and pediatric dentist in Baton Rouge, Louisiana


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