Teething
The process of primary teeth erupting through the gums, occurring continuously from approximately 4 months to 3 years of age.
| Age range | 4 months–3 years |
| Total teeth | 20 primary teeth |
| Peak discomfort | canines and molars (12–24 months) |
| Duration per tooth | 3–7 days of visible symptoms |
Eruption Timeline
| Teeth | Typical Age | Notes |
|---|---|---|
| lower central incisors | 6–10 months | Usually first to appear |
| upper central incisors | 8–12 months | |
| lateral incisors | 9–16 months | |
| first molars | 13–19 months | Often more uncomfortable |
| Canines | 16–23 months | Can cause noticeable discomfort |
| second molars | 23–33 months | Final primary teeth |
Actual Symptoms
Research shows teething causes fewer problems than commonly believed. Confirmed symptoms include:
- Irritability (mild, intermittent)
- Increased drooling
- Desire to chew on objects
- Visible red, swollen gum tissue
- Restless sleep
- Difficulty falling asleep
Not caused by teething: fever above 38°C, diarrhoea, severe sleep disruption, rashes, runny nose. These symptoms coincide with teething age but are unrelated to tooth eruption.
Relief Methods
Cold pressure:
- Refrigerated washcloth — Dampen corner, chill (not freeze), allow chewing
- Chilled teething ring — Refrigerate only; frozen items may cause injury
- Cold food (6+ months) — Chilled cucumber, carrot sticks under supervision
Distraction techniques:
- Outdoor play during symptomatic periods
- Increased social interaction
- Rumbling white noise at night (shower-level volume)
Pain relief:
- Consult GP about paracetamol or ibuprofen 30 minutes before bed
- Avoid teething gels containing benzocaine (ineffective, wash off quickly, overdose risk)
- Avoid amber teething necklaces (strangulation/choking hazard, no evidence of efficacy)
Night-Time Management
Teething discomfort is typically easier to ignore during active daytime hours but more noticeable in quiet, dark conditions. Most children do not require intervention, as symptoms are mild annoyance rather than acute pain.
If night waking occurs:
- Maintain white noise throughout sleep
- Consider pain relief 30 minutes before bedtime (GP consultation)
- Avoid creating new sleep associations (rushing in with teething toys)
When to Consult a Doctor
Seek medical advice if:
- Fever above 38°C
- Persistent diarrhoea or vomiting
- Refusal to feed for multiple sessions
- Symptoms lasting beyond 7 days per tooth
- Signs of infection (pus, extreme swelling)
- No teeth by 18 months
Common Misconceptions
Myth: Teething causes fever, diarrhoea, and severe sleep problems.
Reality: Studies show these symptoms occur independently. Babies aged 4–36 months experience periodic fussiness, illness, and sleep disruption regardless of tooth eruption. The overlap is coincidental timing, not causation.
Prevalence of parental belief: Up to 99% of parents attribute common infant symptoms to teething, though evidence does not support this connection.
self-settling During Teething
Babies who have established self-settling skills typically continue sleeping through teething with minimal disruption. The combination of appropriate white noise and existing sleep habits usually provides sufficient distraction from gum discomfort.
See also: Sleep Disruptions, Pain Relief for Infants, Introducing Solid Foods, Oral Development, Night Waking