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Pediatric - Teething


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Does this describe your child's symptoms?

  • Questions about teething, the normal process of new primary teeth working their way through the gums
  • Teeth come in between 6 and 24 months of age


  • Main symptoms are increased saliva, drooling and desire to chew on things.
  • Occasional symptoms: mild gum pain.  Not enough to cause crying or interfere with sleep.
  • Does not cause fever, diarrhea, diaper rash, ill appearance or lowered resistance to infection.
  • Caution: Blaming teething for fevers can lead to a delayed diagnosis of ear infections, urinary tract infections, meningitis and other infections.
  • There are 2 reasons for the onset of infections between 6 and 12 months of age: The loss of transplacental antibodies and the developmental milestone of chewing on everything.

If not, see these topics

When to Call Your Doctor

Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
Call Your Doctor During Weekday Office Hours If
  • You think your child needs to be seen
  • You have other questions or concerns
Parent Care at Home If
  • Normal teething and you don't think your child needs to be seen

  1. Reassurance:  
    • Teething is a natural process.  
    • It's harmless and it causes little if any pain.
    • It doesn't cause fever or crying. If present, look for another cause.
  2. Gum Massage:  
    • Find the irritated or swollen gum.  
    • Massage it with your finger for 2 minutes.  
    • Do this as often as necessary.  
    • You may use a piece of ice wrapped in a wet cloth to massage the gum.
  3. Teething Rings or Teething Biscuits: Infants massage their own gums by chewing on smooth, hard objects.
    • Offer a teething ring, pacifier or wet washcloth that has been chilled in the refrigerator, but not frozen in the freezer.  A piece of chilled banana may help.
    • Avoid hard foods that could cause choking (e.g., raw carrots).
    • Avoid ice or popsicles that could cause frostbite of the gums.
  4. Cup Feeding:  If your infant refuses nipple feedings, use a cup, spoon or syringe temporarily.
  5. Pain Medicine: If the pain increases, give acetaminophen (e.g., Tylenol) orally for 1 day. Special teething gels are unnecessary and we do not recommend them. They can cause allergic reactions or choking.
  6. Call Your Doctor If:
    • Develops unexplained crying
    • Develops fever
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/24/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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