Teething is the growth of teeth through the gums in the mouth of infants and young children.

Teething usually begins between the 6th and 8th month of life. Further tooth eruption occurs periodically until all 20 teeth of infancy and childhood, or deciduous teeth, are in place. All the deciduous teeth are normally in place by the 30th month of life.

These teeth include 4 incisors, 2 canines, and 4 molars in each jaw for the total of 20. The 2 lower central incisors (bottom front) usually erupt first followed by the 2 upper central incisors, then the lower and upper lateral (side) incisors, lower molars, upper molars, lower canines, upper canines, lower lateral molars, and finally the upper lateral molars. Note that some children do not show any teeth until much later than 8 months, and this is perfectly normal.

The signs of teething are:

• Drooling
• Irritability
• Gum swelling and sensitivity
• Sleeping problems
• Refusing food
• Biting on hard objects

The discomfort that results from teething is due to the pressure exerted on the tissue in the mouth, called the periodontal membrane, as the teeth erupt. This discomfort may be eased by a cool object such as a firm rubber teething ring or a cold apple. Gently rubbing the gums with a cool, wet washcloth, or (until the teeth are right near the surface) a clean finger, can also help.

The gums should not be cut to facilitate the eruption of teeth since infection can result. Teething powders should also be avoided and children should NEVER be given aspirin, due to the risk of developing Reyes syndrome.

Medications such as children's Tylenol or over-the counter teething preparations containing a topical anesthetic can be helpful.

NOTE: Teething does NOT cause fever. If your child develops a fever greater than 100.5 degrees, as taken with a rectal or ear thermometer), look for other signs of illness.