Health Education

Teething and Dental Care

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Babies and young children learn by exploring the environment with their mouth. As they grow older, the mouth and teeth becomes essential for speech and communication as well as chewing. Initiating oral hygiene in the first year of life will establish good habits that last a lifetime.

When does teething start?

For most children, teeth start to move through the gums as early as 2 to 4 months although the teeth don’t usually start to erupt until 6 to 12 months. Believe it or not, most children do not experience pain with teething. The most common symptom of teething is drooling and an increased desire to chew on things. Some children will pull on their ears because the same nerves that control the jaws and the teeth provide sensation to the eardrum. In fact, the most common reason that children pull on their ears in the first year of life is that they are teething. Gums may appear swollen or bruised before teeth erupt.

Teeth usually appear in the following order: 2 lower incisors, 4 upper incisors, 2 lower incisors and first four molars, 4 canines and finally 4 second molars.  However, many children will normally erupt their teeth in a different order.

What can I do if my child experiences teething discomfort?

If your child is uncomfortable, try vigorously massaging her gums for 2 minutes with your finger or a cool cloth. You can also try a giving your child a cold washcloth, teething biscuit or piece of chilled banana to “chew” on. Avoid foods that are frozen to avoid frostbite of the gums.

Medicated teething gels are generally ineffective, unnecessary and are no longer recommended due to a potential harmful side effect. If your child is that uncomfortable, please give her a dose of Acetaminophen (under 6 months) or Ibuprofen (6 months and older) for pain. During the day, distraction is usually sufficient to alleviate teething symptoms. Remember, your child will be teething for the next 2 years so use pain medications judiciously. Teething usually occurs in 1–2 week cycles.

What other symptoms should I expect to see with teething?

Despite popular belief, teething rarely causes fever, diarrhea, or diaper rash. The increased drool may cause stools to be a little looser and the increased saliva often causes an irritant diaper rash. If your child has a temperature over 100.4, the fever is probably due to a virus rather than teething.

When do I need to start dental care?

Dental care should begin in the first six months of life by gently wiping the gums with cotton gauze or cloth once a day. Begin brushing your child’s teeth when they have about 6–8 teeth (usually 15–18 months). You can introduce your child to the toothbrush by letting him or her play with the toothbrush and practice putting it in their mouth. Afterward, brush your child’s teeth for him. Remember, don’t force it. It is more important that a child brush their teeth well at 24 years than at 24 months.

Ideally, school age children should brush their teeth two times a day, especially before bed in order to rid their mouth of all the food particles from the day. If your child isn’t brushing twice a day, at least have them rinse their mouth or drink water after a meal to get rid of food particles on their teeth. Teach your children to always brush their teeth after eating candy or sweets.

What about fluoride?

Not only is fluoride safe, it is important in building up tooth enamel and preventing tooth decay. Most drinking water in urban areas contains fluoride. If you don’t have fluoridated drinking water (well water or rural areas) you need a prescription fluoride supplement. Children need about 1 mg or less of fluoride each day. A whole ribbon of toothpaste contains about 1 mg. To prevent your child from getting too much fluoride, use only a pea sized amount of toothpaste on the brush. Too much fluoride (over 2 mg each day) can cause white spots or mottling on the teeth.

Children should not use fluoridated toothpaste until you can trust that they will spit it out and not swallow it. Toddler toothpastes are available but do not contain fluoride and therefore are useless; water will work just fine.

Does my child need to floss?

Flossing should begin once the molars have started to touch. Young children usually have spaces between their teeth making flossing unnecessary.

When should I take my child to see the dentist?

Most children do not need to see a dentist until they are 3 years old. It is fine to take a young child to the dentist to observe you or siblings having their teeth checked and cleaned so that they are familiar with the routine when it is their turn.

Can babies get cavities?

Yes. As soon as teeth appear in the mouth, decay can occur. One serious form of decay among young children is baby bottle tooth decay. Visit for more information. This happens when an infant is allowed to nurse continuously from a bottle of milk, formula, sugar water, or fruit juice during naps or at night. If these liquids pool around the child's teeth during sleep, the teeth will be attacked by acids for long periods of time, and serious decay can result. If you must give your baby a bottle as a comfort for bedtime, try plain water. It is also not a good idea to dip a pacifier into sugar or honey. If possible, avoiding giving your child any juice; it is not necessary for nutrition and eliminating it will help reduce sugar and cavities.