all about baby teeth
When my little ones were babies, one of the things I dreaded the most was teething. Why? Because I knew so little about teething in general, what to expect, how I could help my little one and what to do in the event of an accident involving baby teeth. So you can face teething without fear, I've written this blog.
WHAT IS TEETHING?
When babies are born, the large majority are born with no teeth; only gums. When the teeth eventually do erupt through the gums, this process is known as teething.
WHEN DOES IT OCCUR?
Some babies are uncommonly born with teeth known as 'natal teeth' or 'neonatal teeth'. When teething begins for others who don't have teeth at birth can vary greatly between babies. Most commonly, teething will occur for the first time around 6 months. Some bubs can experience teething as early as 3-4 months, while others won't get signs of their first tooth until later on in the first year of life [the exact timing of the later date is varied between sources]. Teething may continue until all of bub's baby teeth have erupted through the gums, which occurs by around 27 months [just after 2].
more about 'natal' teeth?
Natal teeth aren't the same as the teeth that come through around 4-6 months. They're uncommon to see and are often small, loose and brown/yellow compared to normal teeth. They're usually not fully developed and have weak roots, but they can impact breastfeeding. The cause of natal teeth is unknown, but they're said to be more common in little ones who also have conditions that affect their growth, such as Sotos syndrome, and can be genetic. If your Doctor or Midwife spots them in bubs mouth at birth, they may be sent for X-rays to see how developed the root is and referred to a Paediatrician and Paediatric dentist for management and treatment. The treatment depends on their severity and their impacts on feeding. Treatment ranges from no treatment to having the edges smoothed or even having them removed if it's impacting feeding, including damaging your nipples, damaging bubs tongue, or there are concerns they will become loose and pose a choking risk.
How many teeth will my bub grow?
There are 20 teeth in a full set of baby teeth, known as primary teeth. Most little ones will have all 20 by their 3rd birthday. In general, they'll get the bottom middle 2 first, followed by the top middle 2. Then the top outer middle 2, followed by the bottom outer middle 2. The age and order of these teeth and the remaining 12 will come through as baby teeth vary.
Symptoms of teething
Symptoms of teething may vary in intensity over time and the symptoms that occur. Symptoms may flare-up in the few days prior to the tooth erupting, so you might notice bub:
- Red or swollen gums
- Is dribbling more than usual
- Is chewing on things, like their fists and toys
- Is biting Is irritable
- Has a blue-grey bubble on the gym [called an eruption cyst]
- Pulling the ear on the same side as their incoming tooth
When little ones are teething, it's so common for them to put things in their mouth more frequently, which puts them at greater risk of catching a sickness. Often what occurs is bub catches an illness while teething, but teething gets the blame for the symptoms of the illness. Some symptoms that aren't caused by teething but may be caused by catching a virus/illness while also teething include:
- Fever
- Runny nose
- Diarrhoea
- Rash
- Changes in sleep or eating patterns
If you're not sure, it's best to take bub to your GP for advice.
Remedies for teething
While teething, bub may be uncomfortable, but there are some things you can try:
- Rub bub's gums. Just like when we've got a sore spot, the natural habit is to 'rub it better'. Wash your hands and use a clean finger or some wet gauze.
- Cool relief. Bubs can find a lot of comfort from a cold spoon or a chilled teething ring. Another idea is to freeze a clean cloth wash dipped in your milk or formula, and bub will love the comfort this brings as it slowly melts while they chew.
- Bub will likely want extra comfort at this time, so soak up those extra cuddles and don't be afraid to feed more often.
- If bub doesn't settle, paracetamol or ibuprofen can really help ease the pain.
- I've heard of mamas freezing breastmilk in ice cube trays, defrosting them a bit to soften and then putting it in a mesh feeder bag for bub to suck on.
- Keep bub's skin, chin and chest dry by wiping the dribble away, wearing bibs and frequently changing wet clothes to avoid skin irritation.
Teething gels + Amber necklaces
Two recommended remedies we often hear are teething gels and amber necklaces.
Amber teething necklaces are made from fossilised tree resin and range in colour from yellow to white and beige to brown. Suppliers claim that when worn close to the skin, succinic acid will be released by the amber beads to relieve the symptoms of teething. Some suppliers also make claims for other conditions, including eczema and asthma. While this all sounds great, there is a risk of strangulation from the necklace. It also poses a choking risk if bubs removes the necklace/bracelet and pops it in their mouth or if it breaks into small parts. The FDA has received reports of deaths and serious injuries to infants and children, including strangulation and choking caused by necklaces like these that are marketed for relieving teething pain. If you still choose to use a teething necklace, follow these guidelines from the ACCC:
- Always supervise bub when wearing the necklace or bracelet
- Remove the necklace or bracelet if your little one is unattended, even if only for a short period of time
- Remove the necklace or bracelet while bub sleeps; day or night
- Don't allow bub to chew on the necklace or bracelet
- Consider using alternate forms of pain relief
Teething gels are designed to be rubbed on bubs gums to ease teething discomfort. Lignocaine, which is commonly referred to as 'Lidocaine', is a local anaesthetic commonly used in teething gels. Recently SA Health announced they were pulling their lidocaine product from shelves. Why?
Lidocaine is no longer recommended for infant teething pain. This is because there is limited evidence to prove it is effective, and it might be harmful if too much is swallowed. If you choose to use it anyway, make sure to discuss it with your GP and pharmacist first and follow instructions as directed on the label. If you choose to consider other options, check out the options listed above.
How to look after baby teeth
If baby teeth decay, it can be painful for little ones, so it's important to care for them properly from the start. You can begin wiping down bub's gums using a clean, damp cloth early on before teeth pop up to get them used to the sensations.
Once a tooth pops up, brush their tooth/ teeth twice a day using a small, soft toothbrush. There is specific toothpaste on the shelves for kids, rather than giving them adult toothpaste. Kids toothpaste isn't recommended until bub is at least 18mo. For little ones under 18m, RCH advises just using water.
Other tips for brushing little teeth:
- Brush for 2 minutes.
- Play a song/ using a tooth brushing app to distract little ones for this long.
- Let them have a turn, then you have a turn to make sure the teeth are properly cleaned.
- Brush in a gentle, circular motion.
- Don't forget to brush inside, outside and along the top of the teeth.
- Brush along the gum line to clean gums too.
- Spit, but don't rinse with water after brushing to avoid washing off the fluoride in the toothpaste, which is protective for teeth.
- Make tooth brushing time exciting.
- Talk to them about why we clean our teeth; they're smarter than we give them credit for.
Royal Children's Hospital recommends that little ones see the dentist for the first time by the age of 1, more so to create a positive experience and to minimise fear if they ever do need a dentist trip. You could even bring them along with you when you go, and get them to sit in the chair, wear the glasses etc. It's also recommended all kids visit the dentist once every 6-12 months to prevent problems, such as tooth decay, from going undetected and becoming severe.
does teething impact breastfeeding?
If bub is teething and has sore gums, they might attempt to bite the breast while feeding. Instead of biting, other bubs may just rest their teeth on the breast, which can leave little marks. The ABA also says that some parents feel that their nipples can become more irritated while bub is teething due to changes in bub's saliva.
These scenarios can cause pain, discomfort and a reluctance to breastfeed. To try and prevent this from occurring, try:
- Giving bub something to chew on before feeding
- Rubbing bub's gums before a feed
- Taking bub off the breast as soon as they bite
- Try and avoid giving a big reaction
- Give bub a toy to play with while feeding as a distraction
- Make sure bub is properly attached for the whole feed; if bub is attached properly and sucking, they're unable to bite because the tongue covers their bottom teeth and gums
- Be aware before and after a feed as this is the most common time babies will bite the breast
- Treating any bites the same as you would a cracked nipple
- Chat to a lactation consultant for further advice
What if a baby tooth is knocked out by accident?
I speak from experience with this one.
When my daughter was 4, she was playing hide and seek with her dad and brothers one afternoon. She was hiding under the blankets in her bed when my husband went to find her. He pulled on the blankets quickly with a big "FOUND YOU!" only to discover that she had been biting on the blanket while hiding under it. Her front, bottom tooth came flying out with the blanket, and she started bleeding from the area.
We rang our local dentist, who told us to put pressure on the area, rinse the tooth under milk quickly, put the tooth in a zip lock bag and bring her in straight away. By the time we got there, the bleeding had settled, and I was crying more than she was. The dentist was very relaxed and even told my daughter that if she had to lose a tooth, it was lucky that it was her baby tooth and that it came out so cleanly. Meanwhile, I was concerned there would be damage to her adult tooth because the baby tooth looked so long.
Following an x-ray, he said that there would be no damage to her adult tooth, and when damage does occur to adult teeth, it's usually caused by a well-meaning parent trying to reinsert a baby tooth that has been knocked out.
Two years on, I'm so happy to say her perfect adult tooth has come through, and we never hide under blankets during hide-and-seek anymore. If your little one has an accident and their baby tooth is knocked out, whatever you do, don't try to put it back in where it was. You can actually do more damage and cause intense pain to your bub.
Instead, control any bleeding with direct pressure to the site [only as firm as needed] and contact your dentist for advice on what to do next. Offer paracetamol for pain relief and give your little one lots and lots of cuddles!
When will baby teeth become loose and fall out for the adult teeth to come through?
Usually, somewhere around the age of six, most little ones will get a loose tooth as the adult tooth grows through to replace it. If it becomes loose and is wobbly, it's not recommended to pull it out. Instead, the advice is to leave it alone until it falls out on its own. If the adult tooth comes through, but the baby tooth doesn't fall out, and is still present after 3 months, chat to your dentist for advice on what to do.
I hope this blog has helped you feel prepared to tackle parenting. Good luck! And if you've got any hacks for helping your little one through the teething process, I'd love to read about them in the comments section on the original post. 🦷
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