Teething Troubles

By April Toyer, DDS, FAAPD

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Teething Troubles

Signs, Timelines, and How to Help – Plus Navigating Loose Teeth & the Tooth Fairy

Teething is an important developmental milestone, but it can be a challenging time for both babies and parents. Understanding what’s normal, what to expect, and how to provide relief can make the process far less stressful.

Teething: When Does It Start?

Most babies begin teething between 4 and 7 months, although some start earlier or later. The two bottom front teeth (lower central incisors) are usually first, followed by the top front teeth. By age 3, most children have a full set of 20 primary (baby) teeth.

Common signs of teething include:

• Increased drooling
• Chewing on hands or objects
• Mild irritability
• Swollen or tender gums
• Disrupted sleep

Some babies may also have a slight rise in temperature, but high fever, diarrhea, or persistent symptoms are not typical of teething and should be evaluated by a healthcare provider.

How to Soothe Teething Discomfort

You can help relieve discomfort safely with:

• A clean, chilled (not frozen) teething ring
• Gently rubbing the gums with a clean finger
• A cool, damp washcloth for baby to chew on
• Infant acetaminophen or ibuprofen (if recommended by your doctor)
• Avoid teething necklaces and topical numbing gels containing benzocaine, which may pose safety risks.

Maintaining oral hygiene is essential—even before teeth erupt. Once teeth appear, brush twice daily with a soft baby toothbrush and a smear of fluoride toothpaste (about the size of a grain of rice).

The Next Stage: Loose Teeth

Around age 6, children begin losing baby teeth to make room for permanent teeth. This stage can last until about age 12. The lower front teeth are typically the first to go, followed by the upper front teeth.

If your child has a loose tooth:

• Encourage gentle wiggling with clean hands
• Avoid forcefully pulling it out
• Offer soft foods if the area is tender

A tooth that is barely attached and bothering your child may be gently removed, but if there is pain, swelling, or bleeding that doesn’t stop, contact your dentist.

Introducing the Tooth Fairy

The loss of a first tooth is a milestone worth celebrating. The Tooth Fairy tradition can transform a slightly anxious moment into an exciting one. Many families leave the tooth under a pillow in exchange for a small monetary gift or note of encouragement. The focus should be fun – not financial value.

Teething and tooth loss are normal parts of childhood. With patience, reassurance, and good oral hygiene, you can help your child move confidently through each stage – one smile at a time.