Teething Troubles

It seems like only yesterday that your baby finally got over her fussy-infant phase. Now she's cranky again, and her cheeks are red. Maybe she's sucking on her fingers, too, and drooling. Is she sick?

Actually, she might just be teething. While about half of all kids sail through without a hitch, the rest experience temporary but often distressing problems -- everything from minor mouth soreness to a low-grade fever, says Kevin J. Hale, D.D.S., a clinical adjunct professor of pediatric dentistry at the University of Michigan, in Ann Arbor. The good news: Here are some simple ways to make the experience easier all around.

Although you won't see your child's teeth until he's several months old, they've been developing since he was in the womb. Soft tooth buds, the precursors of baby teeth, appear as early as the eighth week of pregnancy and begin to harden during the fourth month in utero. His teeth will break through the gums around the time he's 6 months of age -- although occasionally they emerge as early as 4 months or as late as his first birthday.

Baby teeth often -- but not always -- come in the following order: the center bottom two, the center top two, the bottom lateral incisors (they're next to the center teeth), the top lateral incisors, the first molars, the top two eyeteeth (the ones next to the laterals), and then the bottom two eyeteeth. Second molars show up a little later, usually around age 2. In general, your child will cut four teeth for every six months of life, Dr. Hale says. By age 3, he'll probably have all 20 baby teeth.

Fortunately, most kids suffer only mild discomfort during teething. Because your child's gums are irritated, you might see her gnawing and sucking -- on toys and crib rails, even on her clothes and fists. And while most babies drool, you may notice a lot more of it right now. The continual wetness can cause your baby's lower cheeks and chin to redden. Not surprisingly, she may be cranky too. Some kids even lose their appetite for a while, Dr. Hale says.

Your child might also develop a low-grade fever (lower than 101°F), which may be caused by gum inflammation. If she has a runny nose or a bout of diarrhea, however, don't simply chalk it up to her teething; these symptoms are usually caused by a virus or a bacterial infection -- or, in the case of diarrhea, by a change in diet (teething babies are typically trying various solid foods for the first time).

If your child seems ill and you suspect she's teething, inspect her gums. If they're swollen and you can feel at least one tooth-size lump, teething's in progress. If her gums are red or blue (instead of pink) or bleeding, see a dentist, because these symptoms aren't normal, advises Mary J. Hayes, D.D.S., a pediatric dentist in Chicago and a spokesperson for the American Dental Association.

Once you're positive that your child's discomfort is due to his teething, what can you do to soothe him? For starters, look for teething rings and other specially designed chewing toys; gumming them can be extremely comforting. Often, these objects can also be chilled in the refrigerator, which is a bonus, because the coolness can help take the edge off the pain.

Occasionally, your baby may have trouble sleeping through the night because of teething discomfort. Disregard the old wives' tales about rubbing whisky or another alcoholic beverage on his gums to placate him -- it could be dangerous. Instead, ask your pediatrician or dentist whether you can give your child an appropriate dose of acetaminophen or ibuprofen.

By age 3, an astonishing 20 percent of children already have some tooth decay, so it pays to start cleaning your baby's mouth regularly, even before her first teeth appear. After every feeding, be sure to wipe her top and bottom gums with a wet washcloth or a piece of gauze, advises Amy DeYoung, D.D.S., a pediatric dentist in Grand Rapids, Michigan. Once a tooth appears, brush it twice daily -- ideally in the morning and evening -- using a soft toothbrush and water. Some experts recommend brushing your child's tongue as well (if she has a strong gag reflex, however, just stick to cleaning the tooth surfaces). After the evening brushing, don't let your baby go to bed with a bottle of milk or drink any beverage other than water. (If you're breastfeeding, take a moment to wipe off her gums and teeth before putting her down or returning her to her crib.)

In some cases, children can benefit from fluoride supplements. Ask your pediatrician and dentist about this option if you live in an area that does not fluoridate its water supply, if your child is exclusively breastfed, or if she drinks only bottled water that doesn't contain this crucial tooth-strengthening mineral.

After all of your child's baby teeth are in, she'll need to see the dentist twice a year. Before you know it, the Tooth Fairy will be visiting!