Teething: The Ultimate Guide + Everything You Need to Know!

By  Paula McLaren - Norland Nurse NNEB RSH | Updated - 30 January 2021

In this post, I'm going to share with you the Ultimate Guide to Teething!

Covering everything from the stages of teeth eruption, symptoms, remedies, teething foods, sleep regression and even baby tooth care, I will be giving you over 40 years of experience in one post!

I DREAMED of having a resource like this when I started my Norland Nanny training and that's why I'm so excited to share this post with you today! 

Want to learn more? Let's get right in!

Teething Remedies

What Is Teething?

Teething is an inevitable part of your baby’s growth and development. 

From the time your baby's first tooth appears to the final stages at around 3 years of age, the coming of baby teeth will affect your child’s life and yours too. 

Some children sail through with very little discomfort but most experience some typical symptoms at some point.

Knowing what to expect will help you be prepared for whatever teething situation may come your way, will definitely ease the pain for your little one and you!

When Do Babies Start Teething?

Having to help your little one through the discomfort of teething is inevitable and a right of passage for all parents and babies. 

Your baby's first tooth will usually appear in pairs at around 6 months old, starting with the bottom two incisors followed by the top two. 

This timing can vary with some babies getting their first tooth as early as 3 months and some as late as 14 months. 

By 3 years of age, all of the primary teeth should be present and correct with the permanent teeth starting to appear between the ages of 4-6 years.

In What Order Do Baby Teeth Appear?

  • 5-7 months: bottom incisors (front) 
  • 6-8 months: top incisors
  • 9-11 months: top lateral incisors (either side of front teeth)
  • 10-12 months: bottom lateral incisors
  • 12-16 months: first molars (back teeth)
  • 16-20 months: canines (toward the back of the mouth)
  • 20-30 months: second molars

While not all babies will stick to the guideline above most babies will get their first tooth during the first year of life. 

In very rare cases some babies are even born with a tooth! Which should be removed by a trained professional as soon as appropriate.

Baby Teeth Eruption

How long does teething last for?

Although it might feel like longer, on average your little one should only be out of sorts for about 8 days when teething. 

This is 4 days before the tooth breaks through, the day the tooth pops through and 3 days after. 

There is a lot you can do to help your baby over this period and there are many teething remedies both homemade and commercial that are on offer to help soothe their pain. 

Skip straight to my list of the top 15 teething remedies to get instant relief!

Is teething painful?

In a word ‘yes’ it can be.

However the amount of pain and discomfort that each child experiences will definitely vary. Cutting their bottom front teeth will often result in your baby’s gums swelling and becoming tender before their first tooth breaks through.

Providing suitable teething toys at this stage is usually enough to help with any discomfort but in some cases you may need to resort to mild pain relief at night.

When the molars come through between 12-14 months of age and again at around 2-21/2 years old your little one will very likely suffer some pain.

These larger teeth located towards the back of the mouth can cause significant discomfort in some children, even resulting in a slight fever and loss of appetite. 

The incisors that appear at around 18 months of age can also be the cause of pain due mainly to where they are situated, meaning that pain can be experienced shooting up the face and even to the ear.

Understandably, your little one will need your comfort and maybe some mild pain relief to get through this phase.

In all the above, depending on the severity of pain and level of discomfort, offering your little one something to chew on, lots of cuddles and comfort, will get you both through these usually short lived periods of disruption.

What are the first signs of teething?

There are a variety or signs and symptoms for teething.

Your baby may experience, all, some or none of the following, but knowing what to look out for will mean that you will know what is going on should your baby’s behaviour start to change. 

Teething Symptoms

The most common symptoms are as follows:

Teething Symptoms Infographic

Drooling & Teething Rash

The most obvious sign that your baby is starting to teeth is when you notice they are drooling excessively. 

You will be surprised by how much drool your baby can actually produce at this time! 

To prevent a rash developing on the chin or neck, you can put a thin layer of Vaseline on the chin and tie a bib or small cloth around the neck which can be changed regularly.

Red Cheek And Ear Pulling

A teething baby may also have a red or flushed cheek especially if they are rubbing at their face a great deal. 

Nerves in the ears and cheek share the same pathways as the gums therefore pain from teething can present itself in these areas, with your baby rubbing at their face and pulling their ears. 

An ear infection can also cause your baby to pull at their ears, so always check with your doctor to make sure there is nothing else amiss if they are pulling at their ears excessively.

Sleep Disturbance

Teething babies will often find it hard to settle and may wake more often at night

This is usually short-lived and they should settle back into their normal sleep pattern once the tooth has come through. 

However, to avoid sleep regression I would recommend not returning to night feeding more than usual in order to comfort your little one.

Excessive Chewing And Biting

Babies of teething age are always putting things in their mouth anyway, but you may notice them gnawing or biting on toys and their own fists and fingers more furiously when a tooth is about to put in an appearance.

Swollen Gums

Teething in babies will most definitely cause swollen gums and this is often the most definitive way to determine if your little one has a new tooth coming or not. 

By putting your finger in your baby's mouth and passing it over the gums you should also be able to feel the emergent teeth just below the surface.

Teething Tantrums: Irritability And Crying 

The discomfort experienced while teething will probably mean that your baby will be more irritable than usual and this can present itself in short bursts throughout the day, or for longer periods of time until the tooth appears. 

Excessive crying can also be rather hard to handle and again this can vary from baby to baby. 

The first teeth usually hurt the most as your little one will not have experienced this type of discomfort before. 

Chances are that future teeth will not cause such a big teething tantrum, with the exception of the molars and anyone who has experienced wisdom teeth coming through will understand why that is!

Change In Eating Habits

When a new tooth comes through, it can cause your little one to exhibit a change in eating habits.

Their tender gums may lead to them wanting to suck more on the bottle or breast due to a spoon being too uncomfortable. 

For others, it may appear that they are more hungry than usual as the pressure on their gums soothes the discomfort. 

Either way, you are likely to see a change but try to resist the urge to return to night feeding to ease your little one's discomfort.

Teething Fever?

The discussion of a slightly raised temperature in a teething baby is a controversial one. 

Babies who are teething are known to have a slightly raised temperature. However, this should not be above 38 C as this would indicate that there may be something more serious going on. 

When your baby is teething it is important not to assume their fever and symptoms are linked to the emergence of a new tooth. If you are concerned about your little one when teething, I'd recommend getting them checked by your doctor.

15 Best Teething Remedies 

Check Out Teething To Tantrums Youtube Channel here!

1. Cold

One of the best remedies, and a good way to help with teething, is to offer your baby something cold to chew on. 

A teether that has been chilled in the fridge for half an hour will definitely offer relief as will some cold water from a cup or bottle depending on their age. 

If your baby is on solid foods then chilled fruit purees and other cool foods will probably prove popular and slightly older children often enjoy sucking on chunks of a frozen banana or other fruits in a mesh feeder.

2. Warmth

Some babies will find a clean flannel soaked in warm water to suck on helps with baby teething pain. 

The warmth from the cloth can help soothe aching gums and help the offending tooth break through.

3. Teething Rings And Teething Toys

When it comes to teething products the most obvious remedy is a teething ring or toy which now come in so many forms and they can offer a lot of teething help. 

Check out my Parenting Toolbox for a list of my favourite natural teethers! 

For the front incisors, a more conventional teething ring is ideal for your baby to chew on, while a longer thinner design will work best for sore gums when molars start to come through later on. 

The best teething products provide pressure and texture on baby's gums which is very soothing so aim to buy one with a range of textures and that is easy for your baby to hold herself.

4. Massage Gums

Sometimes the best thing for teething relief is the simplest. Massaging your baby's gums with a clean finger can offer great comfort to sore gums.

5. A Warm Bath

A change of scenery will often take your little one's mind off the pain of teething and a nice warm bath often does the trick as it helps them relax.

6. Comfort And Cuddles

One of the best things for teething babies is a parent's comfort so offer lots of cuddles to reassure them that they are not in this alone.

7. Baby Safe Paracetamol and Ibuprofen

It is safe to give your baby over the counter baby safe paracetamol or ibuprofen from 3 months old. 

So if you think your baby is experiencing extreme pain and discomfort you can give them a sugar-free painkiller to help ease their discomfort. 

Always follow advice from your pediatrician and the medical instructions on the packaging.

8. Frozen Fruit Mesh Feeder

As I have already mentioned, when your baby has moved onto solid foods putting frozen fruit in a mesh feeder is a fantastic way to help cool their gums down and keep them happy with the taste of yummy fruits.

9. Organic Fruit Juice Popsicles

As well as mesh feeders, a great way to help an older teething baby in pain is to make your own popsicles for your little one to suck on. 

Made from organic fruit juice they can give some tasty cooling teething relief.

10. Wearable Teething Glove

'Baby Gumz' teething mitten is a new PBA free innovation that is great for babies who are too small to coordinate a teething ring.

11. Freeze A Bottle

Another great teething tip is to fill a bottle with water and freeze it upside down so that the water freezes in the teat which you can let your baby chew on.

12. Organic Teething Biscuits

These are a great option for babies over 6 months. There are a few ready-made options but why not make your own? 

Skip to my teething foods section here!

13. Chilled Spoon

One of the easiest and simplest teething remedies is to give your little one a metal teaspoon that has been chilled in the fridge (not freezer) to gnaw on. 

Again, this is only advisable for babies over 6 months old.

14. Homemade Baby Ice Cream

You can rustle up this tasty pain-relieving treat by mixing 1 can of organic pears, 6 scoops of baby formula and 1/2 cup of organic rice blended together and then freeze in an ice cube tray.

This will definitely give your teething baby relief and it tastes good too!

15. Facial Massage

Some, but not all, babies find comfort in having their faces massaged when they are experiencing teething pain. 

Try rubbing your baby's face and jaw in a circular motion to offer some relief.

What teething treatments to avoid

Teething Gels

The use of teething gel to ease teething problems is really not necessary and there is a proven element of risk in doing so. 

The amount of relief baby teething gel can give is so minimal that it really is not worth the risk and most medical professionals will advise finding safer alternatives to relieving your baby's teething pain.

Teething Necklaces

I would also steer clear of teething necklaces as they pose a serious choking hazard and again with so many other options available, they are an unnecessary risk.

What Food Can I Give My teething baby?

Teething and weaning often coincide so you may find that just when you were happily progressing with getting your little one onto solids, they start to reject certain foods or lose interest in food all together. 

When your baby is teething some babies will definitely prefer soft cool foods while others want hard foods to chew on. 

Some will even regress back to the comfort of sucking on a bottle.

So what are good teething foods for your baby?

Teething Foods

Soft Foods - Any food that your little one can eat easily off a spoon with little to no contact with tender gums may offer comfort. These include fruit and veg purees or soft pasta dishes.

Hard Foods - Some babies will want to bite down on something hare to relieve teething discomfort. 

This can provide a bit of challenge as you have to keep an eye out for choking especially for the younger baby who has just started teething. 

Older children can manage frozen veg sticks and fruit to ease discomfort.

Cool Foods - Quite understandably, cool foods as mentioned above, are ideal for relieving teething pain. 

Try yoghurt directly from the fridge or cold cucumber sticks, strawberries, mashed banana and mashed avocado. 

Another good option is veg or fruit mesh pouches that can be frozen which are ideal for the younger teething baby.

If your little one shows an inclination to want to suck more during teething, then I would suggest you just go with it. 

As soon as the tooth has appeared you will be able to get back on track with weaning. 

If your little one goes off drinking, then try some formula or breastmilk popsicles to ensure they are getting the milk they need while offering comfort at the same time.

Teething Rusks

Teething rusks are a popular solution to teething pain. 

My one word of caution would be that you make sure the rusk you are offering does not have a high sugar content. 

In addition, you should never leave your little one unattended with a rusk. 

Babies as young as 6 months can eat baby rusks but do need to be watched carefully.

If you have the time, I would suggest making your own baby rusks, then you will know exactly what you baby is eating. 

In general, teething biscuits and rusks can be a very effective and soothing remedy for teething pain. 

Here is a fantastic teething rusk recipe from Mas&Pas for Homemade Banana Teething Rusks!

Teething & Sleep Regression

Parents often ask 'do babies sleep more when teething'?

In some rare cases they do, but more often than not, teething and sleep regression will go hand in hand. 

Therefore, it is possible that your baby's bout of teething will trigger a dreaded sleep regression. 

So once the offending tooth has safely emerged and your baby is not easily settling back into their normal sleep routine you will need to implement the usual measures to deal with any other sleep regression such as:

  • Sticking to a strict nap and bedtime routine
  • Providing a healthy sleep environment i.e. darkened room, white noise machine, ideal temperature.
  • Making sure your baby has enough sleep during the day
  • Watching for sleep cues
  • Helping your baby to self settle
  • Keeping nighttime interactions low key
  • Avoiding overstimulation before sleep time

Does baby teething get worse at night?

Baby teething pain at night can be worse purely because your baby has fewer distractions than during the day. 

During the day, you can keep them occupied with playing, singing, going for a walk, massaging their gums and offering them chilled teething rings or other teething toys to ease their discomfort. 

However, babies are just like adults in that we are all more aware of pain at night time when we have less to take our mind off the discomfort it causes and we are tired.

How to soothe a teething baby at night

There is no easy way to answer how to soothe a teething baby at night. It really is a case of trying out different options. 

In order to help a teething baby sleep, you can give the prescribed dose of infant ibuprofen to help them sleep. 

A dummy may also prove to be comforting at night for a teething baby and certain dummies can be cooled in the fridge beforehand, so having one ready for night time is always useful. 

However, try not to fall back on increasing the night time feeding to ease your baby's discomfort and distress, but rather try comforting and patting to resettle your baby. 

You can also offer some cold water or massage your baby's gums. 

When dealing with teething and sleep do not be tempted to change your baby's sleep routine in any way either. 

Teething at night can be difficult to manage but it will help if you stick to your normal nap times and bedtime routine as your baby will recognise the familiar signals for sleep and settle more easily. 

The last thing they need right now is a change in routine!

While trying to solve the problem of teething and sleeping you may have to resort to offering more comfort when your baby wakes such as cuddling and rocking to re settle them, but try to put them back to bed before they are fully asleep. 

You don't want to spoil all your sleep training for a few nights of teething pain.

How to care for baby’s new teeth

Once your little one has a shiny new tooth you will need to introduce healthy dental habits and with all good habits it is never too soon to start.

You can also prepare your baby for teeth cleaning before the first tooth arrives by gently wiping your baby's gums with damp muslin washcloth.

Once they have a tooth use a small, soft infant toothbrush to clean your baby's teeth twice a day. (Only use a very small amount of infant toothpaste!) 

If your baby is not keen on a toothbrush then clean the tooth with a muslin cloth. 

There are some great toothbrush teething toys available to encourage your baby to get used to having a toothbrush in their mouth. 

Try making tooth brushing fun by singing a song, making it a game or brushing your own teeth at the same time. 

Build the brushing of teeth into the bedtime routine and you should be responsible for cleaning your children's teeth until they are about 6 or 7. 

Let them have a go but always make sure you ensure that their teeth are cleaned thoroughly.

When should I take my baby to the dentist?

It is advisable to take your baby to the dentist for the first time when they are around 12 months old. 

Taking them with you when you visit the dentist prior to this will show them that this is just a normal part of life and make them more prepared for when they go for a check up.

Teeth decay in young children is sadly a growing problem these days so it is very important that you encourage healthy dental and eating habits from early on. 

Babies only need breast milk, formula and then water. 

Avoid sugary drinks and never put your baby to bed with a bottle. 

Once they are eating solid food avoid giving your baby foods high in sugar. 

They will not miss what they have never had and sugar is highly addictive!

When to see a doctor about teething

Normally, you would not need to consult a doctor over teething but if your little one has any of the following symptoms while teething then you should get them checked out to rule out any other underlying condition.

  • Is VERY sleepy
  • Cannot be comforted
  • Has persistent, diarrhea and vomiting with fever
  • Has a rash with a fever
  • If under 3 months old, and has a temp over 38C
  • If over 3 months old, and has temp of over 39C
  • Has fever that lasts more than 24 hours

Frequently Asked Questions

Do pacifiers help with teething?

Pacifiers or dummy’s can definitely help with easing the pain from incoming front teeth. 

The desire to suck for comfort can be beneficial and if you put the pacifier in the fridge first that can often offer great relief. 

How can I make my teething baby happy?

Soothing a teething baby can be a tall order for any parent so don’t feel guilty that you can’t stop your baby feeling uncomfortable. 

Accept that your little one is in some degree of discomfort and offer them any of the solutions I have detailed in this article. 

The most important thing is that you offer them as much comfort as possible.

What are the best ways to soothe my baby’s painful gums?

There are many ways to soothe your baby’s gums from offering cool foods, appropriate teething toys or mild pain relief.  

You just need to find the right solution for your baby and I hope some of the many teething remedy suggestions I’ve recommended will work for you and your little one.

Is my baby teething at 3 months?

It is not impossible for your 3 month old to be teething as the time at which a baby starts to teeth iis variable. 

Even some newborns have been known to be born with teeth! 

The main clue is to look out for common teething symptoms to decide whether your little one is about to get a tooth. However, if you are at all concerned or your baby exhibits any of the signs mentioned that may need a doctors attention, then get them checked out.

So, now you know everything there is to know about teething!

What remedies will you be trying out next to help your little one? 

If you enjoyed this content and feel other parents would find it useful, be sure to share it around!

Teething to Tantrums Author

Paula Mclaren is the founder of Teething to Tantrums and has been in the childcare industry as a Norland Nanny since 1982. Since then, her mission has been to help parents become the best they can possibly be. And each year, she continues to help more families understand their child's development, the trials and joys of parenting and of course, how to care for their little ones.

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