Teething baby: signs, and what really helps

Some babies get their teeth with no trouble at all, and some have a few sore, unsettled days (NHS). This guide shows the usual signs, the things that help, and what is not teething and needs checking. UK, German and US advice differ on food to chew and on gels, so the table near the end shows all three.

Spot the signs

1. Expect the first teeth at around 6 months, usually at the bottom front.

   

   Most babies start teething at around 6 months, but some start before 4 months and some after 12 (NHS). The bottom front teeth usually come first, then the top front teeth (NHS, MedlinePlus, kindergesundheit-info.de). Most children have all 20 milk teeth by 2 to 3 years (NHS).

2. Look for dribbling, chewing, a red cheek and sore gums.

   

   Signs include a sore, red gum where the tooth is coming through, one flushed cheek, a rash on the face, rubbing an ear, more dribbling, chewing a lot, being more fretful and sleeping badly (NHS). Some teeth come through with no symptoms at all (NHS).

3. A high temperature or diarrhoea isn't teething: get advice.

   

   A teething baby's temperature may be slightly raised but stays under 38C, and there's no evidence teething causes diarrhoea (NHS). Teething doesn't cause fever or diarrhoea (MedlinePlus), and German advice is to have them checked by a children's doctor (kindergesundheit-info.de). It helps to keep a note of the temperature and when it started.

Soothe the gums

1. Chill a teething ring in the fridge. Never freeze it.

   

   A teething ring gives your baby something safe to chew, and chilling it in the fridge may soothe the gums. The instructions say how long to chill it. Never freeze it, as a frozen ring could damage the gums (NHS). German advice says cooled, not ice-cold (kindergesundheit-info.de). MedlinePlus says to avoid liquid-filled rings and plastic that might break.

2. Never tie a ring, or anything else, round your baby's neck.

   

   A ring tied round the neck may be a choking hazard (NHS, MedlinePlus). kindergesundheit-info.de also advises against amber necklaces because of the risk of choking and injury.

3. Wash your hands, then gently rub the gums with a clean finger.

   

   Gently rubbing the gums with a clean finger may help (NHS). Many babies like a gentle gum massage (kindergesundheit-info.de). MedlinePlus says a finger is fine until the tooth is right near the surface.

4. Let them chew a cool, wet washcloth.

   

   A wet washcloth to chew can help (kindergesundheit-info.de). MedlinePlus suggests rubbing the gums with a cool, wet washcloth, and washing it before using it again.

5. Food to chew? Check your country's advice, and always watch.

   

   The NHS says that from 6 months, if your baby is weaning, you can give healthy things to chew such as raw fruit and vegetables, and soft fruit like melon can soothe gums. Always watch in case they choke. German advice does not recommend cool food to chew, because of the choking risk (kindergesundheit-info.de). MedlinePlus suggests cool, soft foods such as applesauce or yoghurt. Avoid rusks and sugary foods, which can cause decay even with only a few teeth (NHS).

6. Wipe away dribble gently to stop a rash.

   

   Gently wiping your baby's face may help prevent a rash from the extra dribble (NHS, MedlinePlus).

7. Cuddle and play to take their mind off it.

   

   Comforting or playing with your baby can distract them from the pain (NHS). Make sure they drink plenty (kindergesundheit-info.de).

Medicines and gels

1. Still in pain? Ask a pharmacist about a sugar-free baby painkiller.

   

   The NHS says you may want to give a sugar-free painkilling medicine, from the age the medicine allows, and always follow its instructions. If you're not sure, ask a GP or pharmacist. Never give aspirin to children under 16 (NHS), and never put it on the gums (MedlinePlus).

2. Skip teething powders and homeopathic remedies.

   

   MedlinePlus says avoid teething powders and don't use homeopathic remedies. The NHS doesn't recommend homeopathic products, and says some unlicensed ones sold online have been linked to serious side effects. On gels, the NHS says there's a lack of evidence they work and to use only gels made for young children, from a pharmacy. MedlinePlus says no gels under age 2.

Look after the new teeth

1. Brush from the very first tooth.

   

   Clean the first milk teeth with a soft baby toothbrush and plain water. Our dental reviewer, Dr Aaiman Liaqat (BDS), advises no toothpaste for children under 3, or until they can spit it out, and never toothpaste for a 6-month-old baby: a toothbrush and water are enough. A child at high risk of tooth decay may need toothpaste, but only when a dentist advises it. See how to brush teeth properly for older children.

2. Register your baby with a dentist.

   

   In the UK, register your baby with a dentist when their teeth start coming through (NHS).

What each country says

If something isn't right