When will my baby start teething?

Teething generally occurs for most babies between 6-10 months, although there is always the occasional exception to any rule (some babies are born with neonatal teeth, some babies don’t get teeth until 12-15 months, and are still normal). Many parents believe their child is teething around four months as:

1. There is a sleep regression which commonly occurs around 4 months (to do with developmental leaps and busy brains- usually nothing to do with teeth)
2. Babies start to go through what Sigmund Freud termed the “oral phase” of development- lots of sticking their fists in their mouths (often to the point of gagging!) and lots and lots of drool! This is where they explore their environment through their mouths: “what’s this? I dunno, I’ll stick it in my mouth to find out…”

I generally advise parents not to overthink their baby’s teething. The best thing that can happen to a parent is to wake up one morning and find their baby has suddenly popped out a tooth. However, I have met several parents who spent months analyzing every cry and sleepless night as a tooth on its way. 

What do I do if a tooth is genuinely coming, and my baby appears to be in pain?

1. Try not to medicate: paracetamol is for “last ditch, emergency, tried everything already and nothing is working” moments, not for everyday use. In excess, pararcetamol may damage the liver and kidneys. Some babies have been found to have damage even with normal range doses but given over a prolonged duration of time, such as several weeks. 
2. Teething gels and powders very often don’t work. Most are fairly harmless, but tend to be rapidly swallowed or diluted by the excess saliva so generally quite useless. 
3. Cooling gel toys are likely the best for providing relief: try placing them in the fridge (not the freezer as this will change the texture of the gel) and then allowing your baby to gnaw on the cool gel. 
   
4. Similarly, allowing your baby to chew on a damp facecloth that has been placed in the fridge in a ziploc bag will do the same trick. You can have a few in the fridge, and then swap them frequently as your baby needs. 
   

What if my baby’s teeth are crooked?

Often, a baby’s first teeth may come out not quite straight. This may improve as the other teeth erupt and they push each other into line. Even if the teeth remain crooked, your doctor or dentist will not advise any intervention for baby teeth. Just keep them clean. 

Do I need to consider anything else?

Yes! Once your baby has teeth, you have to start looking after them. This means:

1. Getting a baby toothbrush and some baby toothpaste and starting to clean the teeth every day
2. Try not to feed your baby too often overnight. Even breastmilk can result in dental caries if a baby night nurses excessively (which can occur more frequently in children who co-sleep).
3. Consider phasing out milk formula from 12 months onward. For the majority of babies, it is preferable to take full fat cow’s milk rather than formula milk after 12 months as formula has excessive calories and sugar which are not appropriate from 12 months onwards. 
4. Once you have removed formula milk from your baby’s diet, then start to wean your baby from bottles onto sippy or straw cups for their drinks as these are better for your child’s dentition. 
   
5. Try to avoid fruit juice. If you must give fruit juice, give it diluted, and only at mealtimes. Give plain water for hydration between meals.