Teething

GENERAL INFORMATION:

What is it? Teething occurs when new teeth begin to come through your child's gums. A child's first tooth usually appears between four and eight months. The gums may be sore and tender for two or three days as the tooth pushes through. Your child should have 20 primary (baby) teeth by age three.

What are the signs and symptoms of teething?

• Your child may suck on his fingers, and bite on toys or other objects.
  
  
• Your child may be very fussy and may drool more than usual.
  
  
• Your child may have trouble sleeping and may not eat or drink as much usual.
  
  
• Your child may have a small cyst (blister) on his gum. As the tooth comes in, the cyst should break open.

How can I help my child feel better while he is teething?

• Gently rub the swollen gum with a clean finger, cool spoon, or wet gauze pad. Do this as often as you feel it is needed to soothe your child's gum.
  
  
• Your child may enjoy chewing on a clean washcloth. Wet the washcloth with cold water, and wring it out. Put it in the freezer for 30 minutes. Offer it to your child to chew on. Do not leave your child alone while he is chewing on the washcloth.
  
  
• Try giving your child a teething ring. Some children like a cold (but not frozen) teething ring. Do not tie the teething ring around your child's neck. It could catch on something and strangle your child.
  
  
• Give your child frozen juices, popsicles, or a frozen banana that has been cut into small pieces. He may also enjoy teething biscuits. Never give your child hard foods such as carrots to chew on. Do not leave these foods in a place where your child may reach them. A child may put the food in his mouth, and choke on it.
  
  
• Ask your child's caregiver if it is OK to use special teething gels or lotions. Read the label and learn how to use these products before using them on your child.
  
  
• Ask caregivers if you may give your child acetaminophen (a-seet-a-MIN-oh-fen) or ibuprofen (eye-bu-PROH-fen). These medicines may help decrease teething pain. Do not give aspirin to your child. Read the instructions on the box to give your child the correct amount of medicine. Call your child's caregiver if you have questions about how much medicine to give.

Do's and Do nots for tooth care: Once your child has one or more teeth, do the following:

• Do schedule your child's first dental appointment. This should occur between the time that your child's teeth begin to come in and before his first birthday.
  
  
• Do clean your child's teeth using a child-sized, soft bristle toothbrush and water. Begin adding a small amount of fluoride toothpaste to the toothbrush when your child is two years old. Help your child to brush correctly. Do not let your child chew on the toothbrush or eat the toothpaste. Ask your child's dentist or caregiver to show you the right way to brush your child's teeth.
  
  
• Do wean (gradually stop) your baby from a bottle when he is 12 to 24 months old.
  
  
• Do help your child begin to use a cup around age one. Use a spill proof top or straw to help prevent spilling.
  
  
• Do not let your child drink from a bottle while lying down or going to sleep. Having milk, formula, juice or sweet drinks on his teeth while he sleeps can lead to tooth decay (rot). It may also increase your child's risk of getting an ear infection.
  
  
• Do not let your child walk around with his bottle. Do not let him drink from the bottle or breast for times longer than a regular mealtime. This can also lead to tooth decay or a tooth injury if your child falls.
  
  
• Do not give your child fruit juice until he is six months or older. Give your child juice from a cup, not a bottle. Buy 100% fruit juice that is pasteurized. Too much juice can cause diarrhea (loose, runny bowel movements), upset stomach, and tooth decay. Children less than six years old may drink one-half to two-thirds of a cup of juice each day. Do not give your child more than this amount each day. Never give your child juice to drink right before bedtime.

Call your child's caregiver if:

• Fever, vomiting, a rash, or diarrhea (loose stools) are usually not caused by teething. Call your child's caregiver if your child has a temperature over ____, vomiting, or diarrhea while he is teething. Call if he continues to act very uncomfortable and fussy after his teeth have come in.
  
  
• Your child has signs of infection, like pus or very swollen, reddened gums in the area where the tooth is coming in.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

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