Teething Relief: A Pediatric Dental Care Plan During Tooth Eruption

Posted on March 25th, 2020 at 10:43 AM
Teething Relief: A Pediatric Dental Care Plan During Tooth Eruption

As we (and the Tooth Fairy) all know, the teeth you have now are not the teeth you were born with. Twenty primary teeth (aka deciduous, milk, or “baby” teeth) lie hidden in the jawbone at birth; throughout early childhood they erupt through the gums in various stages. Teething is a baby’s attempt to find relief from the pain and discomfort of primary teeth eruption — hands in mouth, excessive drooling, and all-around crankiness and restlessness are common indicators. 

Be prepared, parents — teething occurs in five stages over the average span of two years, although some tend to be worse than others. But by incorporating a regular pediatric dental care plan at an early age, you’ll set your child up for better outcomes later on. 

The five stages of teething (and their associated primary teeth)

Although genetics have some role in the timing of tooth eruption, on average the first primary tooth emerges around 6 months. Soon after that happens, you should be looking to schedule your child’s first dental visit. Here is generally what you can expect during the teething phase.

Stage 1 (birth to 6 months)

At birth (except in rare cases), none of a baby’s primary teeth will have erupted. However, around the half-year mark, the first tooth will start to push against the gums.
Tooth count: 0

Stage 2: (6 to 8 months)

As soon as that first tooth erupts, the baby has entered the second teething stage. Generally speaking, this stage tends to be less painful than those to follow. That’s because the erupting teeth — the central (and lateral) incisors, used for shearing food — have a sharper edge and thus an easier time cutting through the gums. Tooth count: 8

Stage 3 (10 to 14 months)

Sometime around a child’s first birthday, his or her first molars will erupt. Given the larger size and flatter chewing surface of these teeth, their eruption may cause considerable discomfort, leading to a loss of appetite and/or sleep (for everyone).
Tooth count: 12

Stage 4 (16 to 22 months)

During this stage, the canines will erupt. Because of their pointier shape (used for tearing), penetrating the gums is not as labored as it can be with molars. Nonetheless, be on the lookout for signs of teething anyway.
Tooth count: 16

Stage 5 (25 to 33 months)

Between ages 2 and 3, the second set of molars will erupt — and perhaps cause the greatest level of pain of all, as they are the largest teeth in the mouth. Parents are advised to be patient and resourceful during the final stage of teething.
Tooth count: 20

Teething relief methods

When it comes to relieving your child’s teething woes, safety should be your first consideration. Start with simpler methods and only use approved medication as a last resort. 

Here is a basic order of operations you might follow to soothe a teething child. 

  1. Gentle pressure with a clean finger
  2. A clean washcloth or piece of gauze
  3. A frozen washcloth or chilled spoon
  4. A teething ring made from solid rubber (be hypervigilant of materials and construction — avoid liquid-filled models as they may be toxic if punctured)
  5. Teething toasts/crackers (monitor child closely as small shards or fragments could break off and pose a choking hazard)
  6. NSAID (non-steroidal anti-inflammatory drugs): If the child is under 6 months old, you may administer liquid acetaminophen (Tylenol) only — use your child’s most recent weight for dosing. Babies older than six months may be given liquid ibuprofen (Advil). Use this chart for dosing.

Do NOT use:

  • Aspirin
  • Teething necklaces (choking hazard)
  • Topical medications such as benzocaine or belladonna
  • Medications not approved by the FDA

Scheduling baby’s first dental appointments 

Even though the 20 primary teeth are ultimately a stopgap solution for the 32 permanent (adult) teeth, some of them will be in service until a child hits his or her teens! And since deciduous teeth (deciduous meaning they’ll eventually fall out) have a thinner layer of enamel and are weaker than their adult counterparts, establishing a dental care regimen during a child’s early years is critical. 

  • Before 1st birthday: During a child’s first dental appointment, the pediatric dentist (pedodontist) will instruct parent(s) or caregiver(s) on oral care best practices going forward. Recommendations may include drinking a small amount of fluoridated water and brushing young primary teeth with a rice grain-sized amount of fluoride toothpaste.

  • Between age 1 and 2: The pediatric dentist will examine your child’s bite development, ask about pacifier use, and check for any other issues.

  • Between ages 2 and 3: When the child has developed enough, the pediatric dentist will discuss brushing teeth with a pea-sized amount of fluoride toothpaste and flossing technique.

As the child grows older and more teeth erupt, the dentist may apply fluoride varnishes to fortify the primary tooth enamel, especially the chewing surfaces of molars where food particles may get stuck.

Move forward with pedodontic care from Dr. Kevin Mahoney

Despite the current climate, your child’s oral health needs remain a certainty going forward. Dr. Kevin Mahoney’s office is eager to serve new clients after the COVID-19 threat has passed.