As many parents know, babies aren't born with a mouthful of teeth. Twenty primary teeth lie hidden in the jawbone at birth and erupt throughout childhood. These teeth are also called baby teeth, milk teeth, and deciduous teeth. Babies may attempt to find relief from the pain and discomfort of teeth eruption by teething. Hands in mouth, excessive drooling, and general crankiness or restlessness are common indicators of teething. 

Be prepared, parents — teething occurs in five stages over an average span of two years, although some stages 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 a role to play in the timing of tooth eruption, on average the first primary tooth emerges at around 6 months. You should be looking to schedule your child’s first dental visit soon after that.

Here's 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 the following stages. That’s because the erupting teeth — the central and lateral incisors, used for shearing food — have a sharper edge and cut through the gums easier. Tooth count: 8

Stage 3 (10 to 14 months)

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

Stage 4 (16 to 22 months)

During the fourth stage, the canines will erupt. Because of their pointed shape (used for tearing), they can penetrate the gums more easily than the molars. Nonetheless, be on the lookout for signs of teething, as they can still cause discomfort.
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, as they are the largest teeth in the mouth. Parents are advised to be patient and resourceful during this final stage of teething.
Tooth count: 20

Best 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 can follow to soothe your teething child:

1. Gentle pressure with a clean finger
2. A clean washcloth or piece of gauze
3. A frozen washcloth or chilled fruit
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 the child closely as small 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 a child's 20 primary teeth are temporary until their 32 adult teeth come in, caring for them is still important and shouldn't be neglected. And because 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 parents or caregivers on the best oral care 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 ages 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 techniques.
  

As the child grows older and more teeth begin to 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.

Personable pedodontics care from Dr. Kevin Mahoney

Oral health and dental hygiene are crucial during your child's developmental stages. To stay up to date on dental milestones and best practices for your child's dental health, schedule an appointment with Dr. Kevin Mahoney today. Our office is eager to give your child a comfortable experience and help you better understand good dental health during childhood.

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