by Dr. Regina, pediatric dentist

Infants express themselves by crying and fussing, and as parents, our job is to decipher the cries and meet our baby's needs. However, what happens when we don't know the reason our babies are crying? Usually, at around the three-month mark, we start to attribute teething as the reason our babies become fussy. Yet, how do we tell if our little ones are crying from teething pain? When do baby teeth come in?

When do babies start teething?

Babies start forming their first set of teeth – "baby teeth"- when they are still in utero. In fact, when a baby is born, all the baby teeth are already formed and are patiently waiting in the gums to erupt within the little one's first three years of life. However, on rare occasions, some children are born with teeth. These are known as natal teeth. In these instances, the tooth is a baby tooth that happened to erupt much earlier than it should have. If this is the case with your child, please see a pediatric dentist because if the tooth is mobile, loose, or causing issues with eating, it may need to be closely monitored.

When do babies start teething?

On average, infants start teething between three and six months of age, and the first teeth erupt from 6-9 months of age. However, it is not unconventional for a child to begin showing tell-tale signs of teething, such as an increased interest in bringing the hands to the mouth around the three-month mark.

What are some signs of teething?

Signs of teething include:

• Drooling/ rashes around the mouth

Teething causes an increase in saliva production. This increased saliva may become pronounced as drool coming out of an infant's mouth or pool in the corners of the mouth and on the baby's chin, causing a rash. The best way to avoid a rash is to try and keep the area around the mouth as clean and dry as possible. Usually, this means stocking up on many bibs and frequently wiping around the baby's mouth to keep it clean and dry!

• Bringing things into the mouth to gnaw and chew on

As the teeth make their way into the mouth, the gums surrounding the teeth become inflamed and, at times, irritated. Your little one may find relief by gnawing on fingers and other objects because the rubbing sensation reduces pain.

• Swelling or inflammation of the gums

Swelling and inflammation of the gums result from the eruption of the tooth buds into the mouth. This is normal and can appear up to three months before the teeth finally erupt. Remember, teething is a marathon that lasts for the first three years of your little one's life; it's not a sprint!

• Cheek rubbing and ear pulling

Cheek rubbing is another way that the children attempt to push their cheek towards their gums and rub their gums. Additionally, the face and mouth nerves are all very close together and wrap around to the ears. Ear pulling may therefore be a way to alleviate the nerve pain the child is feeling.

• Irritability

Sensitive and inflamed gums lead to a fussy baby. In addition, babies may be irritable because they are dealing with a newfound and often uncomfortable sensation.

Does teething cause a fever?

Teething should NOT cause a high fever. However, teething does lower an infant's immune response and makes them more susceptible to getting sick. As a result, if your infant does spike a fever over 100.4F or has a low-grade fever associated with rash, sneezing, or vomiting, please contact your pediatrician because it is likely that your little one contracted a different illness due to the weakened immune response.

How can I alleviate and help my baby when they are teething?

With teething, the most important thing is keeping the baby comfortable. Often, babywearing may help because your little one is close to you. As a pediatric dentist, I highly recommend silicone or mesh feeders filling with anything frozen (whether a cube of frozen breast milk, formula, or pureed fruits or vegetables that the child has already been introduced to). Frozen feeders or frozen teethers are great because the cold temperature serves as a numbing agent to temporarily reduce the discomfort of swollen gums. Camilia drops is a homeopathic remedy frequently used that has shown great relief for teething; however, it is not certified by the American Food and Drug Association. Please ask your pediatrician before use.