Baby Talk: Your infant is teething. Here’s what you need to know to survive the pain

Teething, or the process of little spikes coming through your baby’s gums, is painful for the child and painful for the parents.

The pain, however, is different.

During the second trimester of pregnancy, tooth buds begin to form under the gums in a baby’s mouth. At around 4 months of age, roots start to grow under the buds. The root pushes the crown of the bud against the gum tissue.

The crown puts pressure on the gums, causing the gum tissue to thin out. As the gum tissue thins, the tooth pushes through and changes your baby’s smile forever.

The first teeth to appear are usually the two bottom front teeth, the central incisors. After they make their appearance, the four upper teeth, central and lateral incisors, typically break through the gum.

They are thinner teeth. They usually do not give the baby as much pain coming through. This process can happen over months.

For some lucky families, the process is easy and quiet, and you wake up one day to your baby showing you a smile with teeth.

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Katie Powers, R.N., is a board-certified lactation consultant and perinatal educator at Manatee Memorial Hospital’s Family BirthPlace.

For other families, it is a different story.

I have seen the comparison of having the first teeth coming through to the pain of childbirth. Except the baby cannot tell you about the pain or get an epidural to relieve the pain.

For many babies, months 4 to 6 are a time when their mouth aches, they cannot get comfortable since it is an unending pain, and they need constant consolation.

Chewing, biting and sucking can relieve some of the discomfort. Many babies put everything they can lay their hands on in their mouth.

Choking can be a real hazard. You cannot be too diligent in surveying the surroundings of your baby and what is within reach.

Other symptoms of teething are drooling, mouth rash, irritability, decreased appetite and a low-grade (less than 100.5) fever.

The drooling is believed to be caused by the increase of muscle movement in the mouth. When the muscles in the mouth are engaged, the salivary glands produce saliva.

The baby cannot swallow all the saliva being produced so it leaks out around the mouth. The drooling can then cause a rash around the baby’s mouth.

The irritability experience will be different from baby to baby. It depends on the temperament of the child and probably the thickness of the gums. It has to hurt having teeth burst through the gums. Excess saliva can cause a depressed appetite.

The low-grade fever may be because the gums are inflamed as the teeth break through. However, if your baby also has a runny nose, diarrhea or any other symptoms, you should call your pediatrician. Teething does not cause cold symptoms or diarrhea.

The molar teeth are big and fat. They are usually some of the last teeth to appear. For some babies, they are also the most painful to break through.

Sometime between the first and third year of life, all of your baby’s 20 teeth should be in place. The American Academy of Pediatric Dentistry and the American Academy of Pediatrics strongly recommend your baby have a dental exam.

Protecting the first teeth lays the foundation for healthy permanent teeth.

Katie Powers, R.N., is a board-certified lactation consultant and perinatal educator at Manatee Memorial Hospital’s Family BirthPlace. Her column appears every other week in Healthy Living in the Bradenton Herald. Contact her at

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