Teething is when teeth first come through a baby's gums. It can be a frustrating time for babies and their parents. Knowing what to expect during teething and how to make it a little less painful can help.
what is the first teeth babies get
The first teeth to appear usually are the two bottom front teeth, also known as the central incisors. They're usually followed 4 to 8 weeks later by the four front upper teeth (central and lateral incisors). About a month later, the lower lateral incisors (the two teeth flanking the bottom front teeth) will appear.
Next to break through are the first molars (the back teeth used for grinding food), then finally the eyeteeth (the pointy teeth in the upper jaw). Most kids have all 20 of their primary teeth by their third birthday. (If your child's teeth come in much slower than this, speak to your doctor.)
In some rare cases, kids are born with one or two teeth or have a tooth emerge within the first few weeks of life. Unless the teeth interfere with feeding or are loose enough to pose a choking risk, this is usually not a cause for concern.
As kids begin teething, they might drool more and want to chew on things. For some babies, teething is painless. Others may have brief periods of irritability, while some may seem cranky for weeks, with crying spells and disrupted sleeping and eating patterns. Teething can be uncomfortable, but if your baby seems very fussy, talk to your doctor.
Although tender and swollen gums could cause your baby's temperature to be a little higher than normal, teething doesn't usually cause high fever or diarrhea. If your baby does develop a fever during the teething phase, something else is probably causing the fever and you should contact your doctor.
The care and cleaning of your baby's teeth is important for long-term dental health. Even though the first set of teeth will fall out, tooth decay makes them fall out more quickly, leaving gaps before the permanent teeth are ready to come in. The remaining primary teeth may then crowd together to attempt to fill in the gaps, which may cause the permanent teeth to come in crooked and out of place.
Daily dental care should begin even before your baby's first tooth comes in. Wipe your baby's gums daily with a clean, damp washcloth or gauze, or brush them gently with a soft, infant-sized toothbrush and water (no toothpaste!).
By the time all your baby's teeth are in, try to brush them at least twice a day and especially after meals. It's also important to get kids used to flossing early on. A good time to start flossing is when two teeth start to touch. Talk to your dentist for advice on flossing those tiny teeth. You also can get toddlers interested in the routine by letting them watch and imitate you as you brush and floss.
The American Dental Association (ADA) recommends that kids see a dentist by age 1, or within 6 months after the first tooth appears, to spot any potential problems and advise parents about preventive care.
Fluoride is a mineral that helps prevent tooth decay by hardening the enamel of teeth. The good news is that fluoride is often added to tap water. Give your baby a few ounces of water in a sippy or straw cup when you begin them on solid foods (about 6 months of age). Speak with your pediatrician to see if your tap water contains fluoride or whether your child needs fluoride supplements. Fluoride is not typically found in most bottled water. See FAQ: Fluoride and Children for more information.
Usually teething doesn't cause children too much discomfort, however, many parents can tell when their baby is teething. Babies may show signs of discomfort in the area where the tooth is coming in, the gums around the tooth may be swollen and tender, and the baby may drool a lot more than usual.
Parents can help ease teething pain by massaging their baby's gums with clean fingers, offering solid, not liquid-filled, teething rings or a clean frozen or wet washcloth. If you offer a teething biscuit, make sure to watch your baby while they are eating it. Chunks can break off easily and can lead to choking. Also, these biscuits are not very nutritious and most contain sugar and salt.
A baby's body temperature may slightly rise when teething; however, according to a 2016 study in Pediatrics, a true fever (temperature over 100.4 degrees Fahrenheit or 38 degrees Celsius) is not associated with teething and is actually a sign of an illness or infection that may require treatment. If your baby is clearly uncomfortable, talk with your pediatrician about giving a weight-appropriate dose of acetaminophen (e.g., Tylenol) or if over 6 months, ibuprofen (e.g., Advil, Motrin). Make sure to ask your pediatrician for the right dose in milliliters (mL) based on your child's age and weight.
Stay away from teething tablets that contain the plant poison belladonna and gels with benzocaine. Belladonna and benzocaine are marketed to numb your child's pain, but the FDA has issued warnings against both due to potential side effects.
In addition, amber teething necklaces are not recommended. Necklaces placed around an infant's neck can pose a strangulation risk or be a potential choking hazard. There is also no research to support the necklace's effectiveness. See Teething Necklaces and Beads: A Caution for Parents for more information.
During regular well-child visits, your pediatrician will check your baby's teeth and gums to ensure they are healthy and talk to you about how to keep them that way. The AAP and the United States Preventive Services Task Force also recommend that children receive fluoride varnish once they have teeth.
If your child does not yet have a dentist, ask your pediatrician if they can apply fluoride varnish to your baby's teeth. Once your child has a dentist, the varnish can be applied in the dental office. The earlier your child receives fluoride varnish the better to help prevent tooth decay.
Both the AAP and the AAPD recommend that all children see a pediatric dentist and establish a "dental home" by age one. A pediatric dentist will make sure all teeth are developing normally and that there are no dental problems. They will also give you further advice on proper hygiene. If you don't have a pediatric dentist in your community, find a general dentist who is comfortable seeing young children.
To get even more specific, most infants begin teething at around 6 months old. Your little one will likely have a full set of their first teeth by age 3, and all the joys of the teeth-brushing routine will have been long established.
Next, their teeth may come in two at a time, one on each side of the mouth. But this pattern can vary, and many factors can influence the timeline (like if your baby was born early or at a low birth weight, for example).
Those sometimes distressing (but always perfectly usual) teething symptoms may come and go during this time period. Or they may be more consistent as your little one cuts new teeth or starts to feel the first symptoms of a tooth emerging.
Some babies also develop flushness around their cheeks or a rash. And if you breastfeed or chestfeed, teething might change the way your baby latches, or they might feed more often to soothe themselves.
Plus, tooth decay can start at a very young age. Children with tooth decay are more likely to have ear and sinus infections, and develop conditions like obesity, diabetes and heart disease. Healthy teeth help children speak quickly and clearly, too, which can give them more confidence as they grow up.
Ntani G, Day PF, Baird J, et al. Maternal and early life factors of tooth emergence patterns and number of teeth at 1 and 2 years of age. J Dev Orig Health Dis. 2015;6(4):299-307. doi:10.1017/S2040174415001130
Give babies only breastmilk or formula until you introduce solids at around 6 months. Breastfed and formula-fed babies older than 6 months can also have small amounts of water. Avoid giving your baby sugary drinks. Once you introduce solids, also avoid giving your baby foods high in sugar.
Dental Health Services Victoria (DHSV). (2010). Teeth: Oral health information for maternal and child health nurses. DHSV. Retrieved 20 June 2022 from __data/assets/pdf_file/0011/3989/teeth-oral-health-information-for-maternal-and-child-health-nurses-manual.pdf.
U.S. Food & Drug Administration (FDA). (2014). FDA drug safety communication: FDA recommends not using lidocaine to treat teething pain and requires new boxed warning. FDA. Retrieved 20 June 2022 from -safety-and-availability/fda-drug-safety-communication-fda-recommends-not-using-lidocaine-treat-teething-pain-and-requires.
Teething begins. Your baby's gums may be swollen and red where the teeth are coming through. The two middle teeth on the bottom (lower central incisors) are usually the first to erupt, often at about the same time.
The middle teeth are usually the first to go (at 6 to 7 years), followed by the ones on either side (at 7 to 8 years). The molars can be lost any time after that but will likely fall out between 9 and 12 years. The bottom canines will probably fall out between 9 and 12 years, and the top canines will come out between 10 and 12 years.
AAP. 2016. Baby's first tooth: 7 Facts parents should know. American Academy of Pediatrics. -stages/baby/teething-tooth-care/Pages/Babys-First-Tooth-Facts-Parents-Should-Know.aspx [Accessed March 2019]
The first baby teeth to fall out are typically the two bottom front teeth (lower central incisors) and the two top front teeth (upper central incisors), followed by the lateral incisors, first molars, canines and second molars.
Baby teeth usually stay in place until they are pushed out by permanent teeth. If a child loses a baby tooth early as a result of tooth decay or an accident, a permanent tooth might drift into the empty space. This can crowd permanent teeth and cause them to come in crooked.
It's important to start practicing good oral hygiene as soon as your child's first baby tooth erupts. As your child starts to lose his or her baby teeth, reinforce the importance of proper dental care. For example: 2ff7e9595c
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