Baby Teeth and Teething: Answers to 20 Most Frequently Asked Questions

Whether you think your baby is teething, or you would like to know whether they are, or you just want to be prepared, here is a quick guide to the top things to know when your baby or child is teething. This will help to ensure you are equipped with the answers to the most common and important questions about teething to help you both get you through this stage.

1. When do babies start teething?

   According to the Australian Dental Association, it’s common for baby teeth to start appearing around 9 months old, however this can vary from 3 to 12 months. The ADA advises that if there are no teeth appearing by 12 months of age, to organise a check up with a dentist.

2. What are some symptoms of teething?

   Symptoms of teething can include the baby biting or mouthing objects, drooling, wanting to rub their gums and biting down. Some babies have slightly inflamed, red gums with an obvious lump when they’re teething. You may even be able to see a white tooth bud just under your baby’s gum margin.

   However, some babies don’t show any signs of teething and one day, a little tooth just appears in their mouth.

3. What order will the teeth arrive?

   The ADA explains that the teeth can arrive in any order, however, often the central bottom teeth arrive first, with teeth towards the back of the mouth to come through over the next 24-30 months. Although teething can happen at different ages, the order that teeth erupt tends to be the same for all babies.

4. How can I relieve my baby’s teething pain?

   Dr Teresa Li, a dentist at TL Dental says you can give Panadol under the advice of a paediatrician to help soothe pain and inflammation.

   She advises against amber necklaces. “There is questionable scientific evidence that they work, and they are strangulation and choking risk.”

   The ADA also suggest rubbing the back of a cold spoon over the gums or using a dummy.

   American Academy of Paediatrics (AAP) advises you can also massage baby's gums with clean fingers or a clean cold washcloth.

5. Should I use teething gel?

   Teething gels generally aren’t recommended because they don’t generally help to ease teething pain. They can also have harmful side effects.

   The ADA advises caution if using these. Over-the-counter teething gel can help, though it may not last long as the gel can be washed away by saliva. Also, babies can swallow the teething gel put on their gums. It is hard to know how much gel is swallowed. This can make the throat numb and be a choking hazard.

   Christidis says, “If swallowed, there is risk of poisoning from teething gel’s main ingredient salicylate. Therapeutic Goods Association have recommended to only use products that have 1.5% lignocaine or less in the gel for babies. Rubbing just a tiny amount on your finger rubbed on the area of inflamed gum can provide relief. Always follow instructions on the packet.”

6. What are symptoms unrelated to teething?

   Many parents report their child develops loose poos and a nappy rash, as well as irritability when they’re teething. However, there is no clear evidence that these symptoms are related to teeth erupting through the gums. A medical check is always needed when a child shows signs of being unwell.

   The ADA also advises that other symptoms may not be related to teething, such as difficulty in sleeping, a loss of appetite, coughing, rashes, diarrhoea, vomiting, seizures, and a very high fever. They advise it’s best to see the doctor if your child is experiencing any of these, to investigate whether it is an illness.

7. When should I start brushing my baby’s teeth?

   You should start brushing their gums even when your baby doesn’t have teeth yet, Dr Li says. “Use a clean washer and massage gums during teething to get baby used to it. When teeth come through, brush with a silicone finger brush and a tiny amount of age-appropriate toothpaste to keep clean.” Another option is to use a toothbrush with a small head and soft bristles.

   The Queensland Department of Health explains that it’s important to look after your baby’s teeth as soon as they start to appear, as baby teeth help maintain the space for permanent teeth. If a baby tooth is lost early, it can reduce the space for the permanent tooth, which can then cause crowded teeth.Remember, baby teeth are precious.

   It’s also useful to start flossing between teeth from around 2 years of age. Once your child has 2 teeth touching side by side, clean in-between them with dental floss.

8. How should I clean my baby’s teeth?

   Use a soft, small headed toothbrush to brush your baby’s teeth twice each day. Start using a small, pea sized amount of children’s fluoridated toothpaste from 18 months onwards. Let your child see you brushing your own teeth and caring for your oral hygiene. Role modelling is often useful.

9. When should my baby have their first visit to see the dentist?

   According to the Australian Dental Association, all children should have a dental check-up when their first tooth appears, or by their first birthday, whichever comes first. Regular dental checks, around every 6 months onwards are beneficial.

   The dentist can check that teeth are developing normally and there are no dental problems. They can also provide advice on proper hygiene and brushing techniques if you are having trouble brushing your child’s teeth. You could coincide this with your own dental check-up. This will help to normalise dental and oral care for your child. It will also help your child to learn that going to the dentist is an important part of their overall healthcare.

10. How long does the teething take?

    Babies are actually born with all 20 teeth. But it’s not until around 9 months of age that their teeth start erupting through their gums. All baby teeth are generally present by the third birthday.

11. What order do a child’s teeth come through?

    Your child’s teeth will usually, although not always, appear in this order:

    1. The lower incisors

    2. The upper incisors

    3. The upper side teeth

    4. The lower side teeth

    5. The first upper molars (back teeth)

    6. The first lower molars

    7. The upper canines

    8. The lower canines

    9. The lower second molars

    10. The upper second molars

    They will probably have all their first teeth, also known as baby teeth, milk teeth, deciduous teeth, or primary teeth by around 3 years of age.

     

12. How do I care for the teeth once erupted?

    Christidis advises, “Stop letting the baby fall asleep with a bottle of milk at night - the bacteria in the mouth breaks down the sugar in the milk causing acid to form, that can cause dental caries. Start with drinking water (to flush away food and milk) after each meal or bottle of milk. Let the baby chew and suck on a clean wet facecloth at bath time. Teeth brushing with water should commence the moment the first tooth has erupted, no matter the baby's age. Children’s toothpaste should only be used from 18 months old.”

13. What foods should I avoid offering to keep my child’s teeth healthy?

    Avoid offering your child any foods that are high in sugar, especially those that are held in the mouth for a long time. Examples of this are sweets and lollies, and also soft drinks and juices, especially when they’re coming from a bottle with a teat. Chewable Vitamin C tablets have also been identified as particularly bad for teeth. Some healthy foods such as dried fruit also contain high levels of sugar and children should be encouraged to rinse their mouths after eating these, and other sweet foods.

14. What are healthy foods for my child’s teeth?

    Savoury foods are generally a better option than those which are sweet, as long as they’re not too high in salt. Another good tip is to try to reduce the number and frequency of times you offer your child processed foods. Tooth friendly foods and snacks include cheese and unsweetened dairy foods, meat, dry crackers and plain rice cakes. Look for food and drink products that contain less than 15 grams of sugar per 100 grams. Be mindful that sugar can also be called glucose, sucrose, maltose and be contained in corn syrup.

15. Does thumb or finger sucking affect teething?

    It’s common for children to soothe themselves by sucking on their thumb or fingers. Generally, this is not a problem unless they’re still sucking when their permanent teeth erupt at around 6 years of age. Distraction, rewards, reminders and often, prompting from other children can help encourage thumb and finger sucking to stop. Speak with your child’s dentist about the way your child’s teeth are aligned and where they are positioned in their mouth.

16. Do I need to give my child fluoride supplements?

    Check with your local Council about whether your water supply is fluoridated. If it is, you don’t need to give your child any extra supplements. They will be getting enough fluoride from the water they drink plus what they are getting in their (children’s) toothpaste from 18 months of age onwards. Speak with your dentist about what’s right for your child.

17. When can my child start brushing their own teeth?

    There’s no harm in allowing your child to ‘practice’ brushing their own teeth as soon as they show interest. However, it’s not until around 8 years of age that children have the manual dexterity of being able to do a thorough tooth cleaning job on their own. Young children need an adult to brush their teeth so that every tooth surface can be reached and cleaned.

18. Is my child's dental care free?

    In New Zealand, basic dental services are free until you or your child turn the age of 18 years. Your local Te Whatu Ora health service pays for you or your child until then.

    Most children are automatically enrolled for dental services when they’re born.

    You will receive a letter or information pack about your child’s teeth by their first birthday. Then, you will need to enroll them by calling 0800 Talk Teeth (0800 825 583). You will be put through to the local service who looks after children’s dental health.

    Remember, your child’s first checkup should be before they turn 2 years of age.

    Your child will receive free care for:

    • regular checkups
    • cleaning
    • x-rays
    • fluoride treatments and fissure sealants
    • fillings and extractions.

    Find out more by checking Ministry of Health for dental care offered by dentists.

19. How long does it take for a tooth to break through gums?

    Baby teeth actually start forming in the gums from around 5 weeks’ gestation. Then, the first tiny tooth buds of the deciduous, or milk teeth, are starting to develop in the baby’s jaw. The process of eruption, or when teeth actually break through the gums is different for every child. This also depends on which tooth is erupting.

    There is no clear, evidence-based period of time it takes for baby teeth to emerge through the gums from the jaw. What’s important is to provide reassurance and comfort according to the individual baby’s teething symptoms.

20. Are teething toys or teething rusks suitable for baby?

    Soft, chewable teething toys are fine for teething babies. One of the more common signs of teething is for babies to want to bite down and chew, this is why soft toys are a popular option. Some teething toys are filled with sterile water and can be chilled in the fridge, which can help to relieve swollen, tender gums. When choosing teething toys for your baby, check they’re made from non-toxic materials, are BPA free and suitable for your baby’s age and stage of development.

    Teething rusks are also fine, as long as they don’t contain sugar and are a suitable consistency for chewing. Always supervise your baby when they have a teething rusk and make sure they’re sitting in an upright position.

    REFERENCES

    Dental care for baby teeth & gums | Raising Children Network

    Baby and toddler oral health - Australian Dental Association (teeth.org.au)

    Written by Tracey Cheung, April 2023. Tracey is a freelance writer who specialises in creating health and wellness content for the community, drawing on her experience as a mother.

    Reviewed and updated by Jane Barry,Midwife and Child Health Nurse, March 2024.