This article appears in Summer Healthy Living 2018.

Teething is uncomfortable for babies and frustrating for parents who want to soothe a fussy child.

Normal symptoms of teething include fussiness, trouble sleeping, irritability, loss of appetite, drooling more than usual, and gum swelling and tenderness, said Cheen Loo, chairwoman of pediatric dentistry at Tufts School of Dental Medicine.

Abnormal teething symptoms include fever, diarrhea and rash.

“If your baby has any of these symptoms while teething and continues to be cranky and uncomfortable, contact your pediatrician,” Loo said.

Your dentist is the best source of advice on what to do about teething, but here’s some easy-to-follow advice from Sean Boynes of the DentalQuest Institute, a non-profit organization that offers clinical care and practice management solutions for providers: “Wet and wring a clean washcloth, place it in the refrigerator or freezer to chill, then let your baby chew on it. You can also massage your baby’s gums and provide them with safe chewing toys.”

Soothing ideas

Teething typically begins between 6 and 8 months, although some children don’t get their first tooth until 12 to 14 months, Loo said.

Teething affects babies differently. Start with non-medicinal methods first, Loo said.

“Give your baby a firm teething ring to chew on. Avoid liquid-filled teething rings or any plastic objects that might break,” she said. “If plastics are a concern to parents, give the child a moist washcloth to chew. Also, be careful that the baby is chewing on age-appropriate items without small parts that could be choking hazards.”

Feeding a child cool, soft foods such as applesauce or yogurt can be soothing as long as baby is eating solid food, Loo said.

“Use a bottle, if it seems to help, but only fill it with water. Formula, milk or juice can all cause tooth decay,” Loo said.

Topical pain relievers and medications that are rubbed on the gums are not useful because they wash out of the baby’s mouth within minutes and can be harmful if overused or swallowed, Loo said.

“It is best to avoid over-the-counter pain medications with benzocaine — an ingredient in some of the options — in light of a recent FDA consumer update on its use for teething,” Boynes said. Benzocaine has been associated with methemoglobinemia, a rare but serious (and sometimes fatal) condition that reduces the amount of oxygen in the blood, Loo said.

“The FDA also urges parents not to use — and dispose of — homeopathic teething tablets after lab testing found ‘inconsistent amounts of belladonna, a toxic substance, in certain homeopathic teething tablets, sometimes far exceeding the amount claimed on the label,’” Loo said.

Why care for baby teeth

“There are many misconceptions about babies’ teeth, the most significant being that caring for baby teeth isn’t important — they fall out anyway,” Boynes said. “In fact, caring for baby teeth means caring for your child’s teeth until they are age 11 or 12, which would be a long time for anyone to live with health issues associated with tooth decay.”

“The American Academy of Pediatrics and the American Academy of Pediatric Dentistry now both recommend that a baby see a dentist after he gets his first tooth or by his first birthday. This instills the habit of frequent dentist visits at an early age and gives the dentist the opportunity to chat with parents about proper tooth care,” Loo said.