Few milestones in a baby's first year generate as much discussion—and sometimes distress—as teething. Those tiny teeth pushing through tender gums can transform a usually content baby into a fussy, drooling, cheek-chewing bundle of frustration. For Australian parents, understanding what's normal during teething and what actually helps can make this developmental phase more manageable for everyone.
When Does Teething Begin?
Most babies begin teething somewhere between four and seven months of age, though there's considerable variation. Some babies are born with a tooth already visible (natal teeth), while others don't see their first tooth until after their first birthday. Both extremes are perfectly normal and don't indicate any developmental concerns.
The timing of teething is largely genetic. If you or your partner teethed early or late, your baby may follow a similar pattern.
The typical order of tooth eruption starts with the two bottom front teeth (lower central incisors), followed by the four upper front teeth. However, teeth can appear in almost any order, and this variation is completely normal. By age three, most children have all twenty primary teeth.
Recognising Genuine Teething Symptoms
One of the biggest challenges for parents is distinguishing between teething symptoms and illness. Research has shown that many symptoms traditionally blamed on teething may actually be coincidental infections or normal developmental behaviours. Understanding what teething actually causes can help you respond appropriately.
Likely Teething Symptoms
- Increased drooling: Saliva production ramps up during teething, though drooling also increases around three to four months regardless of teething
- Gum rubbing or biting: Babies instinctively apply counter-pressure to sore gums by chewing on objects, fingers, or their fists
- Mild fussiness: Some irritability is common, particularly in the day or two before a tooth breaks through
- Slightly raised temperature: Research suggests teething may cause a mild temperature increase, but not a true fever above 38°C
- Gum swelling or tenderness: You may notice redness or slight swelling where a tooth is emerging
- Changes to eating or sleeping: Sucking can increase gum discomfort, temporarily affecting feeding
High fever, diarrhoea, vomiting, and rashes are NOT caused by teething. These symptoms indicate illness and should be assessed by a healthcare professional. Don't dismiss concerning symptoms as "just teething."
Safe and Effective Teething Relief
When your baby is clearly uncomfortable from teething, you naturally want to help. Fortunately, several safe methods can provide genuine relief. The key is choosing evidence-based approaches while avoiding products that could cause harm.
Recommended Relief Methods
Chilled teething rings: Solid teething rings cooled in the refrigerator (not freezer) provide soothing counter-pressure. Avoid liquid-filled rings that could leak and never freeze teething rings as extreme cold can damage gum tissue. Look for rings without BPA, PVC, or phthalates.
Cold washcloth: Wet a clean washcloth, wring it out, and chill it in the refrigerator. The texture and coolness provide comfort, and it's a simple, cost-free solution.
Gum massage: Using a clean finger, gently massage your baby's gums. The pressure can provide temporary relief, and the skin-to-skin contact is calming.
Age-appropriate pain relief: If your baby seems particularly uncomfortable, infant paracetamol (for babies over one month) can help. Always follow dosage instructions carefully and consult your pharmacist or doctor if unsure. Note that ibuprofen isn't recommended for babies under three months.
Keep a few washcloths in the fridge door during peak teething periods so you always have a cold one ready. Rotate them so there's always one chilled and available.
Products to Avoid
Teething gels with benzocaine or lidocaine: The Therapeutic Goods Administration (TGA) and health authorities worldwide warn against numbing gels. They can cause rare but serious side effects and wash away quickly, providing minimal relief.
Amber teething necklaces: Despite persistent marketing claims, there's no scientific evidence that amber releases pain-relieving compounds through the skin. More concerning, these necklaces pose strangulation and choking hazards. Red Nose Australia and other child safety organisations strongly advise against them.
Homeopathic teething tablets: Some of these products have been recalled due to inconsistent and potentially harmful belladonna levels. Their claimed benefits have no scientific basis.
Caring for Those New Teeth
Good dental habits should begin as soon as the first tooth appears. The Australian Dental Association recommends wiping new teeth with a clean, damp cloth after feeds. Once multiple teeth have emerged, transition to a soft infant toothbrush with a rice-grain sized smear of low-fluoride toothpaste designed for children under six.
- Begin cleaning teeth as soon as they appear
- Use low-fluoride toothpaste for children under six
- Schedule a first dental visit by age one or within six months of the first tooth
- Avoid putting baby to bed with bottles of milk or juice
- Limit sugary foods and drinks
Baby bottle tooth decay is a significant concern, particularly when babies are put to bed with bottles of milk or formula. The sugars pool around the teeth during sleep, promoting decay. If your baby needs a bottle for comfort at night, consider transitioning to water.
When to Consult a Healthcare Professional
While teething is a normal process, certain situations warrant professional advice. Contact your GP, maternal child health nurse, or call Health Direct (1800 022 222) if you notice:
- Fever above 38°C, which indicates illness rather than teething
- Persistent diarrhoea or vomiting
- A rash that doesn't disappear when pressed
- Refusal to feed for extended periods
- Signs of infection around emerging teeth (pus, excessive swelling)
- No teeth by 18 months of age
- Teeth appearing discoloured or malformed
The Emotional Side of Teething
Sleep disruptions during teething can leave parents exhausted and frustrated. It's important to recognise that this phase, while challenging, is temporary. Most babies experience the most discomfort in the one to two days before and after a tooth breaks through, not throughout the entire teething period.
If you're struggling with a particularly unsettled teether, remember that it's okay to ask for help. Share night duties with a partner if possible, accept offers of help from family members, and don't hesitate to speak with your child health nurse if you're finding it difficult to cope.
A Note on Teething Timelines
While most children have their full set of twenty baby teeth by age three, the teething process varies significantly. Some babies seem barely bothered by teething, while others find it genuinely distressing. Neither response indicates anything about the child's pain tolerance or future dental health.
If your baby's teeth seem delayed, don't panic. Some perfectly healthy children don't get their first tooth until after their first birthday. However, if no teeth have appeared by eighteen months, it's worth mentioning to your GP or dentist just to rule out any underlying issues.
Teething is one of many developmental milestones you'll navigate together. With understanding, appropriate relief methods, and the knowledge of when to seek help, you can help your baby through this phase while protecting those precious new teeth for years to come.
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