Everything you need to know
Oral health in a teething baby
It can seem an odd thing to talk about dentists when your baby doesn’t even have teeth yet, but good oral care starts right from the word go – bacteria in their mouth won’t wait until they’ve got a full set of baby teeth, and you can’t wait either.
So, in this article we’re going to introduce you to everything you need to know about how to look after your child’s mouth as their first baby teeth come through.
In this guide
Teething: What’s happening in your baby’s mouth?
Teething occurs around the time infants turn six months old. At this point, their first baby teeth are going to want to start poking through the gum, known as ‘rupturing’ – which is when you’ll first see them. In most babies, the first teeth to appear will be their front lower teeth.
After this point, their front upper teeth will start to rupture (at around eight months to a year old), and from here until they turn about three you’ll see various canines and molars come through.
Signs that teething is beginning
In most cases, the first signs that your baby is teething will be spotting their first incisors (that’s those front teeth) coming through the gum. For a lot of babies, this will be a relatively smooth process and they’ll pop up with no trouble at all.
That said, there are symptoms you can keep an eye on to tell if your baby is beginning to teeth, and some of these could be uncomfortable for the infant. They include:
Redness or swelling on their gums
Irritability, crying or seeming grumpy without obvious reason
Drooling more than normal
Coughing or gagging
Wanting to suck things or bite things
Not sleeping well
Not eating well
Rubbing their cheek or pulling the ear on the same side as the erupting tooth
Drooling rash appears on cheeks or chin
Slight fever
Red cheeks
Diarrhoea
Teething symptoms seem more severe: What should you do?
What we’ve listed above are the most commonly reported symptoms of teething. However, more severe symptoms can occur as an indirect result of the teething process. For example, your baby may put their hands in their mouth more regularly if they are uncomfortable, and if their hands are unclean, this could lead to an infection.
Those fever and diarrhoea symptoms are the ones to keep an eye on, as well as any redness in the gums.
Fever: A slight increase in temperature may not be anything to worry about, but if it starts to climb past that 37-38°C mark then you should consider seeing a paediatrician for guidance.
Diarrhoea: Likewise, with diarrhoea, this also may not be anything to worry about at first. It’s thought that because babies produce more saliva than normal when teething, it can cause their stool to become loose. This could lead to a degree of runnier stool than normal.
If it seems more severe (genuine diarrhoea, not just loose stool) or you’re worried at all, go to a professional for help.
Redness: A bit of redness is natural when teething. But if this redness turns into bleeding, swelling in the mouth or face, and/or pus on the gums, it’s time to see a doctor. Teething does not make babies sick, so any signs of an infection should be taken seriously.
Caring for a baby while teething
If your baby’s teeth are appearing, there’s probably going to be some tears. As we’ve discussed, for the most part this will be OK (at least from a health perspective). But we know you’re going to want to do whatever you can to help ease your baby’s discomfort - so what can you do?
Here are a few ideas:
Rub their gums with a clean finger.
Apply gentle pressure to their gum with a clean finger, like a light massage.
Offer them a clean hard-silicone chew toy, like a chew ring.
Consider teething biscuits or rusks, but only if they are sugar-free (sugar is very damaging to teeth).
Soothe the discomfort with something cold, such as a chilled toy, wet cloth that has been chilled, or apply a few ice cubes wrapped in muslin to the cheek (not the gum).
Avoid the use of teething necklaces, i.e. amber bead necklaces. There is currently very little scientific evidence to support amber’s role in soothing pain, and these necklaces pose a serious strangulation risk in infants.
Is there anything I can buy at the pharmacy to help?
There are such products as teething gels and paracetamol for children.
Teething gels advertise themselves as being able to soothe teething discomfort, although there is some debate over their effectiveness.
Painkillers for infants (paracetamol specifically) can also help with severe discomfort, especially if your child is also suffering a fever.
In either case, before purchasing and using any pharmaceutical medication for your infant you must make sure that you understand it. You can talk to your pharmacist or pediatrician for professional advice, and always follow the instructions before using a product – to ensure you apply the correct dose.
Learn more:
“My baby’s teeth are coming in crooked: What should I do?”
“5 quick tips to help soothe baby teething pain”
Teething while breastfeeding
Generally, it’s perfectly OK to keep breastfeeding while your baby teeths if that’s what you want to do for your child. There may be a risk of biting in some children, but this can be managed. When to wean should remain up to you, and the advice of any professional you’re talking to.
So will it hurt to breastfeed while my baby teeths?
Breastfeeding will not automatically start to hurt when your baby’s first teeth come through. This is because when a baby latches on to the nipple, their tongue is usually between your body and their new bottom teeth – preventing them from biting you.
That said, some babies may bite rather than latch. They’re moving into that stage of their lives, after all, where they start to chew everything. This can be painful, as their fresh baby teeth will likely be very sharp.
What to do to prevent or stop a baby biting
Preventing biting
Give your baby other things to chew between feeding sessions.
If they bite as soon as they latch, they may have wanted to chew instead of feed - in which case try offering something to chew instead.
If they bite at the end, it may be because they were getting restless or falling asleep. Try to learn the warning signs that they are about to bite and remove them before this happens.
Offer your baby a finger before the nipple to see if they’ll bite. This can be a good way to check what they want when you’re still learning their body language.
Reacting to biting
Try not to yell or exclaim in pain - this could alarm your baby, or even amuse them (making them want to do it more). Of course, we respect that this is easier said than done.
Remove your baby immediately if they bite - this is an important teaching moment (see below). Insert your finger into the corner of their mouth to break the suction.
Gently say “No biting” as you remove your infant.
Take a short break before trying again. Some experts even suggest placing the baby down during this break.
This act of removing your child when they bite, asking them not to bite, and taking a break, will quickly teach them that biting and feeding don’t mix. Babies are fast learners, and you’ll likely find they stop biting during feeding relatively quickly (within days).
If your baby ever takes a bottle to feed, you may notice they bite that too. You can use the same techniques of removal and taking a break to train them out of the habit here as well.
Oral hygiene tips for a newborn
Oral care starts even before a baby’s teeth erupt
That’s right – looking after your baby’s mouth and oral health must start even before they’ve got teeth to brush.
Bacteria will start to grow in your baby’s mouth right from the start, which means you’ll need to keep their gums clean to help prevent gum disease or, in future, tooth decay. As a bonus, cleaning their gums now will get them used to you handling their mouth, which can make brushing their teeth when they erupt easier.
How to clean a baby’s gums
Grab a clean cloth or piece of gauze.
Moisten it and wrap it around your finger.
Gently wipe your baby’s gums with this cloth. Don’t forget the backs as well as the fronts.
Try to get into the habit of doing this at least twice a day, particularly around feeding times and bedtime.
Read more: Gum disease
After those teeth erupt: Brush twice a day
Just like adults, babies need to have their teeth brushed at least twice a day to reduce the chances that they will develop gum disease.
Here’s some important advice to keep in mind:
Your baby’s toothbrush should have a small head and soft bristles.
Make sure to use regular-strength fluoride toothpaste, but only a very small amount (the size of a grain of rice) each time you brush. The fluoride part is important – while we know there’s some controversy and misinformation out there about it, fluoride can strengthen teeth and prevent decay.
If you’re worried the bristles are too hard, soak the toothbrush in warm water before use as it can help soften them.
One of the times you brush their teeth per day should be before bed, so their mouth isn’t sitting with bacteria in it overnight.
How to brush a baby’s teeth:
Place your baby in a place they are secure and stable, for example on your lap.
Hold their chin in your hands, with their head against your body.
Hold the brush at a 45° angle to the gumline.
Brush in gentle, circular motions.
Don’t forget the front and back of their teeth, as well as their gums and tongue.
If your baby isn’t comfortable having its tongue brushed, you can resort back to a damp cloth or piece of gauze and try again later.
If they have any baby teeth that are touching, consider flossing. It is not generally necessary to floss until two teeth are next to each other, very close together (baby teeth usually have a gap between them and their neighbour).
Rinse their toothbrush with water and store it upright to air dry.
Once a month: Inspect their mouth
You can help your dentist a whole lot and go far to preventing uncomfortable or painful tooth decay in your child’s mouth by inspecting it at least once a month.
All you need to do is lift their lip and inspect the teeth that have come through. You’re looking for any chalky white spots or lines near their gums – this is a sign of early decay. Brown marks and cavities are a greater sign that something is wrong and your baby needs to see a dentist.
Of course, if you’re ever worried or unsure, come in and see us at Kowhai and we’ll take a look as well.
Learn more: Lift the lip (NZ Dental Association)
Avoid putting your baby to bed with a bottle
As your infant gets older, you may believe it will help them feel comfortable overnight – and give them something to suck – if you put them to bed with a bottle.
The reason we have suggested cleaning their gums and teeth before sleep time is because it removes bacteria that could build up overnight, contributing to tooth decay. Putting your infant to bed with a bottle means they are going to bed with something that will feed that bacteria and help it grow.
Want to give your child something to suck on overnight? Consider a pacifier instead.
Learn more: “When to wean your child off dummies – for their oral health!”
Avoid sugar
There are a lot of child food and drink products out there. As you wean your baby off breastfeeding and move them to alternatives, you’ll be spoilt for choice.
The products to avoid are any that contain sugar – especially those that contain lots of sugar. These sweet foods and drinks are yet more contributing factors to tooth decay and are best avoided. Plus, they can give your baby a taste for sugary foods which will make it harder to wean them off sugar later on.
Young infants don’t need chocolate milk or juice – milk and water are all they need to drink. Have a look at food labels before you buy to check for sugar, and if you’re ever unsure you can talk to your dentist for their recommendations.
Brushing a baby’s teeth when they refuse
It’s all very well offering all of this oral health care advice, but sometimes a baby just doesn’t want to play along. So, how do you keep their mouth nice and healthy if they just don’t want that?
Make it fun
Making activities fun is a great way for kids to engage and learn – and also distract them if they are being grumpy.
To make brushing fun, you can bring in their favourite dolls or play music they enjoy to distract them while you brush. As your baby gets older you could also let them ‘brush’ their doll’s teeth so they feel included – this is also going to help instill healthy habits later on, and teach them about keeping up their oral health.
Silly stories and voices can also work well as a distraction. They will feel like they are playing, and all the while you’re gently cleaning their mouth.
Another alternative is to try different toothpastes. Kids toothpaste comes in all sorts of flavours, and it could be that your baby just doesn’t like the one you’ve got. Experiment with some others and see if they like them more!
Use teamwork
If you have someone to help you, you can work together as a duo to clean your baby’s teeth.
Sit so that both people are facing each other, knees touching. Rest the top half of your baby on one person’s lap, and the other half on the other person’s lap (of course, you’ll need to make sure the baby is stable and not at risk of falling between you both).
One person distracts your baby by being playful, distracting them, and holding their hands so they don’t get in the way.
The other person can gently lift your baby’s lips and brush.
When to take your baby to the dentist for the first time
The short answer? If your baby has a tooth – even just one – then it’s time they start going for regular dental check-ups.
Going to the dentist early in your baby’s life can set up healthy habits for the rest of their life. They will get used to the experience of being in the dentist’s chair, and having an unfamiliar person handling their mouth. This could go far to reducing any dental anxiety they may experience now or as they grow older.
This first trip doesn’t have to be a long one!
In fact, it’ll probably only be 30-45 minutes. It’s a bit of a meet and greet, and an opportunity for your dentist to examine your baby’s oral health for the first time, check for any issues, see how their development is getting on, and offer you any advice.
Learn more: “When to take your baby to the dentist for the first time”
Now to find a dentist near you
If at any point you don’t feel confident in your baby’s oral health, you need personalised advice, or it’s time for a check-up, bring your child to Kowhai Dental on Maunu Road here in Whangarei.
Our friendly experts will be able to walk you through every step of the process, from teething tips right all the way through their toddler, school and teen years and into adulthood.
Making an appointment is easy:
More children’s dental guides:
Oral health in a teething baby: Everything you need to know
What to do when your baby’s teeth start to fall out: A guide →