Teething Troubles? A Complete Guide to Helping Your Child Through This Milestone

Those first baby teeth pushing through tender gums mark an exciting developmental milestone—and one of the more challenging periods many Laredo parents face. Between the drool, the fussiness, the disrupted sleep, and the uncertainty about what's normal versus what requires professional attention, teething can test even the most patient caregivers.

Understanding what your toddler is experiencing and knowing how to provide effective, safe relief makes this phase easier for everyone in your household. While teething is a natural process every child goes through, you don't have to navigate it alone or without support.

Understanding the Teething Timeline

Most babies get their first tooth between six and twelve months of age, though some early bloomers sprout teeth as young as three months while others don't see that first pearly white until after their first birthday. Both scenarios fall within the normal range of development.

The process typically follows a predictable pattern, though individual variation is common. The lower central incisors—those two bottom front teeth—usually arrive first, followed by the upper central incisors. Next come the lateral incisors on both top and bottom, then the first molars, the canines, and finally the second molars.

By age three, most children have all twenty primary teeth. However, the timeline matters less than the overall progression. If your toddler seems significantly delayed compared to peers, mention it at your next dental appointment, but don't panic. Dr. Ayala and our team at Tots to Teens Pediatric Dentistry & Orthodontics can evaluate your child's development and provide guidance specific to their situation.

The discomfort associated with teething typically begins several days before the tooth actually breaks through the gum tissue. You might notice changes in your toddler's behavior or mood before you can see or feel any evidence of the tooth itself.

Molars often cause more discomfort than the smaller front teeth because of their larger size and broader surface area. Many parents report that their child's behavior worsens when those back teeth start coming in, usually between 13-19 months for the first molars and 25-33 months for the second molars.

Recognizing Teething Symptoms

Knowing what to expect helps you distinguish typical teething discomfort from symptoms that might indicate illness or other concerns.

Increased Drooling: One of the earliest and most obvious signs, excessive drooling often begins before you can see or feel the tooth. The drool can cause a rash around your child's mouth, chin, and neck. Gently wiping the area throughout the day and applying a thin layer of petroleum jelly before bed helps protect sensitive skin.

Gum Swelling and Sensitivity: The gums where teeth are emerging often appear red, swollen, and tender to touch. You might notice your toddler rubbing their gums or refusing foods that previously didn't cause problems. Running a clean finger gently along the gum line sometimes reveals a hard spot where the tooth is preparing to break through.

Irritability and Fussiness: Even the most easygoing toddler may become cranky during teething. The constant low-level discomfort affects mood and patience. Your usually cheerful child might seem more easily frustrated, cry more readily, or have trouble settling for activities they typically enjoy.

Disrupted Sleep Patterns: Teething pain doesn't take a break at night. Many toddlers who previously slept well start waking more frequently or have difficulty falling asleep when teeth are coming in. The discomfort that's manageable during the day's distractions becomes more noticeable when trying to rest.

Changes in Eating Habits: Some toddlers eat more during teething, finding that the pressure of chewing provides relief. Others eat less because the pressure on sore gums causes pain. Nursing toddlers might change their feeding patterns, either wanting to nurse more for comfort or nursing less if sucking increases discomfort.

Increased Chewing: Toddlers instinctively seek out things to chew on to relieve the pressure in their gums. You might notice your child gnawing on toys, furniture, their hands, or even inappropriate objects. This behavior is normal and helpful—within safe boundaries.

Ear Pulling or Cheek Rubbing: Pain from the gums can radiate to nearby areas, leading toddlers to pull at their ears or rub their cheeks. While ear infections can cause similar behavior, if your child shows other teething signs without fever or other illness symptoms, the discomfort likely stems from emerging teeth.

Low-Grade Temperature: Some children develop a slight temperature elevation—under 100.4°F—during teething. However, teething does not cause true fevers. If your child's temperature exceeds 100.4°F or if they seem genuinely ill, contact your pediatrician. The illness may be coincidental to teething rather than caused by it.

Our board-certified pediatric dentists emphasize the importance of distinguishing typical teething symptoms from signs of illness. While teething creates discomfort, it shouldn't make your child seriously ill.

What Teething Does NOT Cause

Several symptoms commonly attributed to teething are actually signs of other issues that happen to coincide with this developmental stage.

High Fever: True fever—temperature of 100.4°F or higher—indicates illness, not teething. While teething might cause a very slight temperature increase, significant fever suggests infection or another medical issue requiring pediatric evaluation.

Diarrhea: Although many parents report loose stools during teething, research hasn't established a direct connection. The increased drooling might lead to slightly looser stools if your child swallows significant amounts of saliva, but true diarrhea suggests a stomach bug or other illness.

Vomiting: Teething doesn't cause vomiting. If your toddler is throwing up, something else is responsible. Contact your pediatrician, especially if vomiting is accompanied by fever, lethargy, or other concerning symptoms.

Severe Cold Symptoms: While a slightly runny nose from excess saliva is possible, teething doesn't cause congestion, coughing, or other significant cold symptoms. These indicate respiratory illness that may require treatment.

Severe Diaper Rash: While some parents notice slightly more frequent stools during teething periods, severe diaper rash suggests dietary factors, infection, or other causes unrelated to emerging teeth.

The confusion arises partly because teething occurs during the same period when babies lose maternal antibodies and become more susceptible to common childhood illnesses. The timing coincides, leading many to assume causation when it's actually just correlation.

Safe and Effective Relief Strategies

You have numerous options for helping your toddler feel better during teething episodes. Not every strategy works for every child, so be prepared to try different approaches.

Cold Therapy: Cold temperatures naturally numb discomfort and reduce swelling. A clean, damp washcloth that's been chilled in the refrigerator provides wonderful relief—simply let your toddler chew on it. Refrigerated teething rings work similarly. Avoid freezing these items, as extreme cold can damage sensitive gum tissue.

Firm Pressure: Many toddlers find relief from counter-pressure on their gums. Clean teething toys with varied textures give them something appropriate to chew on. Massaging your child's gums with a clean finger also helps. Apply gentle but firm pressure in a circular motion along the gum line.

Cold Foods for Older Toddlers: If your child is eating solid foods, cold applesauce, refrigerated cucumber slices, or chilled fruit pieces can provide soothing relief. Mesh feeders allow younger toddlers to gnaw on frozen fruit safely without choking risk. Always supervise your child during eating.

Over-the-Counter Pain Relief: Infant acetaminophen or ibuprofen, given according to your pediatrician's weight-based dosing instructions, can reduce pain and inflammation. Our team recommends using these medications when teething discomfort significantly interferes with sleeping or eating, but they shouldn't become a daily routine. Consult your pediatrician about appropriate use.

Distraction: Sometimes the best medicine is simply taking your toddler's mind off the discomfort. Extra playtime, new toys, special attention, or a favorite video can help get through particularly difficult moments.

Comfort Items: Many toddlers want extra cuddles, nursing sessions, or quiet time with parents during teething episodes. While it's important to maintain routines when possible, some flexibility during these uncomfortable periods benefits everyone.

Teething Products to Avoid

Not every product marketed for teething is safe or effective. Some can actually harm your child.

Benzocaine Products: The FDA has warned against using benzocaine-containing products like Orajel in children under two years old. These topical anesthetics can cause a rare but serious condition called methemoglobinemia, which reduces the oxygen-carrying capacity of blood.

Lidocaine Products: Similar to benzocaine, viscous lidocaine poses risks for young children and should not be used for teething pain.

Teething Tablets: Many teething tablets contain ingredients that haven't been adequately tested for safety in children. Some products have been found to contain inconsistent amounts of active ingredients, making proper dosing impossible.

Amber Teething Necklaces: These popular items pose strangulation and choking hazards without providing any proven benefit. The theory behind them—that body heat releases pain-relieving substances from the amber—has no scientific support. The American Academy of Pediatrics advises against their use.

Teething Gels with Alcohol or Other Questionable Ingredients: Some products contain alcohol or herbal ingredients that haven't been proven safe or effective for infants. Stick with products specifically recommended by pediatric health professionals.

When in doubt about any teething product, ask our team before using it. We stay current on safety warnings and can recommend evidence-based options for your child.

When to Schedule Your Child's First Dental Visit

The American Academy of Pediatric Dentistry recommends that children have their first dental appointment by their first birthday or within six months of the first tooth erupting, whichever comes first.

This early visit serves multiple purposes beyond just checking those new teeth. We establish a dental home for your child, creating a relationship that supports their oral health throughout childhood. Early visits accustom toddlers to the dental office in a low-pressure setting, building positive associations that reduce anxiety during future appointments.

During the first visit, we examine your child's emerging teeth, assess their bite development, and look for any potential concerns. We also provide guidance on oral hygiene practices appropriate for your child's age, discuss proper nutrition for dental health, and address any questions you have about teething, pacifier use, bottle habits, or other common concerns.

Dr. Ayala, who is a Diplomate of the American Board of Pediatric Dentistry, emphasizes that early dental visits often prevent problems before they start. Catching issues in their earliest stages makes treatment easier, less expensive, and less stressful for both children and parents.

Many parents wait until their child has a problem before seeking dental care, but preventive visits help ensure problems never develop in the first place. Establishing good dental care habits from the beginning sets the foundation for a lifetime of healthy smiles.

Caring for Those New Teeth

As soon as that first tooth appears, it needs care. Many parents don't realize that baby teeth require attention from the moment they erupt.

Brushing: Use a small, soft-bristled toothbrush and a tiny smear of fluoride toothpaste—about the size of a grain of rice—to brush your child's teeth twice daily. Even one tooth needs brushing. Position yourself so you can see into your child's mouth easily, making thorough cleaning more manageable.

Fluoride Toothpaste: Despite old advice about waiting until children can spit, current guidelines recommend using fluoride toothpaste from the first tooth. The tiny amount used for young toddlers is safe if swallowed, and fluoride provides crucial protection against tooth decay.

Avoid Bottle at Bedtime: Putting your toddler to bed with a bottle of milk, juice, or formula bathes their teeth in sugary liquid throughout the night, creating perfect conditions for tooth decay. If your child needs a bedtime bottle for comfort, fill it with water only.

Limit Sugary Foods and Drinks: Frequent exposure to sugars feeds the bacteria that cause cavities. While occasional treats are fine, making water the primary beverage and offering healthy snacks protects developing teeth.

Clean Bottle Nipples and Pacifiers: These items spend significant time in your child's mouth and can harbor bacteria if not cleaned properly. Never "clean" a pacifier by putting it in your own mouth, as this transfers cavity-causing bacteria to your child.

Watch for Early Decay: Check your child's teeth regularly for white spots, brown discoloration, or other changes that might indicate decay. Catching problems early allows for less invasive treatment.

Special Teething Situations

Some children face unique circumstances that require additional attention during the teething process.

Premature Babies: Babies born early may have delayed teething, with first teeth appearing later than full-term peers. However, they eventually catch up developmentally. If you have concerns about your premature baby's dental development, discuss them with our team.

Children with Special Health Care Needs: Some medical conditions affect tooth development and eruption. Children with certain syndromes, chromosomal differences, or other health issues may experience delayed, early, or unusual teething patterns. We work closely with your child's medical team to provide coordinated care.

Natal and Neonatal Teeth: Occasionally, babies are born with teeth already present or teeth erupt within the first month of life. While usually not problematic, these early teeth sometimes need evaluation to ensure they're properly attached and not causing feeding difficulties.

Tooth Discoloration: Most baby teeth emerge white, but some appear with discoloration or unusual spots. Various factors can affect tooth color, including medications taken during pregnancy, illness during tooth development, or trauma. Schedule an appointment so we can evaluate the cause and determine if treatment is needed.

Thick or Tight Gums: Some toddlers have particularly thick gum tissue that makes tooth eruption more difficult and painful. While this eventually resolves, the process may take longer and cause more discomfort than typical teething. We can examine your child and provide guidance specific to their situation.

Managing Parental Stress During Teething

The toddler isn't the only one who suffers during teething episodes. Parents lose sleep, worry about their child's discomfort, and sometimes feel helpless in the face of persistent crying and fussiness.

Remember that this stage is temporary. Even though it might feel endless during a particularly rough night, teething passes. Those twenty primary teeth will all eventually come in, and the difficult periods will become distant memories.

Don't hesitate to ask for help. Whether it's a partner taking a feeding shift, a grandparent watching your toddler so you can nap, or friends bringing dinner on a tough evening, support makes difficult stages more manageable. There's no badge of honor for suffering through solo.

Take care of yourself too. Your stress level affects your child—toddlers are remarkably perceptive about parental emotions. When you're calm and confident, your child feels more secure even when uncomfortable.

Connect with other parents who understand what you're experiencing. Knowing others are navigating the same challenges—and surviving them—provides perspective and encouragement.

And remember, it's always okay to reach out to our office with questions or concerns. We'd rather answer a question you worry might be silly than have you spend nights stressing unnecessarily. That's what we're here for.

Building a Foundation for Lifelong Oral Health

The care you provide during your child's teething stage establishes patterns that influence their relationship with dental health throughout life. Toddlers who associate tooth brushing with pleasant routines, who visit the dentist regularly for positive experiences, and who receive proper oral care from their earliest teeth are more likely to maintain good dental hygiene as they grow.

Make oral care a non-negotiable part of your daily routine from the beginning. Just as you wouldn't skip bathing or dressing, tooth brushing becomes a normal, expected part of the day rather than something to argue about.

Model good oral health habits yourself. Children learn by watching their parents, and a toddler who sees you brushing and flossing regularly understands that dental care matters.

Frame dental visits positively. Avoid using the dentist as a threat or talking about dental appointments with anxiety in front of your child. Instead, present visits as exciting opportunities to see the friendly staff who help keep teeth healthy and strong.

Celebrate dental milestones. Those first teeth emerging, successful dental checkups, and mastered brushing techniques all deserve acknowledgment. Positive reinforcement creates positive associations.

Your Laredo Partner in Pediatric Dental Health

Teething represents just the beginning of your child's dental journey, and the foundation you establish now influences their oral health for decades to come. At Tots to Teens Pediatric Dentistry & Orthodontics, we partner with Laredo families to provide comprehensive, compassionate care from that very first tooth through the teen years.

Our experienced team—Dr. Anna Stell, Dr. Kara Whittington, Dr. Joanna Ayala, and Dr. Diana Villarreal—is dedicated to making every dental experience positive for your family.

Whether your toddler is cutting their first tooth, needs their first dental checkup, or is experiencing teething complications that concern you, we're here to help. We understand that every child develops differently, and we tailor our approach to your toddler's unique needs and your family's circumstances.

Don't wait until problems develop to establish dental care. Early visits create a dental home for your child, build positive associations with oral health care, and allow us to catch potential concerns before they become major issues.

Call Tots to Teens Pediatric Dentistry & Orthodontics at (956) 725-3100 to schedule your toddler's appointment at our Laredo office on McPherson Road. Let's work together to ensure your child's teething experience is as comfortable as possible and that those emerging baby teeth stay healthy and strong throughout early childhood.

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