Teething: Which remedies are safe for babies?

The arrival of your infant’s first tooth is a milestone. But it can also signal the beginning of a trying phase for both of you: teething.

Your baby was born with 20 teeth below their gumline. “The timing of teething varies from child to child. “Teeth may begin to erupt anywhere between 4 and 12 months,” says Dr. Molly Lederman at Lexington Pediatrics of the Boston Children’s Primary Care Alliance network.

Some infants glide through teething with only occasional fussiness. For others, it’s more challenging.

To help your family through the teething stage, Dr. Lederman shares some tried-and-true remedies and highlights a few popular methods you should avoid.

How to know your baby is teething

Every baby is different. Yours may be hardly fazed by the imminent arrival of a new tooth, while others may begin drooling, biting and gnawing, or refusing to eat. Irritability and red or swollen gums are also common. Usually, these symptoms go away after a few days.

Dr. Lederman outlines specific signs that indicate it’s time to call your pediatrician:

• inconsolable crying
• diarrhea or watery stool as it could be a sign of infection
• a slight rise in body temperature during teething is normal. A 2016 study found that a temperature over 100.4 degrees points to an illness or infection, not teething
• if any of their symptoms last for weeks at a time

How to soothe a teething infant

“Massaging the sore part of their gums with a clean finger can provide relief,” Dr. Lederman says. Teething may cause mild discomfort and fussiness. “A cold, solid-rubber teether and even a frozen washcloth to chew on can be soothing.” 

You can also talk with your pediatrician about trying a weight-appropriate dose of acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) if they’re older than 6 months.

Teething remedies to avoid

Avoid numbing gels that contain benzocaine. In 2018, the Food and Drug Administration (FDA) recommended caregivers refrain from using benzocaine products for kids younger than 2.

“These products carry serious risks and provide little to no benefits for treating oral pain, including sore gums in infants due to teething,” the agency’s statement reads.

“In the past years, teething necklaces and beads have grown in popularity,” says Dr. Lederman. “However, they pose a choking and strangulation hazard. And, there is little scientific evidence that they provide relief to your infant.”

The FDA also recommends against using homeopathic teething tablets, which are not evaluated for safety and effectiveness by the FDA. In certain teething tablets, a toxic substance “far exceeding the amount claimed on the label” was discovered during lab testing.

Plan your next steps

Once your baby cuts their first tooth, schedule their first dental appointment.

“It may seem premature, but a pediatric dentist will make sure their teeth are developing normally,” Dr. Lederman says. “They’ll also provide guidance on how to best support your infant’s dental hygiene.”

It’s important to keep new teeth clean and healthy by brushing daily with fluoride toothpaste. Start brushing twice a day with a dab of fluoride toothpaste no larger than a grain of rice. Once your child turns three, you can increase to a pea-size amount. When they’re able to, teach them to spit out the excess toothpaste.

We typically recommend establishing a dental home for your child around 12 to 18 months of age. “Your pediatric dentist will provide guidance on how to best support your infant’s dental hygiene,” says Dr. Lederman.

“Most children pick that up pretty quickly,” she adds. “You should assist your child with brushing their teeth until around 7 or 8 years of age.” 

Until then, if you need help managing your child’s teething, don’t hesitate to contact your pediatrician.

Boston Children’s Primary Care Alliance practices offer support for new and experienced parents. Find a practice near you.