Teething

Symptoms

Most teething symptoms are often caused by the mild pain of tooth development. The classic symptoms linked to teething are drooling and putting fingers in the mouth. This is often true. But these may also just be signs of normal development. Common teething symptoms include:

• Drooling.

• Redness around the mouth and chin.

• Irritability, fussiness, and crying.

• Rubbing gums.

• Biting, and chewing.

• Not wanting to eat.

• Sleep problems.

• Ear rubbing.

• A fever below 100.4°F.

Home care

• Wipe drool away from your baby's face often, so it doesn't cause a rash.

• Offer a chilled teething ring. This may help to soothe your baby's gums. Keep these in the refrigerator, not the freezer. They shouldn't be frozen or too cold.

• Gently rub or massage your baby’s gums with a clean finger to ease symptoms. Always wash your hands with soap and clean, running water for at least 20 seconds before you do this.

• Give your child a smooth, hard teething ring to bite on. Firm rubber is best. You can also offer a cool, wet washcloth. Don't give your baby anything they can swallow, such as beads.

• Follow your health care provider’s instructions on using over-the-counter pain medicines, such as acetaminophen for fever, fussiness, or discomfort. Don't give ibuprofen to children younger than age 6 months. Don’t give aspirin or medicine that contains aspirin to a child younger than age 19. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

• Don't use numbing gels or liquids on children's gums. These are medicines containing benzocaine. They may give short-term relief, but they can cause a rare but serious and possibly life-threatening illness.

Follow-up care

Follow up with your child’s health care provider, or as advised.

When to get medical advice

Contact your child's health care provider right away if your child:

• Has a fever. (See "Fever and children" below.)

• Is pulling at an ear, which may be a sign of an earache.

• Has neck pain or stiffness or a headache.

• Has a rash with fever.

• Has frequent diarrhea or vomiting.

• Is a baby and is fussy or crying and can't be soothed.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the health care provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.

Below is when to call the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.

For a baby under 3 months old:

• First, ask your child’s health care provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________ as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider