Teething is the emergence of teeth through the gums of the mouth in infants and young children.

Teething usually begins between the 6th and 8th month of life. Further tooth eruption occurs periodically until all 20 teeth of infancy and childhood, or deciduous teeth, are in place. All the deciduous teeth are normally in place by the 30th month of life.

These teeth include 4 incisors, 2 canines, and 4 molars in each jaw for the total of 20. The 2 lower incisors usually erupt first followed by the 2 lower incisors, upper lateral incisors, lower molar, upper molar, lower canine, upper canine, lower lateral molar, and finally the upper lateral molar. Note that some children do not show any teeth until much later than 8 months, and this is perfectly normal.

The signs of teething are:

• Drooling
• Irritability
• Gum swelling and sensitivity
• Sleeping problems
• Refusing food
• Biting on hard objects
• Low grade fevers (but NOT over 100 degrees)

The discomfort that results from teething is due to the pressure exerted on the tissue in the mouth, called the periodontal membrane, as the teeth erupt. This discomfort may be eased by a cool object such as a firm rubber teething ring or a cold apple. Gently rubbing the gums with a cool, wet washcloth may also provide comfort.

The gums should not be cut to facilitate the eruption of teeth since infection can result. Teething powders and aspirin should also be avoided. Medications such as children's Tylenol or over-the-counter teething medications containing a topical anesthetic can be helpful.

Note: Teething has NOT been shown to cause a high-grade fever. If your child develops a fever greater than 100 degrees, look for other signs of illness.