Understanding the stages of teething

Teething happens when a baby’s first tooth breaks through the gums. It usually starts around 6 months of age and can continue until about age 3.

Teething symptoms

• Increased biting/chewing
• Fussiness
• Increased salivation/drooling
• Gum-rubbing
• Sleep disturbances
• Loss of appetite

Why do babies lose their baby teeth?

Children lose their baby teeth to make room for permanent teeth. Baby teeth act as placeholders and hold space for adult teeth to erupt into their final positions in the dental arch. While tooth loss is a normal part of development, factors like cavities, injury, or certain health conditions like diabetes and periodontal problems can accelerate it.

Dental decay, a leading cause of early tooth loss, can damage the tooth structure enough to require extraction. Trauma from falls or accidents can also cause premature loss of baby teeth.

Which teeth are first to fall out?

The bottom front teeth, known as the mandibular central incisors, are usually the first baby teeth to fall out. The second molars are last to fall out. The typical timeline for losing baby teeth generally follows this pattern:

1. Lower central incisors
2. Upper central incisors.
3. Upper lateral incisors.
4. Lower lateral incisors.
5. First molars.
6. Canines.
7. Second molars.  

While the timing and sequence can vary from child to child, the general pattern tends to be  consistent.

Ways to soothe a teething baby

Here are some effective methods to help comfort your teething baby. Always supervise closely while using these techniques:

• Provide a chilled teething ring for chewing.
• Gently massage the gums with a clean finger.
• Offer a cold, damp washcloth for chewing.
• Give a safe teething toy.
• Use a cold spoon to ease gum irritation.
• Offer solid foods like chilled fruits (for older infants).
• Administer acetaminophen or ibuprofen (for babies 6+ months) as needed for pain relief.

Teething remedies to avoid

Some teething remedies can be unsafe for babies. Here are a few to avoid:

• Topical numbing creams or teething gels with benzocaine, which can increase the risk of methemoglobinemia, a life-threatening blood condition.
• Teething necklaces or bracelets, which pose choking and strangulation risks.
• Homeopathic teething tablets, which can have unsafe ingredients and can pose a choking risk.

How to soothe a teething baby at night

If your baby is struggling with teething pain at night, try these soothing methods:

• Offer a chilled teething ring to help numb sore gums.
• Gently massage their gums with a clean finger.
• If your baby is in significant discomfort, give acetaminophen or ibuprofen

How to care for infant teeth

• After feedings, gently wipe your baby's gums with a clean, damp cloth.
• Once teeth appear, brush them using a small, soft-bristled toothbrush with a tiny, pea-sized smear of fluoride toothpaste.

When to consult your pediatrician

Contact your local or Summer Health pediatrician if your baby experiences:

• A high fever
• Extreme irritability that cannot be soothed
• Difficulty feeding
• Unusual drowsiness or lack of alertness
• Symptoms that persist or worsen

If you have questions about teething, your child's first tooth, or excessive drooling, reach out to your local or Summer Health pediatrician for support. Summer Health is a pediatric telehealth platform offering 24/7 care, providing answers for everything from urgent concerns to everyday questions about your child’s health.