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Ear, nose and throat
A baby's first tooth usually arrives at around six months of age but all babies are different and teeth can arrive earlier or later. Very occasionally a baby is born with a tooth. The first teeth to appear are the two central teeth in the lower jaw, called the incisors. These are followed by the two upper incisors a month or so later. The other teeth will appear periodically over the next year or so and eventually your baby will have 20 milk teeth. Milk teeth begin to fall out at about six years of age and are replaced by permanent teeth.
The new teeth coming up through the jaws and gums cause the pain and discomfort of teething.
A hard ridge may be noticeable on the baby's gum for many weeks or months before the tooth actually breaks through the gum. Each baby will experience teething differently and some seem to have more pain than others. The first few teeth, the lower and upper incisors, can appear relatively painlessly, merely causing lots of biting and dribbling. Molars coming through at the back of the mouth tend to cause babies more discomfort, especially if several are coming through at the same time. Many babies start to dribble and this can cause a rash around the mouth. Others seem to develop very flushed cheeks. A baby may also seem more irritable than usual and feeding patterns might change. Some babies also seem to have looser and more frequent bowel motions when they are teething, which in turn may lead to nappy ras
Teething gels containing the local anaesthetic lidocaine can be rubbed onto the gums to ease pain, but they should not be applied too often. If teething seems really painful a baby can be given the recommended dose of an infant suspension containing the analgesics paracetamol or ibuprofen. Aspirin should not be rubbed onto the gums, and the use of aspirin in any form, including teething gels containing choline salicylate, must not be used.
When to see your pharmacist
All of the teething gels and infant analgesic suspensions are available from your local pharmacy without the need for a prescription. If your child starts teething particularly early, let your pharmacist know as some of the preparations are not recommended for very young babies or those below a particular weight.

If you have been using teething gels containing choline salicylate (Bonjela, Bonjela Cool Mint) previously, then stop using them as they are no longer recommended in children under 16 years of age. Instead, switch to Bonjela Teething Gel that contains lidocaine instead of choline salicylate, and which has been specially formulated so that it suitable for babies over 2 months of age.
When to see your doctor
It is important that you distinguish the symptoms of teething (irritability, dribbling, flushed cheeks) from other signs of illness. Teething will not cause a high temperature but looser bowel motions or diarrhoea may be a sign of a more serious illness. Pulling or rubbing at their ears may also be a sign of middle ear infection, which needs prompt treatment. If you are worried about your baby, always seek advice from your doctor or health visitor.
Living with a baby that is teething
There are many things that you can do to ease your baby's pain during teething. Babies love to chew on things while they are teething as it appears to ease the pain and helps the teeth break through the gums. Teething rings, slices of carrot or cucumber, or teething biscuits will all help. Babies particularly like these things if they are cold, so place them in the refrigerator to cool first. However, do not place the items in the freezer as they could cause freezer burns to the baby's fingers and mouth. Always keep an eye on your baby when using these things to make sure that there is no risk of choking from small pieces of food breaking off. Clean the teething ring each time it is used and throw away any old pieces of food.

Another way to ease pain is to gently rub your baby's gum with a clean finger, and an extra cuddle goes a long way to soothe and calm an upset baby.

If teething causes your baby to dribble, gently wipe the saliva away before it irritates the skin. Similarly, if your baby develops an upset tummy, change nappies regularly and use a barrier cream to avoid nappy rash.
Useful Tips
  • Give plenty of cool drinks
  • Give your baby something to chew; making it cold may help further