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Some Babies Are Born with Teeth That Need Immediate Attention

Parents have a lot of questions about teething in their little ones. When do teeth come in? In what order? What if my baby were born with teeth? Why are some babies miserable and others don't seem bothered at all when they're teething? When do they need to see a pediatric dentist? So let's talk teething basics.

If your baby had teeth at birth, those are called natal teeth, and they actually need to be removed by a pediatric dentist as soon as possible. They don't have proper roots, and they can affect feeding or even break off, and your ÑÇÖÞ×ÔοÊÓƵ would be at risk of aspirating them.

The Teething Timeline and Early Signs

Babies actually start the teething process when they are between 2 and 4 months old. They will start drooling and chewing on things, usually their hands or your hands. You won't see any teeth till they're about 6 to 10 months old, but those teeth are starting to move up into the gums.

Other signs of teething are biting down hard on things, drool rashes on their chin from all the saliva irritating their skin, fussiness, waking at night, chewing on their food rather than actually eating, pulling or rubbing their ears because of pain referred from their gums, and even white bumps or blue bumps on the gums. White bumps are called gingival cysts, and they are collections of gum tissue that form as the tooth moves up in the gums. Blue bumps are gum hematomas from broken blood vessels as the teeth move up. Both of these resolve once the tooth comes in.

Some babies cruise right through the teething process. Like my older son, who just after he turned a year, I looked in his mouth because I thought he had put something in there that he shouldn't have, but what I was actually seeing is that he had three molars erupt all at once within days of each other, and he wasn't bothered at all. My younger son was late with teeth and got several in around his first birthday, and he was a little bear.

Safe vs Unsafe Ways to Soothe Your Baby's Teething Pain

We don't know why some babies are bothered more than others. They just are. If your baby is struggling with teething, the best thing is to let them chew on safe things: cold, wet washcloths, teething toys, or use a soft toothbrush on their gums. You can even give Tylenol, if needed, for really bad discomfort if your baby is over 3 months old.

What shouldn't you do? Don't use teething gels that contain benzocaine. That is a numbing agent, and some babies actually will have a serious complication called methemoglobinemia, which will land them in the intensive care unit because of dropping oxygen levels in the blood. Some natural teething tablets have belladonna in them. That's evening nightshade, which can cause breathing issues and seizures in babies, and it's not recommended either. Some parents use amber teething necklaces, but the American Academy of Pediatrics strongly warns against those as well due to choking and strangulation risks.

What to Expect as Baby Teeth Erupt and When to See a Dentist

Your baby will have 20 teeth when they come in. They usually come in with the bottom two central incisors first, then the top two central incisors, and then the teeth start filling in. First molars come through around 12 months. Second molars and canines finish up the teething process between 18 months and 2 years.

Once your baby starts getting teeth, most pediatric dentists will start seeing them. This is a good way to get them seeing a dentist and have the dentist make sure the teeth are coming in properly, can make sure no cavities are forming, apply fluoride varnish, and talk to you about proper dental hygiene as your ÑÇÖÞ×ÔοÊÓƵ gets more teeth in and learns how to brush their teeth. Many questions about teething in general can be answered by your pediatrician. But if you have dental-specific questions, the best resource is your pediatric dentist.