Teething and Oral Care

new photo parents playing with baby.jpg

At 4 months old, the newborn stage is ending. Your child is really blossoming! Forget the smiling – they are really engaging and talking now. They are people – beautiful little ones – and they may even be sleeping through the night! Then it starts. A little saliva. Hands in the mouth. A little fussiness, and then maybe a sleepless night. Those teeth are starting to descend. Every child eventually gets their 20 teeth – there is no such thing as delayed teeth. Most will start to “pre-teeth,” or feel the pressure of the teeth coming in, around 3 to 4 months. The first two may not cut until 7 to 10 months, and I have seen much earlier and much later. But they will always come in – all 20 of them – by 2 years old. Teething doesn’t really bother some babies, but most babies do feel a bit of discomfort. It usually takes 2 to 3 days for the teeth to really cut through the gums, and these are the toughest days for a baby. 

How To Help The Pain

There are many teething toys out there. Some you freeze and some will vibrate – and we all love Sophie the Giraffe. It is always nice when babies find their own fingers and self-soothe, but you can also help by giving her a cold washcloth, your cleaned fingers, or a frozen bagel (as long as they don’t chew off a big piece).

Many swear by amber’s powers in healing, but just make sure your baby doesn’t choke on anything like a bracelet or necklace. There are many brands of homeopathic teething tablets, but do not use any with belladonna, which is not safe for kids. The other kinds are safe, but they may not fully cure the pain.


When it comes to teething, medication should be used sparingly, in the right dosage, and for a limited amount of time. If your child is acting a bit fussy but the teeth aren’t cutting through yet, I would recommend the non-medicated options mentioned above. But when the teeth are literally getting ready to cut through the gums (the gums get red and swollen, and you can really see the whites of the teeth emerging) and your baby is crying, it is time to help them with the pain. Tylenol is safe when used in the right doses for a few nights, every 4 to 6 hours, and Motrin can also be helpful, used every 6 to 8 hours. The proper doses can be found here. Some people give these medicines for a 2- to 3-week period, but I would limit it to the 2 to 3 days that it takes for the teeth to actually cut through. 

Teething and Sleep

Yes, teething can definitely interfere with sleep. But it is only during those few days when the teeth are cutting through that the baby is in true pain. During those days, I would recommend going to the baby at night to console him with a lot of love and maybe a little meds. The other days, if they are mostly happy and playful during the day, I wouldn’t change the nighttime routine or alter an attempt to sleep train because of teething. 

Other Symptoms

Teething can cause other symptoms, such as fussiness, slightly looser stools, and even a low fever. But a real fever (anything over 101 degrees) or any significant symptoms still have to be taken seriously, as they may not be “just teething.” Babies will sometimes eat less, which can affect sleep, but don’t fall into the habit of blaming too much on teething. 

Cavity Prevention

It is wild to think about, but even two teeth need to be cared for! This first set of teeth will eventually fall out starting around 6 years old, but that doesn’t mean we should ignore them in the meantime. Quite the contrary: Oral health should start during babyhood, and we need to brush the teeth as soon as they make an appearance.

Some parents start off with a washcloth or finger brush, but to really brush those teeth, you should use a baby toothbrush and a pea-size amount of baby toothpaste. The baby toothpaste is fluoride-free so it’s safe to swallow. Brush your baby twice a day, every day – after the first and last meals. Formula and breast milk have natural sugars in it, so do brush the teeth at night, even if it breaks the night-time routine. If your child resists or says no, you say yes! Parenting is all about choosing your battles, and I would choose this battle. Getting a cavity drilled is no fun – and I often see cavities happening with kids as young as 2 or 3 – so brush often and limit the sweets and treats.

An adult or family dentist will see your child, but when your kids are young, you should see a true pediatric dentist. There are many excellent local pediatric dentists. Check your insurance plans, as you want the services to be covered, but unfortunately many local dentists don’t fully accept insurance plans or are out of network. Pediatric dentists will see your child starting at age 1, but if your pediatrician doesn’t see any signs of cavities, it may be ok to wait until 2. Just don’t wait any longer than that! 

More Oral Care Tips

* Try to lose the pacifier by 12 months – it can curve the upper teeth.
* Aim to lose the bottle by 15 months (18 months at the latest) for the same reason – and never let your baby fall asleep with the bottle in his mouth. It’s very bad for the teeth!
* Try to avoid all sugary beverages, including juice. If you do give juice, make it 100% juice diluted with water.
* If you never give your baby tap water, which contains fluorides, you may need fluoride supplementation. Consider filtered tap water instead of bottled water.
* Flossing is also a good idea, but not always realistic with very young children. Keep trying though!

Local Dentists 

The following dentists have proven themselves to be excellent local resources and have received positive reviews from many of our patients.

Dr. Lois Jackson 16 Court Street, Suite 2211, 718.855.8833, www.drloisjackson.com
Dr. Cormac MacDermott 120 Montague Street, 718.855.2855, www.brownstonedental.com

Dr. Zev Tendler 32 Court Street 7186245437 www.pdofbrooklyn.com (takes some insurance)
Dr. Mindy Homer 62 2nd Place, 718.797.KIDS, www.doctor-mindy.com
Dr. Janice Lau 148 Atlantic Avenue, 718.875.5437, www.brooklynheightspediatricdentistry.com

Dr. Francis 150 4th Avenue, www.parkslopekidsdental.com 7184880200 (takes insurance, including healthfirst)
Dr. Eric Last (for older kids and adults) 21 Schermerhorn Street, 718.625.7102, www.dentistryinbrooklynheights.com

See other health topics