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

Teething usually begins when a baby is between 6 and 8 months old. More teeth grow in from time to time until all 20 baby, or deciduous, teeth are in place. These teeth are normally in place by the time a child is 30 months old.

Such teeth include:

• Incisors
• Canines
• Molars in each jaw

The two bottom front teeth (lower central incisors) usually come in first. Next to grow in are usually the two top front teeth (upper central incisors), then the lower and upper lateral (side) incisors, lower molars, upper molars, lower canines, upper canines, lower lateral molars, and finally the upper lateral molars.

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:

• Biting on hard objects
• Drooling
• Gum swelling and sensitivity
• Irritability
• Sleeping problems
• Refusing food

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, or (until the teeth are right near the surface) a clean finger, can also help.

Medications such as children's Tylenol or over-the counter teething preparations containing a topical anesthetic can be helpful.

Never cut the gums to help a tooth grow in, because this can lead to infection. Teething powders should also be avoided. Children should NEVER be given aspirin due to the risk of developing Reye syndrome.

NOTE: Teething does NOT cause fever. If your child develops a fever greater than 100.5 degrees, as taken with a rectal or ear thermometer, look for other signs of illness.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.