Teething

Symptoms

Most teething symptoms are often caused by the mild pain of tooth development. The classic symptoms linked to teething are drooling and putting fingers in the mouth. This is often true. But these may also just be signs of normal development. Common teething symptoms include:

• Drooling

• Redness around the mouth and chin

• Irritability, fussiness, and crying

• Rubbing gums

• Biting, chewing

• Not wanting to eat

• Sleep problems

• Ear rubbing

• Fever below 100.4°F

Home care

• Wipe drool away from your baby's face often, so it doesn't cause a rash.

• Offer a chilled teething ring. Keep these in the refrigerator, not the freezer. They shouldn't be frozen or too cold.

• Gently rub or massage your baby’s gums with a clean finger to ease symptoms. Always wash your hands with soap and clean, running water for at least 20 seconds before you do this.

• Give your child a smooth, hard teething ring to bite on. Firm rubber is best. You can also offer a cool, wet washcloth. Don't give your baby anything they can swallow, such as beads.

• Follow your healthcare provider’s instructions on using over-the-counter pain medicines, such as acetaminophen for fever, fussiness, or discomfort. Don't give ibuprofen to children younger than age 6 months. Don’t give aspirin or medicine that contains aspirin to a child younger than age 19.Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

• Don't use numbing gels or liquids on children's gums. These are medicines containing benzocaine. They may give short-term relief, but they can cause a rare but serious and possibly life-threatening illness.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to get medical advice

Call your child's healthcare provider right away if your child:

• Has a fever (See "Fever and children" below.)

• Is pulling at an ear, which may be a sign of an earache

• Has neck pain or stiffness or headache

• Has a rash with fever

• Has frequent diarrhea or vomiting

• Is a baby and is fussy or crying and can't be soothed

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° F (38° C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older