Babies & Toddler Information

The teething process can be a difficult period for both the baby and the parents. The process starts at different ages depending on each baby but usually by age of 3 most infants have their primary teeth in place. If by one year your baby still has not got his first tooth it would be wise to see your doctor and dentist.

There are 20 primary or "baby" teeth that every child has during their lifetime, with ten in the upper jaw and ten in the lower. Usually, the appearance of baby teeth is as follows: the upper and lower incisors come first, then the upper lateral incisors come in a few months later, followed shortly thereafter with the bottom lateral incisors. The top and bottom molars are the next set to come through, usually right around 18 months. The cuspids, or eyeteeth, usually follow soon after the molars. At approximately two, to two and a half years, the second set of molars will appear.

Usually there is no set order in which baby teeth appear - again this depends on the individual baby. It is unusual for a child not to get all twenty teeth.

Some babies can be born with a front tooth (this happens in about 1 in every 2000 cases). In this even it is wise to consult a paediatric dentist. This situation can affect the breastfeeding process so a paediatric dentist should be consulted as soon as possible, especially if you intend to breastfeed.

Here are the signs that your baby may be teething:• Bulging gums - you'll be able to see the outline of the teeth as they try and push through his gums.

• Nighttime crying and walking.

• More fuss than normal.

• "Clingy" behaviour.

• An increase in the amount of drooling seen.

• Chewing on fingers, teething rings, and other objects.

• Swollen, red, inflamed gums.

• Poor appetite.

• Interrupted sleep.

There is some debate about this, but it is now generally accepted that teething will not cause fever, sleep issues or lower immunity to infection.

Teething is very painful - if you have ever bitten the inside of your cheek you know how painful this can be - now imagine a baby that is used to a soft smooth surface (gums) and suddenly she has a hard and sharp tooth pushing through her swollen gums. Generally it's the first tooth that will cause the most discomfort.

When babies are going through the teething process they sometimes bring their hands to their mouths - this brings some relief when the gums have pressure applied to them. You can gently massage your baby to reduce the discomfort of teething - clean your fingers and rub the gums firmly - this may be uncomfortable for your baby initially but she will get used to, and appreciate, the massage the more you do it.

Give your baby something cool to chew on - this again provides relief for a little time. Wet washcloths (you can soak this in apple juice if you wish) that have been left in the freezer for 30 minutes or so - can be given to your baby to chew. Just remember, whatever you use make sure that your baby cannot choke on it. Other things that your baby can chew on include a chilled banana or an iced Popsicle. An old wives tale remedy recommends that you dab some alcohol on your baby's gums - it is strongly recommended that you do NOT do this.

While primary teeth will at one stage be replaced by the permanent teeth, they are very important for several reasons - including chewing and speech. Once these teeth are in, you can clean them with a special baby toothbrush.

Be sure to never allow your baby to fall asleep with a bottle. This will lead to tooth decay. Whether a baby is bottle fed or nursed, he will be vulnerable to "baby bottle tooth decay". Such decay occurs when freshly sprouted baby teeth are exposed to liquids containing sugars (basically, anything other than water) for long periods of time. Bacteria in the mouth will grow in the sugar, which attack the tooth enamel and cause cavities. The best treatment for "baby bottle tooth decay" is prevention. Don't let your baby use a bottle as a pacifier or fall asleep with a bottle containing anything but water. Also, be sure to gently clean his teeth and gums after each feeding.

You may also see some teething symptoms - on the whole these are fairly harmless. For example, drool rash where a red rash can be seen on the face, lips, chin and chest. This can be washed with warm water and a cloth and your doctor may prescribe a lanolin ointment as treatment for this. Sometimes other symptoms can include mild diarrhoea and a cough caused by excess saliva dripping down the baby's throat.

Here are some good tips to use to care for your baby's teeth:

• Clean your baby's mouth before the teething process. You can wipe the gums after each feeding with a warm, wet washcloth.

• Take good care of the teeth once they start to come in. Some parents wrongly believe that because primary teeth are eventually replaced they are not that important - this is false as they preserve the space for the permanent teeth, not to mention help with chewing and talking.

• Actively watch for cavities - if you spot any discolouration or pitting then they could be signs of cavities. Try and avoid putting your baby to sleep with milk (or even worse sweet juice) as it could lead to cavities. In addition follow up meals with water as this helps to wash off most infant foods quite easily.

• Introduce a toothbrush as soon as possible. In addition you should monitor your baby's fluoride intake as this can help prevent tooth decay. It's also important to schedule a dental check up for your baby - shortly after the first year is a good time for the first visit.

Creating good dental practice from the start will help ensure that you baby continues good dental hygiene for years into the future.