Is your teething baby keeping you up at night? Understand how to soothe sore gums and care for your baby's new teeth. By Mayo Clinic Staff

Drooling, crankiness and tears can make teething an ordeal for parents and babies alike. Here's help easing the pain — for both of you.

Although timing varies widely, babies often begin teething by about age 6 months. The two bottom front teeth (lower central incisors) are usually the first to appear, followed by the two top front teeth (upper central incisors).

Classic signs and symptoms of teething include:

  • Drooling
  • Chewing on solid objects
  • Irritability or crankiness
  • Sore or tender gums

Many parents suspect that teething causes fever and diarrhea, but researchers say this isn't true. Teething can cause signs and symptoms in the mouth and gums — but not elsewhere in the body.

If your teething baby seems uncomfortable, consider these simple tips:

  • Rub your baby's gums. Use a clean finger, moistened gauze pad or damp washcloth to massage your baby's gums. The pressure can ease your baby's discomfort.
  • Offer a teething ring. Try one made of firm rubber. The liquid-filled variety might break under the pressure of your baby's chewing. If a bottle seems to do the trick, fill it with water. Prolonged contact with sugar from formula, milk or juice contributes to tooth decay.
  • Keep it cool. A cold washcloth or chilled teething ring can be soothing on a baby's gums. Don't give your baby a frozen teething ring, however. Contact with extreme cold can be harmful.
  • Try hard foods. If your baby is eating solid foods, you might offer something edible for gnawing — such as a peeled and chilled cucumber or carrot. Keep a close eye on your baby, however. Any pieces that break off might pose a choking hazard.
  • Dry the drool. Excessive drooling is part of the teething process. To prevent skin irritation, keep a clean cloth handy to dry your baby's chin.
  • Try an over-the-counter remedy. If your baby is especially cranky, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) might help. Avoid teething medications that contain the pain reliever benzocaine. Benzocaine products have been associated with methemoglobinemia — a rare but serious condition that reduces the amount of oxygen in the blood.

Teething can usually be handled at home. Contact the doctor if your baby develops a fever, seems particularly uncomfortable, or has other signs or symptoms of illness that could be unrelated to the teething.

Ideally, you've been running a clean, damp washcloth over your baby's gums every day. If not, now's a great time to start. The washcloth can keep bacteria from building up in your baby's mouth. When your baby's first teeth appear, switch to a small, soft-bristled toothbrush. Until your child learns to spit — at about age 3 — use a smear of fluoride toothpaste no bigger than the size of a grain of rice.

It's also time to think about regular dental checkups. The American Dental Association and the American Academy of Pediatric Dentistry recommend scheduling a child's first dental visit after the first tooth erupts and no later than his or her first birthday. Your baby's teeth and gums will also be examined at well-baby checkups. Remember, regular childhood dental care helps set the stage for a lifetime of healthy teeth and gums.

Apr. 11, 2014