PlayWell Publications

PlayWell Pediatric Blog

Teething: What Is It? Common Misconceptions, and the Do's and Don'ts of Teething

March 21, 2023

When it comes to teething, there are a great deal many misconceptions out there. Teething is when a tooth develops and calcifies within the bone. While in the bone, the gum tissues of the baby overlay a smooth bony ridge. While this means eating the last inch of a bag of chips (you know, where it’s a handful of tiny sharp chip crumbs) would not feel very good, babies (and the edentulous elderly) do pretty well with eating most things comfortably; the smooth gums are being chewed down upon smooth bone. But once the tooth has erupted through the bone but not yet through the gums, the child is now chewing food with their gums down upon a knobled & gnarled, lumpy & bumpy tooth surface, pinching the gums down upon the sharp peaks of the tooth surface. Baby literally has to “cut the tooth” as the saying goes, and the tooth has to make its way through the gum tissue. The analogy I like to give is that it’s like you’ve got rocks in your shoes poking into your feet as you walk.

Teething can be painful and distressing and cause a lot of unhappiness and frustration. Babies can be fussy, irritable, and sleepless with sore & tender gums. Much like one might hold and put pressure on their knee after a scrape, the child will often find some comfort with pressure and self-stimulation by chewing on objects. Sharp intra-oral pain will cause a lot of saliva production as well, which means some kids drool excessively, while those who swallow their spit and/or nurse more (increase fluid intake) can have loose stools.

However, actual diarrhea and any fever over 100.4oF are NOT associated with teething. Kids are teething for almost 2 years straight (from 6 months to 2 years 6 months), and they have many illnesses & infections throughout this time, as well. While these findings therefore correlate in the same time period, one does not cause the other. If a child does have persistent symptoms of illness, they should be examined by their physician to rule out upper respiratory tract infection, ear infection, or other common childhood conditions. 

To treat teething, here are some do’s and don’ts of symptomatic relief:


DO encourage sucking on cold silicone teething rings or washcloths. There even exist molds for making breast milk popsicles!

DON’T use fluid-filled teethers (intended to be frozen) – they can be too hard and cause harm, or break open and baby can choke or ingest the liquid, which may not be safe for consumption.


DO consider the pre-bedtime use of analgesics like Tylenol and Ibuprofen, if age-appropriate.

DON’T ever give a teething child aspirin due to concern for developing Reye’s syndrome.


DO encourage chewing for the pressure and the positive sensory experience; consider cold celery (if child is eating solids), washcloths / towels. Even a pizza crust can be used as an effective chew toy. 

DON’T use homeopathic remedies. Homeopathic remedies are not FDA-regulated. The AAPD, AAP, and FDA actually recommend against their use, indicating that they “may pose serious risk to infants and children” due to being more likely to have manufacturing irregularities, contain unlisted substances, or contain quantities different from listed.

DON’T use topical numbing gels, which are black labeled for kids under 2 years of age due to the risk of inducing a serious blood condition called methemoglobinemia which can lead to hypoxia and death. 


DO give LOTS of love and support, extra nursing for fluid replacement and for comfort, and lots of patience and understanding. Just like a baby with gas, they’re uncomfortable and in pain. Kids are just trying to communicate and, while mom and dad normally make everything better, sometimes we can’t make it all go away and it’s understandably upsetting for kids and for parents alike. 

A kid playing with his toys

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