A while ago, blog reader Michelle asked for help for a teething baby. I asked Dr. Daniel Levy, a pediatrician who chairs the oral health task force for the Maryland chapter of the American Academy of Pediatrics, for his tips. Here's what he wrote back:
"Teething, or the eruption of the first (deciduous, or 'milk,' teeth) commonly occurs in infants in the period between 4 months and 18 months, with the average around 6-12 months. The bottom two teeth (lower incisors) tend to erupt first, followed by the middle or lateral upper incisors.
"This phenomenon may be accompanied by mild pain at the site of eruption. Typically, small pits form in the gums ... followed by swelling, and then the appearance of teeth. Occasionally, an eruption cyst forms at the point of eruption, looking like a blood blister.
"Babies vary in the pain they experience, but most of the discomfort may be relieved with acetaminophen drops or ibuprofen drops. Anything cold helps as well. Teething rings, frozen and stale bagels, cold carrots, etc. make life more bearable for baby.
"We discourage topical teething remedies that can be purchased over-the-counter, because they may retard the gag reflex if used excessively. As an alternative, try mixing a teaspoon of Benadryl liquid with an ounce of Maalox, chill the concoction, and dab it on the gums for relief.
Levy also wrote that "the notion that fever is associated with teething is an old wives' tale!"
"Don't forget, as soon as teeth erupt, they should be brushed twice daily with an infant tooth brush and a tiny dab of children's toothpaste," he wrote. "A first dental appointment should be arranged at 1 year of age."