By Dr Megan Yap - PaediatricianBabies16 Aug 2017

Hey there guys,

A quick follow up to the “crying baby” post… Another cause for irritable crying babies.  I thought this might be a useful add on.

My littlest man is now 21 months old (corrected age – he was born a couple of months prem), and he is still cutting some of his back teeth.  It seems for some kids, teeth just appear and asides from a little drooling, they are otherwise unaffected.  For others, it is like a volcano is erupting from their gums… sometimes multiple volcanoes with the associated carnage – disrupted sleep, rashes, general crankiness and crying etc.  We would know when my little guy was cutting  a tooth as he would be cranky, and would vomit a lot (ie more than his usual, fairly frequent vomiting).  Good times (*face palm*).


Alright, let’s set the record straight.  Like EVERYTHING there is to do with babies, there is a lot of “cotton-wool-fluff-(mis)-information” out there, and then there is the truth.  Let’s talk about the latter.


Teething can occur in a range 3-15 months.  It’s a broad range and this is normal.

The average range for a first tooth is around 4-7 months.  The bottom two, middle, front teeth (central incisors) are usually the first to erupt, followed by the top, middle 4 teeth (central and lateral incisors).  Rarely, a baby can be born with a tooth or two (we call these “natal teeth”) and in my experience, they usually need to be extracted for various reasons (eg they are at high risk of falling out and blocking the baby’s airway; it can be difficult (not to mention painful for mum) for them to attach to breastfeed etc).


What do we look for with teething?


  • Drooling
  • Coughing
  • Looser than normal stool (do NOT get this confused with frank diarrhoea.  It is said that sometimes the increase in production in saliva associated with teething can make the stool a little bit looser.  However, if your baby has significant and/or persistent diarrhoea, it would be wise to consult your doctor).
  • Low grade fever (see my past blog post on fever; please note that depending on your source, some will say that teething will not cause fever AT ALL). For sure though, teething will NOT cause a temperature at or more than 38 degrees.  If you child has a fever, another cause must be considered.
    • Normal temp = 37-37.5 degrees
    • Low grade = 37.6-37.9 degrees
    • Fever = 38+ degrees
  • Chin rash, red cheek
  • Biting and gnawing
  • Cheek rubbing and ear pulling
  • Not sleeping well
  • General irritability


So what can we do to help a miserable little cherub who is teething?


  • Analgesia (ie pain relief)
    • Baby paracetamol (eg Panadol, Dymadon)
    • Children’s ibuprofen (eg Nurofen)
  • Teething gels
    • Orased jel, Bonjela
    • Xylocaine viscous
  • Teething rings/rusks
    • The baby biting down results in equalising the pressure of erupting tooth, and this can ease pain (until the pressure is released)
  • Cold water/chilled foods
    • Chilled apple puree, cold water in a cup/bottle
  • Reassure yourself as a parent, that “this too shall pass” and remind yourself that it won’t last forever (I promise)


If your child doesn’t have teeth by 4-5 months, don’t let it stop you from starting solids.  You can cook and puree pretty much everything, and it is important from an allergy point of view AND an exposure (ie to avoid a raising kid who will only eat white bread, chicken nuggets and plain pasta etc) point of view, to start solids at the 4-5 month mark (can be a bit earlier for premmies).   That being said, when I saw my best mate’s littlest guy (who is now 1 year old), was gumming down on a proper slice of pizza (and now I think about it, a chicken drumstick too) before he could sit up properly in a chair (like at 5-6 months old) and before he had cut ANY teeth at all – that was amazing.  My kids were still gagging on chunky soft solids at 10 months old (*eye roll*).


Again, hoping this information was useful for you.   I will definitely be doing some posts relevant to parents with OLDER, school-age kids soon – lots of people are asking me about behavioural stuff. I will get there…


Until next time, please leave me a comment, share with any of your friends that you think might find it helpful and happy parenting!!


xx Dr Megs

For more articles from Dr Megan Yap visit her blog – “Dr Megs – Paeds & Feeds” at http://www.kids-health.guru/


We have a number of locations around Brisbane to help make it easier for you to find us!