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Latest Edit: Iva Lloyd, ND 2013-10-16 (EDT)

Teething refers to the gradual process by which an infant's primary teeth first appear. It typically begins at 3 to 6 months of age and is complete by 2 to 3 years of age, when all 20 primary teeth are formed. Most babies experience pain when teething and can be irritable, with drooling, poor feeding, and disturbed sleep.


In general, teeth begin to appear on the following schedule: the central incisors, the teeth right in the middle of the jaw on the top and bottom, come in at 6 to 12 months; lateral incisors at 9 to 13 months; canine (cuspids) at 16 to 22 months; the first molars at 13 to 19 months; and the second molars at 25 to 33 months. Most children have all of their primary teeth by age three.

Signs and Symptoms

Classic signs or symptoms of teething may include:[1]

  • Pain in the mouth or face that can also be referred to the ear
  • Dribbling, drooling
  • Restlessness
  • Sleep disturbance
  • Poor feeding
  • Execerbation of eczema
  • Mild diarrhea
  • Rubbing cheek
  • Pulling ear
  • Mild cough

Diagnostic Testing

Diagnosis is based on history and examination after excluding acute illness of the infant.

Examination involves:[2]:

  • Full general pediatric examination
  • General assessment, which involves checking if the child is alert- teething does not cause any altered level of consciousness
  • Check for fever- teething is not associated with fever (more than 0.5 degrees or more than normal body temperature)
  • Check for rash, photophobia, paradoxical irritability, and tense fontanales to rule out meningitis
  • Ears, nose, and throat examination
  • Fundoscopy, based on related concerns
  • Cardiovascular examination
  • Abdominal palpation

Related Symptoms and Conditions

In addition to teething, drooling can be seen accompanying other conditions [3]:

Naturopathic Treatment

The goal of naturopathic treatment is to support the natural process of teething by minimizing the pain and discomfort for both the child and their parents.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies that can reduce the intensity and duration of teething include:

  • Cold
  • Cold is generally soothing to a teething baby. This cold can be accomplished by putting the following in a freezer and then giving it to your teething child for comfort: a baby towel or dish-cloth; a baby bottle, up-side-down and full of water; a metal baby-spoon, or a banana.
  • Massage
  • Massage the child's gums. It is best done by applying a little pressure along the gum line with a clean finger.
  • Let Them Chew
  • Chewing helps teeth work their way through the gums, so keep your baby's jaws moving. Choose clean, nontoxic, natural, chewable, and either too large or too small to block the child's airway should it get swallowed.
  • Good dental hygiene is critical. Rubbing the gums with a clean cloth, or a baby's toothbrush if they have started to sprout teeth, is helpful to both teething and to preventing any problems.

Naturopathic Therapies for teething include:

  • There are certain foods that tend to soothing to a teething child: apple wedges, carrots and "cold" applesauce.


  1. Macknin ML, Piedmonte M, Jacobs J, and Skibinski C. (2000) Symptoms associated with infant teething: A prospective study, Pediatrics;105(4):747-752.
  2. Teething, retrieved on January 14, 2013, from http://ezproxy.ccnm.edu:2066/das/pdxmd/body/395614958-2/0?type=med&eid=9-u1.0-_1_mt_1014386&tab=T
  3. Tighe M, and Roe MFE. (2007) Does a teething child need serious illness excluding?, Arch Dis Child;92:266-268.
  4. Hechtman, Leah (2011) Clinical Naturopathic Medicine. Churchhill Livingstone, Australia.