The first tooth usually comes when the baby is six to eight months old, but anything between four and twelve months is normal. The signs are drooling, chewing on everything, red and swollen gums and a worse mood, especially at night. What helps is cold and pressure: a chilled teething ring, cold pieces of food and a clean finger rubbing the gums.
Teething gets the blame for most things during the first year: a wakeful night, a bad mood, loose stools. Some of it is true, much of it is not. Here is what actually belongs to teething, what does not, and what our nannies do with the babies they look after during these months.
Twenty to midnight in Vällingby. The eight-month-old who has slept through the night since July wakes for the third time, bites everything within reach and has one cheek redder than the other. Mum runs a finger along the gum: a small hard edge at the front of the lower jaw. That is how most parents find the first tooth, in the dark, with a thumb.
Signs that a tooth is on its way
- Drools more than usual, often with a red rash around the mouth from the moisture
- Bites and chews on everything: fingers, toys, your shoulders
- Red, swollen gums, sometimes with a white or bluish lump where the tooth is about to come through
- Worse mood, cries more easily, harder to comfort
- Sleeps worse, wakes more often
- Wants to feed more, or less, depending on whether the pressure soothes or hurts
What is not teething
A fever above 38 degrees, diarrhoea, vomiting, a rash on the body or a cough are caused by something else, often an ordinary infection that happens to arrive at the same time. Treat the baby as ill and call 1177 (the national healthcare helpline) if you are unsure. Teeth are a convenient explanation, but they are rarely the whole truth.
| Sign | Fits with teething | Is something else |
|---|---|---|
| Temperature | Slightly raised | Fever above 38 degrees, see Fever in children |
| Stools | Slightly looser | Diarrhoea, vomiting |
| Mood | Whiny, can be comforted | Inconsolable, listless, hard to engage |
| Skin | Red around the mouth from drool | A rash on the body |
| Airways | Nothing | Cough, runny nose, laboured breathing |
| Ears | Pulls at the ear sometimes | Pulls at the ear, screams, fever: could be Ear infections in children |
How long does it go on?
Each tooth usually causes trouble for a few days, just before it breaks through the gum, and settles once it is out. But the teeth come in waves, and during the second year, when the molars arrive, it can feel as if it never ends. By around age three most children have all twenty milk teeth. In other words it is two and a half years with pauses, not one period.
In what order do the teeth come?
| Tooth | Approximate age |
|---|---|
| Lower front teeth, two of them | 6 to 10 months |
| Upper front teeth | 8 to 12 months |
| The teeth next to the front teeth | 9 to 16 months |
| First molars | 13 to 19 months |
| Canines | 16 to 23 months |
| Second molars | 23 to 33 months |
What helps
- Cold. A teething ring that has been in the fridge, not the freezer. Frozen teething rings can damage the gums.
- Pressure. Rub the gums with a clean finger. Many babies settle straight away.
- Cold food. For babies who have started solids: cold cucumber, cold banana, a piece of cold watermelon under supervision.
- Dry the mouth. Soft cloth around the mouth, a little barrier cream on the skin so the drool does not cause a rash.
- Closeness. A baby carrier, more skin contact, an extra settling at night. It hurts, and comforting is allowed.
- Pain relief. Only on advice from BVC (the child health clinic every family is enrolled in) or 1177, and in the right dose for age and weight.
What to avoid
- Amber necklaces. No effect, and a strangulation and choking risk. Never on a baby, not even when sleeping.
- Frozen teething rings. They damage the gums. Chill in the fridge instead.
- Numbing gels or drops. Only on advice from BVC or the pharmacy, and never anything intended for adults.
- Honey on the dummy. Never under one year, and sugar on teeth that have just come through is a bad start.
- Hard pieces of food without supervision. Raw carrot and apple in pieces for a baby without molars are a choking risk. Grate, cook or sit alongside.
The night: how to get through it
- Rub the gums and offer the chilled teething ring for a while before bedtime, not in the cot.
- More closeness, breastfeeding or a bottle is comfort, not a bad habit. You can go back to the routine in a week.
- Take turns: three nights each, so that one of you sleeps.
- Pain relief on advice from BVC can be right for a baby who is not sleeping at all for several nights.
- It passes, often in three to four nights. What sleep usually looks like at this age is described in Baby sleep from 0 to 6 months and Baby bedtime routine.
Food during teething
Babies who have started solids often eat less for a few days and prefer cold and soft: cold porridge, filmjölk (Swedish soured milk), cold fruit purées, and for babies over six months cold pieces of cucumber or melon under supervision. Eating less for three days is not dangerous, what matters is the fluids. If you are breastfeeding and the baby bites: take the baby off calmly, say no without drama and offer again after a while. Most stop within a few days. How to start solids is in Starting solids.
Dental care from the first tooth
Start brushing as soon as the first tooth shows, with a small soft toothbrush and a very small amount of fluoride toothpaste, the size of a grain of rice. Twice a day. The baby will protest for weeks, that is normal. Folktandvården (the public dental service) calls children in for a first check-up around age three, and some regions earlier. How to make it work without a battle is in Brushing children's teeth.
How we do it with our families
Esther looks after a nine-month-old girl in Täby on Tuesday and Thursday mornings while mum works from home. One Tuesday the girl wakes after a twenty-minute morning nap instead of an hour, wants everything in her mouth and cries when she is given the bottle. Esther feels the gums, finds a swelling on the right of the upper jaw, chills the teething ring in the fridge and takes a longer walk with the pram. On the note she writes: "Slept 20 min, biting everything, swollen upper right, ate half the porridge cold, calmer after the walk." Mum, who was in a meeting in the next room, had not had a chance to see it. By Thursday a white edge is showing. Our nannies who look after babies in their first year often notice teething before the parents, not because they are better, but because they are watching one child at a time. And next Tuesday she sees whether the tooth has come.
This text is general information and does not replace advice from BVC, your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
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Read more: Brushing children's teeth · Baby sleep from 0 to 6 months · A nanny for your baby · Frequently asked questions
Frequently asked questions
When does the first tooth come?
Usually between six and eight months, but anything between four and twelve months is common, and some children get their first tooth only after a year. The odd child is born with a tooth. It says nothing about the child's development otherwise, and there is nothing you can do to hurry it along. By three, most have all twenty milk teeth.
Does teething cause a fever?
A slightly raised temperature can occur in the days before a tooth breaks through, but a fever above 38 degrees, diarrhoea or vomiting is normally due to something else, often an infection that happens to arrive at the same time. Treat the baby as ill then, not as teething, and call 1177 if you are unsure or if the baby is under three months.
Can you give pain relief?
Ask BVC or 1177 before you give anything to a baby, and follow the dose for age and weight. For most babies a chilled teething ring, something cold to chew on and rubbing the gums with a clean finger is enough. Pain relief can be right for a baby who is not sleeping at all for several nights, but that is a decision you make together with a healthcare professional.
In what order do the teeth come?
Usually the two lower front teeth first, then the upper ones, then the teeth next to the front teeth. The first molars come around one year and the canines after that, the second molars last. The order varies, and a child who deviates is almost always perfectly healthy. By three, most children have all twenty milk teeth.
Are amber necklaces good for teething?
No. There is no proven effect, and a necklace on a baby is a strangulation and choking risk, both when the baby sleeps and when the beads come loose. Healthcare professionals advise against them. Cold, pressure on the gums and closeness do more, and they are free. The same goes for amber bracelets and anklets.