Pediatric Associates of Richmond

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Teething

First Tooth

Most children have their first tooth at 6-9 months old. Occasionally, a first tooth may break through as early as 3-4 months old. Some children do not have their first tooth until they are 1 year old.

Drooling

Most babies start drooling and putting their hands in their mouths at 3-4 months old as their gums become sensitive. Babies also put their hands in their mouths at 3-4 months old because this is a new developmental skill they acquire and enjoy exploring the environment with their sense of taste.

Pain, Fussiness and Fever

With teething many children are fussy and may not eat much, especially solids.

The nerves that control sensation to the gums run along the jaw lines, meet up in front of the ears and dive into the brain just behind and under the ears. As the nerve signals are being transmitted from the gums to the brain it is common for children to get ‘referred pain’ or sensation to the ears when they are teething. This often manifests itself by digging in, scratching or pulling at the ears.

Fever over 101°F should not be attributed to just teething.

Comforting a Teething Infant or Toddler

You can help your child with teething by giving acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) for the discomfort. Refer to the charts below to find the dose that is appropriate for your child’s weight. Also, cold things to suck on are helpful, such as cold pacifiers, a cold spoon, popsicles or cold juices. Another option is gently massaging the gums with your finger.

Ibuprofen is only safe for children 6 months of age and older.

If your teething child is having uncharacteristic nighttime awakenings, you may give acetaminophen or ibuprofen prior to bedtime.

We do not recommend benzocaine-containing teething gels/drops/liquids, which include but are not limited to Anbesol, Hurricaine, Orajel, Baby Orajel, and Orabase, due to the risk noted by the FDA for a rare but sometimes fatal condition called methemoglobinemia.

 

Weight Age* Acetaminophen Infant/Children’s Oral Suspension 160mg/5ml
Acetaminophen Children’s suspension 160mg/5ml Acetaminophen Children’s Meltaways 80mg/tablet Acetaminophen Junior Meltaways 160mg/tablet
6-11 lbs 0-3 mo 1.25 ml (40mg)   n/a   n/a   n/a
12-17 lbs 4-11 mo 2.5 ml (80mg) 2.5 ml   n/a   n/a
18-23 lbs 12-23 mo 3.75ml
(120mg)
3.75 ml   n/a   n/a
24-35 lbs 2-3 yrs 5.0 ml
(160mg)
5 ml 2 tablets   n/a
36-47 lbs 4-5 yrs  n/a 7.5 ml 3 tablets   n/a
48-59 lbs 6-8 yrs   n/a 10 ml 4 tablets 2 tablets
60-71 lbs 9-10 yrs   n/a 12.5 ml 5 tablets 2½ tablets
72-95 lbs 11 yrs   n/a 15 ml 6 tablets 3 tablets
96 lbs and over 12 yrs   n/a   n/a   n/a 4 tablets

*use only when wt not available

Weight Age* Ibuprofen Infant Drops 50mg/1.25ml Ibuprofen Children’s Suspension 100mg/5ml Ibuprofen Junior Strength Chewable Tablets 100mg/tab Ibuprofen Junior Strength Tablets 100mg/tab (swallow)
6-11 lbs 0-3 mo   n/a   n/a   n/a   n/a
12-17 lbs 6-11 mo 1.25 ml  2.5 ml   n/a   n/a
18-23 lbs 12-23 mo 1.875 ml  3.75 ml   n/a   n/a
24-35 lbs 2-3 yrs   n/a 5 ml   n/a   n/a
36-47 lbs 4-5 yrs   n/a 7.5 ml   n/a   n/a
48-59 lbs 6-8 yrs   n/a 10 ml 2 tablets 2 caplets
60-71 lbs 9-10 yrs   n/a 12.5 ml 2½ tablets 2½ caplets
72-95 lbs 11 yrs   n/a 15 ml 3 tablets 3 caplets
96 lbs and over 12 yrs   n/a   n/a   4 tablets   4 caplets

*use only when wt not available