Teething symptoms and why it hurts

The old term “cutting teeth” is not accurate. Rather than “erupting,” teeth twist and shift as they make their way up from under the gum line. Don’t freak out if they show up looking crooked, or spaced far apart. Expect them to continue to shift a bit.

Teeth usually emerge in a fairly predictable pattern and in pairs, with lowers preceding uppers: First the two bottom front teeth (called the “central incisors”), and about four to eight weeks later the four top front teeth (the “central incisors” and the “lateral incisors”) emerge. About a month after that emerge the lower incisors. [see chart]. Again, some babies follow a different timeline, getting teeth more or less frequently.

Teething chart

The first four teeth are flat and sharp, and typically don’t cause as much pain as the later teeth. But this is Baby’s first experience with this type of discomfort. (And remember, some babies breeze through a full mouthful of teeth with barely a whimper.) Some say the most painful teeth to come in are the canines (the pointy ones), because of their large surface area.

Most babies have their first four teeth by eight or nine months, and by their first birthday are working on the four molars farthest back in the mouth. These molars, like the canines, can be more painful because of their sheer size, and there is often swelling or even a blister, which Dr. Sears in The Baby Book explains is a collection of blood beneath the blood tissue best treated by cold compresses. Thankfully, by this age Baby is often so “busy” and on-the-go they may cause him or her less trouble than you might expect. (That’s what happened with my son.) The canine teeth come along between 18 and 24 months, and the two-year molars show up between 24 and 30 months.

Expect Baby to react accordingly when two or even three or more teeth decide to erupt at once.

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