Got a teething toddler on your hands? Ouch for both of you. While teething is nothing new — by the end of their first year, most kids have experienced their share of teething pain — the arrival of her first molars and canines around the 13- to 19-month-mark can take the discomfort to a whole new level.
Thanks to their larger size and double edges, the 1-year and 2-year molars can be twice as difficult to cut as those baby incisors — and that usually means double the toddler teething pain. Luckily, there are plenty of ways you can help ease the aches.
When does toddler teething typically happen?
Baby teeth usually start appearing during the first year. The very first baby tooth can develop as soon as 4 months, while the last ones should grow in by the time your child is 3 years old.
While you can't predict just how many teeth your little one will have by the age of 1 or 2, the order in which your child's new pearly whites will appear is a bit more dependable. Your teething toddler will probably follow this timeline:
6 to 15 months
The upper and lower central incisors — the teeth in the middle of the mouth — usually appear between months 6 and 12, with the lower ones making their debut first. When that first tooth appears, it's time to start brushing. (It's also time to book that first dental appointment, which should happen by the time your little one turns 1, whether or not she has any teeth yet.)
Next, the lateral incisors — the teeth on either side of the center ones — should break through starting by month 9.
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The first toddler molars are the next to break through the gums, typically appearing early in the second year, though some tots may not start cutting those toddler molars until 18 or 19 months. And be prepared: Because of their (relatively) large size and double edges, toddler molars tend to hurt as they poke through the gums.
16 to 23 months
Here come your toddler's pointy fang teeth! The canines (also called the cuspids) are located between the lateral incisors and the first toddler molars. Usually, the upper canines turn up a few months before the lower ones do.
While teething ages can vary quite a bit, be sure to talk to your child's doctor if she doesn't have any toddler teeth by the time she's 16 to 18 months.
23 and 33 months
The second, or back, molars on the top and bottom can start popping up toward the end of the second year. Your teething toddler's last set of molars will probably be in by month 33, if not before, and by the age of 3, your child's grin will likely display a full set of 20 baby teeth.
When will those baby teeth fall out? Most kids lose their first baby tooth around the age of 6. The earlier the teeth come in, the earlier they may fall out — and vice versa. If your child doesn't get her first tooth by age 1, she may not lose any teeth until she's 7.
Toddler teething symptoms
There's a chance that your toddler will cut both sets of molars with little or no pain. Others, however, won't be so lucky. If that's the case for your little one, just know that toddler teething symptoms can mimic the same ones she experienced in infancy. Here are some of the most common toddler teething symptoms:
- Crankiness: Teething can turn even the most easy-going tots into fussbudgets. Cutting molars, in particular, can be especially tough on toddlers.
- Swollen, sensitive gums: As her teeth come in, you can expect your child to have some soreness and swelling in her gums. She may use her fingers to press or poke where the tooth is erupting.
- Ear pulling and cheek rubbing: Gums, ears and cheeks share the same nerve pathways, so it's not uncommon for tots to feel teething pain in the ears and cheeks, too. Still, this is one teething symptom that's sometimes mistaken for ear infection pain. One way to tell the difference? If the pain continues to worsen, she may have ear infection; if it comes and goes, it could signal teething. Call your doctor if you're not sure what's ailing her.
- Chewing: Is your toddler gnawing on everything in sight? That's because she's trying to ease the pressure on her gums.
- Disrupted sleep: Your child may have been blissfully sleeping through the night, but the pain from her erupting teeth can wake her out of her slumber and keep her from settling down again.
- Drooling: If your toddler's drool output has reached epic proportions, that's a sign that some of her teeth are ready to come in. And all that extra saliva can irritate the skin on her cheeks and chin, especially if she's always had sensitive skin.
- Refusing to eat: Teething pain can rob your toddler of her appetite for a few days — even if she's not usually a finicky eater (unlikely, but toddlers who aren't picky eaters do exist). Plus, sucking on a sippy cup or straw can worsen her gum pain, so don't be surprised if she's not in the mood for drinking milk.
When will my toddler get her 2-year molars?
The 2-year molars — located at the very back of the mouth — typically appear (not surprisingly) in the second year. The lower molars can come in first, starting at 23 months, though they may not appear until 31 months. The upper second molars usually develop anywhere from 25 months to 33 months.
Will my toddler also get 3-year molars and if so when?
By the time your tot is 3 years old, chances are, she'll have a full set of baby teeth. Still, every child is different, and some babies' teeth appear later or sooner than expected. If your child doesn't have molars by the age of 3, bring it up to your doctor.
What can you do for toddler teething relief?
Use these tried-and-true teething treatments to help your toddler feel better:
- Chill out. Offer soft, cold foods, such as chilled yogurt or applesauce. Or offer her some ice water in a cup with a lid. If she wants to sip from an open cup, skip the ice.
- Chomp on toys. If her teeth aren't big enough to bite through plastic, you can let your toddler gnaw on a chilled teething toy. (Steer clear of frozen ones though, since they can be hard on her mouth.) You can also give her a cold or chilled washcloth to chew on. Of course, always be aware of possible choking risks.
- Use meds. If your little one is very uncomfortable, ask your doctor if your child can have acetaminophen or ibuprofen. (The best choice will depend on your toddler's age and symptoms.) And be sure to confirm the dosage first.
- Give a massage. Use a finger brush to gently massage your child's gums right before a feeding.
- Stick to the schedule. If you change up your little one's bedtime routine to soothe a teething toddler, that can lead to more sleeping problems down the road.
Don't give your child any topical teething gels or liquids that contain benzocaine, a type of anesthetic found in many over-the-counter teething gels. The Food and Drug Administration warns that benzocaine can cause a rare-but-deadly condition called methemoglobinemia, which reduces the oxygen in the bloodstream to dangerously low levels.[1]
"Homeopathic" treatments — including teething gels, liquids and tablets — are also unsafe for infants and other children, in part because they could be made with an active ingredient that causes serious side effects.
Similarly, don't give your toddler amber, wood, marble or silicone teething necklaces, which can pose a strangulation and choking risk for babies and toddlers.
What should you do if your toddler is grinding her teeth?
Teeth grinding — also called bruxism — is common in toddlers, particularly if they're teething or are in pain.[2] Tots tend to grind their teeth in their sleep, which accounts for that "grating" sound you hear when they're in bed.
Luckily, most toddlers stop grinding before the age of 6, or about the time when their permanent teeth appear, so it's unlikely that any damage will come from the habit. If you're still concerned about toddler teeth grinding, talk to your child's dentist.
Brushing your toddler's teeth
Just because your toddler's baby teeth will fall out in a few years doesn't mean that you should skimp on tooth care. Baby teeth help kids speak clearly and chew their food, and they also help form the path for permanent teeth to follow, according to the American Academy of Pediatric Dentistry (AAPD).[3]
To clean your little one's teeth — starting as soon as the first one comes in — use a child-size, soft-bristled toothbrush and a smear of fluoride toothpaste (no more than the size of a grain of rice) once in the morning and once at night.
Set a timer for two minutes or sing a two-minute song with your little one to make sure you're brushing for the recommended amount of time.
Remember that children shouldn't swallow too much toothpaste. If she can't spit, have her tilt her head down, which will allow the toothpaste to dribble out of her mouth and into the sink or a cup.
Older children, such as those aged 3 to 6, can use about a pea-sized dab of fluoride toothpaste and brush their teeth themselves, if they're able to do so. The American Academy of Pediatrics (AAP) says that until kids are about 7 or 8, you'll need to help them brush their teeth.[4]
When should you take your toddler to the dentist?
Schedule your baby's first dentist appointment once she's sprouted her first tooth or by the time she's 1 year old, whichever comes first.[5]
Why the early start? As soon as your baby develops teeth, she can also develop cavities.
Another reason: You'll want to find a regular dentist so he or she can see your toddler if an accident occurs — say, a broken tooth or a tooth that's been knocked out completely.
At your first visit, your dentist — either a pediatric dentist or one that's good with children — can teach you more about oral hygiene in babies and toddlers and will also schedule your next appointment.
Some experts recommend regular six-month check-ups even when they're this young, but that can vary from child to child.
When to call the doctor about toddler teething
Chances are, toddler teething doesn't require a call or visit to the doctor (though it will require a lot of patience).
But if your tot develops a fever or seems especially uncomfortable, contact your pediatrician or pediatric dentist, who can help you find the right remedy for your child's teething pain.
And above all else, just hang in there. While you may be in for a few months of crankiness and night wakings, toddler teething will be over before you know it.
And after that, her tooth-related milestones will be more fun than frustrating — we're talking gap-toothed grins and the Tooth Fairy!
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