Ask: How to ease the pain of teething

Posted by Dr. Brian Eichner on December 17, 2013 

Q. My daughter is teething and is really, really fussy about it. What can I do to ease her pain (and mine!)?

A. As much as most parents look forward to being able to advance their child’s diet (for which teeth are necessary), parents have at least an equivalent quantity of angst about teething. It is painful, interferes with sleep and behavior (child and parent) and occurs at an age when language and reasoning skills are minimal, leaving parents to guess when it’s occurring and how to help their child. 

Symptoms of teething are very variable, but often include increased drooling, fussiness and mouthing of objects, in addition to low-grade fever and loose bowel movements. To ease discomfort associated with teething, different strategies work for different children, and for a given child may even vary from one episode to another.

The simplest intervention is offering a cold object for your child to put in her mouth. This is dependent on your daughter being developmentally advanced enough to place objects in her mouth. Teething toys, stored in the freezer, can be very effective for many young children. Alternatively, a slightly wet washcloth that’s been permitted to sit in the freezer is a more cost-effective option (although less visually appealing to a child). It is important that teething rings and toys be age-appropriate, meaning that they are only one piece to avoid the risk of choking.

Many children also do well with pain medication, such as ibuprofen (i.e., Motrin) or acetaminophen (i.e., Tylenol). You should check with your pediatrician for dosage and safety information, but both are safe if used properly (note that ibuprofen can only be used in infants older than six months).

In children under two years old, it is wise to avoid using topical pain relief medications that have benzocaine as an active ingredient, such as Orajel. If swallowed, benzocaine can be absorbed and can lead to a dangerous blood condition (methemoglobinemia). Also, please avoid placing sweeteners, such as sucrose, on pacifiers or other objects, as this can contribute to cavities and other dental problems (the last thing you should have to worry about when the teeth are first coming in!). 

The good news: teething pain will end as quickly as it started … until the next round of teeth.

If you have a question about your child's health or happiness, ask Dr. Eichner or any of our experts by sending email to mom2mom@newsobserver.com.


Brian Eichner is a general pediatrician and assistant professor of pediatrics at Duke Children's Primary Care-Roxboro Street in Durham. He enjoys providing care for children who are healthy as well as those with complex medical conditions. Dr. Eichner also serves as the medical director of the Duke Pediatric Diagnostic Clinic. He and his wife have lived in the Triangle since 2006.

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