First Tooth

Hi Lisa,

I am writing to you to ask you if it is normal for a one month old baby to have teeth coming in? It hasn't broken in yet but I just wanted to know if that is normal.

Well Thank you.

“momsbadgirl”

Dear “momsbadgirl”,

The onset of teething varies from child to child. The duration of teething and amount of pain experienced is also different for each child. The average age for the first tooth eruption is between 6 and 8 months old. (1) This does not mean that it is not normal for a child to “break a tooth” as early as one month old or as late as a year old. The onset of teething often follows heredity patterns. Therefore, if the mother or father was an early teether, then the child may follow the same pattern.(1)

In general, an “early teether” experiences her first tooth eruption at 4 months old. A “late teether” may not develop her first tooth until after she turns one year old.(1) The lower central incisors (bottom middle teeth) are usually the first teeth to come in, followed by the four upper incisors. Next the first four molars usually erupt. The second molars typically do not erupt until after the age of two. Between the ages of 2 and 3 years old a child is expected to have 20 teeth.

Signs of teething typically begin a month or more before the tooth actually erupts. The signs of teething include; drooling, waking at night, bulging gums, bleeding gums, fussiness, irritability, putting objects or fists in the mouth, biting and gnawing.(1) Just before a tooth is about to erupt other symptoms may develop such as a diaper rash, diarrhea, low grade fever and cough. (1)
Some people are under the impression that a high fever is a sign of teething. There is no research or data that supports this notion.(1)

A high fever in a baby that is teething is more likely due to an infection such as a virus. Children who are teething frequently develop viruses.(1) The frequent mouthing of various items such as their hands or teething rings may be responsible for transmitting the germs to the child that cause the infection.

So you do not have to be concerned if your child “breaks a tooth” at one month old. The only challenge of an early teether is keeping the teeth clean. It can be quite difficult to open a young infant's mouth and maneuver your fingers in order to properly clean the teeth. Once the first tooth erupts, it is recommended that it should be cleaned on a daily basis.

The way to clean a young infant’s teeth is to wet a clean wash cloth or piece of gauze and gently rub the teeth each night before bedtime. (1) Using a soft bristle toothbrush and water is another alternative. The American Academy of Pediatric Dentistry does not recommend using toothpaste with fluoride until a child is 2 or 3 years old.

On many occasions parents have informed me that they believed their infant was teething because they saw something white on their child’s gums. In many of these cases a coating of milk or a plaque of oral thrush were mistaken for a tooth. So I would not be surprised if the white you are seeing is something else besides teething. If you are not sure, an examination by your Doctor or Nurse Practitioner will be able to tell you if your child is teething or not.

It is a challenge for many parents to figure out if their child is teething. One major clue is, in many cases teething is accompanied by other symptoms such as drooling or waking at night. Therefore looking for other signs of teething may be helpful. It is true that some children can "break a tooth" and show little or no symptoms at all.(1) From my experience, “early teethers” tend to have additional symptoms such as drooling, gnawing or irritability.

I hope this information helps. I wish you good luck with your new baby.

If you are interested in reading other Pediatric Advice Stories covering topics discussed:

Infant Drooling

Caring for Infant's Teeth

Oral Thrush

References:
(1)Grassia T. Talking teething: Start god oral hygiene early. Infectious Diseases in Children. 2006. August:44.


Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice About Infant Care