First teeth

Illustration: Bertrand Lachance


Essential information to rememberDon’t immediately assume that your baby’s fever, diarrhea, and red bottom are related to teething. They may be caused by something else.

Your baby’s teeth start to form during pregnancy. At birth, she has 20 baby teeth, or primary teeth, that are still growing under the gums. Young children’s diet influences the formation of their baby teeth as well as their permanent teeth.

Baby teeth generally appear around 6 months. But they can come in earlier or later, even as late as 12 months. The lower front teeth usually break through first.

Teething may go unnoticed or may cause discomfort. Starting at 4 months, it’s normal for your baby to drool a lot. When she’s teething, she may drool more and feel the need to chew on something.

Your baby may also have red cheeks or irritated skin around the mouth or on the face, she may fret more than usual or refuse to eat. When their molars (back teeth) come in, some babies touch their ears more because they’re feeling pain in that area. If your child’s discomfort seems serious, contact Info-Santé.

In some babies a blue swelling (also known as an eruption cyst) appears on the gum just before the tooth comes in. This cyst usually needs no treatment. If necessary, talk to your health professional.

Fever, diarrhea, and a red bottom are not necessarily related to teething. They may be caused by something else.

What to do during teething?

If necessary, give your baby a clean washcloth soaked in cold water or a teething ring to chew. You can cool the teething ring in the refrigerator, but don’t freeze it because your baby can injure her mouth with it. You can also rub her gums with a clean finger. Give her acetaminophen, if needed.

Various products are available to relieve the discomfort of teething. They have not been shown to be effective and can be dangerous:

Information to which you should pay special attentionTeething necklaces are a strangulation and choking hazard for babies.

  • Teething necklaces: Babies can choke on the wooden beads or other parts of a teething necklace, or can strangle themselves with it.
  • Teething syrups and gels: They act superficially only and can decrease the swallowing reflex that allows your baby to swallow her milk and food. These products increase the risk of choking.
  • Teething biscuits: They do not relieve your baby’s discomfort. What’s more, they contain sugar and can therefore cause tooth decay.

Don’t give your baby pieces of raw fruit or vegetables to chew. They can get stuck in her throat and choke her.


Essential information to rememberAs soon as the first teeth appear, brush them twice a day. The evening brushing is the most important.

Photo: Anne-Marie Turgeon

The purpose of brushing is to put fluoride toothpaste on your baby’s teeth and clean them as well as possible.

As soon as the first teeth appear, brush them twice a day. The evening brushing is the most important because there is less saliva in your baby’s mouth when she’s sleeping. So tooth decay can progress more easily if the teeth are not brushed.

If your child wants to brush her teeth herself, encourage her, and then do a final brushing. Since children love to imitate, you can also brush your teeth at the same time.

Tooth brush

  • Use a children’s toothbrush with soft bristles. Change it as soon as the bristles start to bend.
  • Rinse the toothbrush after every use.
  • Let it air dry upright. Do not put a cap on it.
  • To prevent spreading germs, make sure it doesn’t touch other toothbrushes.
  • Your child should have her own toothbrush and should not share it with anyone.


Essential information to rememberUse only a small amount of fluoride toothpaste, about the size of a grain of rice.

As soon as you start brushing your child’s teeth, you can use the toothpaste of your choice as long as it

  • Contains fluoride (a natural substance that effectively protects teeth against decay)
  • Is recommended for children under 12

Since children tend to swallow toothpaste, use only a very small amount, about the size of a grain of rice.

To prevent children from consuming too much toothpaste, store it out of their reach.

Beware of sugar

The more your child’s teeth are in contact with sugar, the more your child risks developing tooth decay. Beware, sugar is often added to drinks, food, and drugs for children. Sugars also naturally occur in fruits, juices and milk (e.g., breast milk, commercial infant formula and cow’s milk).

Baby bottle – Prolonged contact between your child’s teeth and her bottle containing milk or sweet liquids can cause tooth decay.

Don’t let your baby drink from or suck on her bottle for long periods of time. Don’t let her sleep with or carry around a bottle or sippy cup containing juice or any other liquid except water.

If your baby has gotten into one of these habits, gradually dilute the fluid with water until it contains nothing else. To reduce the risk of tooth decay, it’s best to wean her off the bottle when she’s about a year old.

Pacifier – Don’t dip your baby’s pacifier in honey, corn syrup, or any other sweet product.

Tooth decay

Tooth decay can occur when your child is small, even before age 2. Once it appears, it can quickly get worse. The decay is caused by bacteria producing acid that attacks the structure of the tooth. It can be painful and may interfere with your child’s sleep or feeding.

If you see dull white, yellowish, or brownish stains near your child’s gums, it is advisable to see the dental hygienist. It could be the start of tooth decay. It’s important for the health of young children to have tooth decay treated, even though they will eventually lose their baby teeth.

Régie de l’assurance maladie du Québec covers the cost of dental exams and some treatments for children under 10.