Teething in the second year

When will my toddler’s next teeth appear?

Your toddler probably already has his front eight incisors. The next teeth to cut through are likely to be:

• his first molars between 12 months and 16 months
• his canines between 16 months and 20 months
• his second molars between 20 months and two and a half years
  (NHS 2014a)

What are the signs that my toddler is teething?

When a tooth is about to emerge, your toddler's cheek on the affected side may become hot and red. Teething won’t make your toddler ill, but it may be painful enough to make him miserable and irritable.

Other signs and symptoms that your toddler may be teething include:

• biting or sucking more than usual
• rubbing or pulling on his ears
• drooling and a drooling rash
• difficulty sleeping
  (CKS 2014)

It's possible that your toddler will have a mild fever (under 38 degrees). If his temperature is higher than this, seek advice from your GP to rule out any illness (CKS 2014).

An erupting tooth may cause pain for up to five days before it actually appears (CKS 2014). Your toddler's first molars and second molars will probably cause him the most discomfort. This is because they are big and blunt, so they’ll be slow to push through (Mersch 2014). In comparison, his canines should be a little easier.

If your toddler relies on sucking his thumb or a dummy to fall asleep, he may have a particularly difficult time settling. It may hurt when he sucks his thumb or dummy and it may continue to be painful, even after he has stopped.

Breastfeeding or bottle-feeding may also make your toddler’s gums hurt. Let him suck for as long as he feels it’s worthwhile, but offer drinks from a cup as well, so he gets enough to drink.

How can I help to ease my toddler's teething pain?

Give your toddler something cold to bite on to comfort and distract him. Gel-filled teething rings may not withstand toddler teeth, and may leak or cause a choking hazard (Bhavneet 2012). Try a raw carrot or stick of celery that has been cooled in the fridge, (CKS 2014, NCT nd)or even just a wet flannel (NHS 2014b).

Children's teething gel is not recommended, though. This is because there's not enough evidence that they work, and there have been cases of adverse side effects when using these treatments (NICE 2014). However, simply rubbing your toddler's affected gum with a clean finger may help (NCT nd).

If all else fails, and your toddler is in real distress, you can give him a dose of sugar-free infant paracetamol or ibuprofen. This will relieve his pain and reduce inflammation (NHS 2014b, NCT nd, CKS 2014). Always check the instructions on the packet, or ask your doctor or pharmacist about how much to give your toddler.

Can teething make my toddler ill?

Teething may cause discomfort, but it won't make your toddler ill. If your toddler has diarrhoea or a high temperature, teething is unlikely to be the cause (CKS 2014, NHS 2014a, Ramos-Jorge et al 2011).

If you think your toddler may be ill, or if he has additional symptoms that aren't normally associated with teething, take him to see your GP (NHS 2014a).

Learn more about easing the distress of toddler teething.