If your baby or toddler has disrupted sleep, you may be tempted to blame teething, and you may be right.
There’s no question that for some babies, teething involves discomfort. But it may not be the huge sleep wrecker that parents assume it to be – and many of the common symptoms parents blame on teething may have nothing to do with those emerging pearly whites.
Here’s how to determine if teething is the real culprit or if there are other causes for your baby’s sleepless nights.
The Teething Timeline
Most babies begin teething between four and eight months of age, but order and timing are variable. Genetics and gender play a role in teething – early teething parents tend to have early teething children, and girls tend to teethe earlier than boys. Teeth usually emerge in pairs on the left and right sides of the mouth, starting with the two bottom front teeth and proceeding from front to back, alternating between lower and upper jaws. Most children get four new teeth every four months and have all 20 of their baby teeth – ten on top and ten on the bottom – by the time they’re 2 ½ to 3 years of age.
There’s a common misconception that teeth actually “cut” through the gums as they emerge, but teeth don’t pierce or puncture the flesh. Gums move out of the way and create a pathway for new teeth as they push up, so there’s no bleeding.
Teething Symptoms
Studies have yet to find a causal relationship between any specific cluster of symptoms and the emergence of teeth. Symptoms like drooling, gum rubbing, fussiness, decreased appetite for solids, mild temperature increases, and wakefulness can sometimes be associated with the eruption of teeth. Still, congestion, high fever, loose stools, cough, body rashes, and decreased interest in liquids are not.
Studies suggest that if teething-related symptoms are truly related to an emerging tooth, they will only appear for a few days before the tooth’s eruption and afterward. That means that if your child has symptoms for more than a few days and a tooth doesn’t appear, it’s unlikely that teething is the problem.
Teething and Sleep
Of course, if your child is clearly bothered, you’ll want to do whatever it takes to comfort them and help them get the rest they need. Offer cool teething rings and avoid choking hazards like frozen bagels and teething necklaces. Check with your pediatrician before giving your child over-the-counter pain medications, and call them if your child develops a fever or exhibits other symptoms of illness that could be unrelated to the teething.
If you’re not sure, start by assessing their daytime behavior. If your baby is behaving normally during the day, even if they’re drooling like a faucet or chewing everything in sight, it’s unlikely that teething is suddenly an issue at night. If you need more convincing, look for red, swollen gums or the tip of a tooth. If you don’t see anything but are still not convinced, use the pick-up test. If your child stops crying when you lift them out of the crib, they’re probably not in discomfort or pain.
Looking for changes in sleep patterns can also help you determine if teething is to blame for your child’s wake-ups—discomfort and pain cause wake-ups at unusual times. Think about your child’s typical sleep patterns and compare them to what’s going on now. Does your child typically sleep for three hours at a stretch but suddenly wake up every 20 minutes? If so, teething may be disrupting their sleep.
If, on the other hand, your child has ingrained sleep associations like rocking or nursing to sleep and is waking up at the same predictable times or the same time frames (for example, every 60 to 90 minutes), you may be blaming teething when it’s the sleep association that’s waking them up. If the disruption lasts for more than three or four days, you can bet that that’s the case, and you may want to work on gently teaching your child to learn how to put themselves to sleep and back to sleep without your help.
