What you need to know about your kid's first molars

Thought you were done with teething? Sadly, no. Somewhere between your child’s first and third birthdays, eight molars will be breaking through. And if a sharp little incisor made your baby miserable, just think what a big square molar can do!

Molar teething symptoms

Some children do sail through teething with very little trouble. For others, it’s a few days of drooling, irritability and perhaps picky eating (it may feel good to bite down on the sore places, or it may hurt and put them off eating).

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At the other end are the children who really suffer. They may cry off and on through the day because of the pain, and have a broken, miserable sleep at night.

If your child will let you touch his mouth, you may be able to confirm that the molars are about to break through by feeling the swollen bumps in his gum, says Peter Nieman, a Calgary paediatrician.

Remedies for molar teething pain

Nieman says chewing a cold teething ring or washcloth can help by easing the inflammation. For the same reason, he says ibuprofen (Children’s Motrin) is more effective than acetaminophen—both relieve pain and fever, but “ibuprofen has better anti-inflammatory properties.” It’s important not to exceed the recommended dosage, and some children will only need painkillers at night, to help everyone sleep.

Are homeopathic teething remedies safe?

The FDA has advised parents stop using homeopathic teething gels and tablets after multiple incidents where  babies and toddlers had seizures after taking them.

Does teething ever cause fever or loose stools?

In Nieman’s experience, it sometimes can, though there are health professionals who disagree. “I think we all agree that it’s important that parents don’t assume a fever or diarrhea is caused by teething,” he says. “They may then miss an important diagnosis like middle ear infection or meningitis” (see When to See a Doctor below).

Erin Ripley saw it all with her 15-month-old son, Cameron. He had a low fever and a bout of diarrhea. “Then, that day, he threw his head back and started crying and sure enough—there they were! After his teeth broke through, he was a bit fussy for about a day and a half.”

Ripley says she is just thankful that Cameron’s twin brother, Cael, didn’t get his molars at the same time. Tandem teething—that’s not a pretty prospect.

When to see a doctor

A slight fever or mildly loose stools, accompanied by drooly, tender gums, is probably straightforward teething. But a baby can be teething and sick, so watch for these signs that something more serious may be going on:

• Pain medication doesn’t bring relief
• The fever is high, over 40ºC, or cannot be controlled with medication
• The child seems to be in severe pain, or is extremely irritable or lethargic
• Symptoms last for more than two or three days
• Diarrhea is very watery or contains blood
• The child is vomiting

Read more: How to tell the difference between a teething baby and a sick baby How to brush your toddler's teeth when she's not into it Teething symptoms and solutions for your baby