• Introduction* Teething is the term used to describe the eruption (emergence) of the baby teeth. When baby teeth erupt they have to push through the gum to come up into the mouth. Teething can cause pain, irritability, poor sleep and drooling.

• About* The first baby tooth usually erupts between 6 and 9 months of age, with the rest of the teeth following rapidly. By the age of 3 the average child will have twenty baby or "milk" teeth. Teething can be uncomfortable, particularly when a number of teeth are erupting at the same time. Signs that your baby may have teething pain include fussiness, crying, poor sleep, pulling or rubbing at the ear and dribbling. Babies may wish to chew on something hard during this process (e.g., rusks or a teething ring) as it seems to provide some comfort. Some teeth may cause more pain than others, and some babies are not troubled by teething at all. Teething does NOT cause high fever, diarrhoea, ear infections or other illness. If you are in any doubt, always contact your medical practitioner.

Ice cubes gently rubbed over the gum where the tooth is trying to emerge seems to provide some relief. Teething gels (which are topical anaesthetics) may provide temporary relief, but should never be used in excess as children tend to swallow a little of these gels.

As the teeth erupt, children often seem to make more saliva, and so tend to dribble. There is no harm in this as the saliva provides some decay protection for the teeth, although children will need to drink more to cope with the fluid loss. The fluid loss may be what makes children apparently more irritable and tired around this time. Some children may also develop a rash on their chin from constant dribbling. Regular application of zinc cream may help clear this up.

• Health care* As with all dental conditions your Dentist should be consulted. Your Dentist will diagnose and treat your child's particular problem. Ask your Dentist about how to brush and care for your child's teeth.

• Diet tips* . Fully seven months BEFORE baby is born, the first teeth begin to form in the gums. It follows that as baby is entirely dependent on the mother for nourishment, she should eat the kind of food which helps form sound teeth. From the earliest stage of development, baby needs calcium and phosphorus to form good teeth, as well as to form good bones. It is very important that the mother's meals should contain plenty of calcium and phosphorus. If they do not contain these essential elements, a vitamin supplement should be considered.

• Supp notes* In early childhood, as the first few teeth are erupting children often begin to acquire the usual childhood infections. One infection which may be significant is due to the herpes simplex virus. This virus is the cause of cold sores and is very common. Most children get exposed to this virus (from kissing, sharing spoons etc.) around the time of teething. In some children there is a strong reaction which results in pain, excess saliva and swelling and redness in the gums. This condition is called primary herpetic gingivostomatitis. Because this problem is due to a virus, there is very little that can be done as treatment (antibiotics don't work against viruses) other than to wait till the body heals itself (usually about 7-10 days). During this period children will often not wish to eat, due to pain. It is very important to ensure your child drinks enough fluids, as children can very quickly dehydrate. You should see your medical practitioner if you think your child is suffering this condition.