When can you give your baby a teether?

A teether is fine to offer as soon as your baby can hold something and bring it to her mouth, usually around 3 to 4 months. The first tooth normally arrives at about 6 months. Chill a one-piece silicone or solid rubber teether in the fridge, never the freezer, and skip numbing gels, teething powders and anything worn around her neck.

Behind the teether question sits a harder one: is this teething at all?

When to start offering one

There is no minimum age printed anywhere, because the limit is her coordination. At around 3 to 4 months she starts reaching for things and taking them to her mouth on purpose, and from then a teether is a toy she can use.

This mouthing stage comes before the teeth do. It is how babies explore, and it is part of normal development.

Teething itself makes the chewing more determined. She will bite harder, on firmer things, and may favour one side.

When teeth actually arrive

The NHS puts the first tooth at around 6 months, with a wide normal range. Some babies start before 4 months, some after their first birthday, and a few are born with one already through.

The usual order:

Most children have all 20 milk teeth by about two and a half to three years. No teeth at all by the first birthday is worth mentioning at your klinik kesihatan visit, and is very often just late.

How do you tell teething from illness?

Likely teething. Drooling, chewing everything, a red or swollen patch of gum, a flushed cheek on one side, crankiness, broken sleep, and feeds that start and stop.

Not teething. A fever of 38°C or more. Diarrhoea. A rash over the body. Vomiting. Being floppy or unusually sleepy. The American Academy of Pediatrics is clear that teething does not cause high fever or diarrhoea.

That difference matters a lot in Malaysia. Hand, foot and mouth disease spreads through nurseries and taska, and it starts with a drooly, miserable baby who will not eat, which looks just like teething until the mouth ulcers and spots appear. Dengue can start as a high fever and nothing else.

So a baby with a temperature needs to be seen by a doctor. Do not put it down to teething. If your baby is under 3 months with any fever, or is floppy, hard to wake or struggling to breathe, get help straight away and call 999 in an emergency.

Which teethers to choose

One solid piece. Silicone or firm rubber, with nothing that can come off.

Too big to fit in whole. Wider than her mouth.

No liquid inside. Liquid-filled teethers can split, and in our humidity anything with a hollow inside can grow mould you cannot see.

Nothing around the neck. A clip to her clothes is fine. A cord around her neck is not.

Easy to wash. Boilable or dishwasher-safe, because you will clean it several times a day.

Textured silicone and solid wooden teethers both work. Wooden ones need drying properly after washing, which takes longer than you expect in this climate.

Chilled, never frozen

Cold dulls the soreness and helps with swelling, and it is one of the simplest things you can do for sore gums.

Put the teether in the fridge, not the freezer. A frozen teether gets hard enough to bruise the gums, and the American Academy of Pediatrics advises against it for that reason.

Other options that work:

• A clean, damp face cloth, chilled and offered to chew
• Firm pressure on the gum from your clean finger
• A chilled spoon
• Cool water from a cup, once she is drinking water
• Chilled cucumber or melon in a mesh feeder, once she has started solids, with you watching the whole time

For a baby over 2 months, infant paracetamol at the right dose for her weight is reasonable for a bad night. A pharmacist or your klinik kesihatan will confirm the dose.

Our article on teething in babies has more ways to soothe sore gums, and if you are breastfeeding, breastfeeding a teething baby helps with biting.

What to keep away from her

Teething jewellery. The US FDA has warned against amber and other teething necklaces and bracelets because of choking and strangulation, including deaths. There is no evidence amber eases anything.

Benzocaine and lidocaine gels. The FDA has warned against both for teething in young children. Benzocaine can cause methaemoglobinaemia, a rare condition that reduces the blood's ability to carry oxygen. These gels are still sold in some places.

Homeopathic and herbal teething tablets, powders and gels. The FDA has acted on homeopathic products found to contain varying amounts of belladonna. Ask a pharmacist before using anything you are unsure about.

Oils and balms with camphor or menthol, rubbed on the gums or under the nose. They are common in many homes and not suitable for babies.

Honey on a teether or dummy. Never give honey to a baby under 1, because of the risk of botulism.

Anything with liquid, batteries, glitter or small parts.

Keeping teethers clean in this weather

A teether goes from a baby's mouth to the floor to a bag and back. Humidity makes that worse, because anything left damp starts to grow something.

• Wash with soap and hot water after each use, and dry it fully
• Boil or sterilise silicone ones every few days
• Dry wooden ones standing up, out of a closed bag
• Throw away anything cracked, split or sticky
• Keep a second one in rotation so one is always dry

Once the first tooth is through

Start brushing that day, twice a day. KKM and most dental bodies recommend a smear of fluoride toothpaste the size of a grain of rice from the first tooth, with you holding the brush. A baby who cannot spit will swallow some, which is why the amount is so small.

If you prefer a fluoride-free paste for a baby who swallows most of it, choose one made for babies. Our Baby & Kids Toothpaste is for babies from 6 months, with hydroxyapatite and xylitol and no fluoride, sulfates or colourants, in strawberry, orange and bubble gum. It cleans teeth and gums and helps remove plaque, and in a Mama's Choice use test with 28 mothers in Indonesia (2022), 93% agreed their child's teeth and gums felt cleaner. It is halal certified by BPJPH, Indonesia. If your child has had decay or your dentist advises fluoride, follow their advice.

From 12 months, our Baby Silicone Toothbrush gives her a soft brush of her own, with a shield that stops it going too far into the mouth and a suction base so it stands up to dry. You can clean it with hot water or steam.

Milk or juice in a bottle at bedtime pools sugar against the new top front teeth, where early decay often shows first. Finish the feed, brush, then bed.

Her first dental visit belongs around the first birthday, or when the first tooth appears if that is sooner. Government dental clinics see babies that young, and your klinik kesihatan can refer you. Our guide to choosing a kids toothpaste covers the fluoride question in full, and cavities in toddlers explains what early decay looks like.