Signs of teething
Short of actually seeing a tooth poking through, and given that the process is different for every baby, some possible symptoms to watch for:
The need to gnaw
The pressure of an emerging tooth beneath the gums may be relieved by counterpressure, so teething babies often want to chomp on things. The chewing instinct may also be a response to the odd sensation that something's going on in there.
Before a new tooth erupts, it can cause a red, swollen and bruised-looking area on a baby's gums. Sometimes the gum bulges with the emerging tooth, which you can see faintly beneath the skin (if you can convince your baby to open his mouth for long enough).
Increased spittle can herald a new tooth—but it's also a normal developmental stage of infancy, so don't assume that drooling means teething. There's no way to tell whether your baby's saliva is the result of teething or not, though it may be if you also see...
Fussiness, especially at night
Tooth eruption—when the tooth moves through the bone and gum—tends to come in stages, with more activity at night than during the day, so your baby may be more irritable then.
While it can also be a sign of an ear infection, tugging can be a symptom of teething: The pain from the jaw gets transferred to the ear canal.
A change in eating habits
Babies who are eating solids may want to nurse or bottle-feed more because a spoon irritates their inflamed gums. Others may do the opposite, eating more than usual because the counterpressure feels good. And babies who are still on the bottle or breast may begin feeding eagerly but pull back because the activity of sucking puts uncomfortable pressure on the gums and ear canals.
Ways to soothe the pain
You may need to try a few methods to see what works best for your child:
A wet, frozen washcloth (leave one end dry so she can get a good grip)
The thick fabric feels good, and the icy cold numbs sore gums. A teething toy that's been chilled in the refrigerator also works, but frozen toys may be too harsh on an infant's sensitive gums.
If the tooth is still deep in the gum and hasn't formed a painful bruise, counterpressure or friction where it's about to erupt can work wonders. Try rubbing the area with your clean finger (bare or wrapped in a washcloth).
Acetaminophen and ibuprofen are good bets for temporary pain relief, as are topical oral anesthetics, as long as you don't exceed the recommended dosage.
Teething pain is like headache pain—it causes chronic, low-grade discomfort. You can often soothe your child simply by getting her mind off the pain. Give her more one-on-one time or offer her a new toy. And don't underestimate the healing power of touch: A little extra cuddling on the sofa may be all that's needed to take a child's mind off her mouth.