Children are technically teething until around age 12. By the time they’ve gotten all their baby teeth in around age 3, they start losing them around age 6 and then continue to lose baby teeth and gain adult teeth until around age 12. Then in their late teens to their early twenties they potentially “teethe” again when their wisdom teeth start to come in.
In the early years, when our babies can’t communicate clearly with us, teeth get blamed for a lot of things - fevers, diarrhea, crankiness, lack of sleep - and though teething can play a factor in some of those things, I’d venture to say that it has less to do with them than we realize.
Let’s focus on how teething affects your child’s sleep.
(Disclaimer: I’m not a dentist or medical professional. The information provided here is not to be taken as medical advice or prescriptive. As always, if you have specific concerns about your child’s health or wellbeing, please seek out counsel from their pediatrician.)
Is teething painful enough to cause sleep disturbances?
Many doctors agree that even for the most sensitive babies, teething does not cause excruciating pain. If that were the case, from the age of roughly 6 months old to roughly 3 years old, they’d be miserable.
But, since the feeling of pain is subjective, varying from person to person, we can’t make the blanket statement that “teething never causes sleep disturbances.”
But, we can say that teething does not cause long-lasting sleep disturbances.
Pain associated with teething - whether mild or extreme - is only present within the few days before and after the tooth emerges from the gums. (And the tooth does just emerge by slowly pushing its way through the membrane; it does not literally “cut” through it.)
If you are noticing long-lasting sleep disturbances and feel it’s due to teething, there's something else going on.
Are we woken up by pain?
Most tend to believe that once we fall asleep we are to stay asleep and only wake up in the morning. But, it’s not so clear-cut.
What most think a night of sleep looks like:
What it actually looks like:
It’s normal for us to have brief wakings in the night, passing from one sleep cycle to another. If the body feels pain during those brief wakings, it may become aware of the pain and have a harder time getting back to sleep. And, if your little one used your assistance to get to sleep at bedtime, they’ll most likely need it or expect it again for each waking in the night.
How to ease the pain and improve sleep during teething
This isn’t to say teething pain isn’t real! Here are a few ways to ease that pain:
Cold (not frozen), damp washcloths
Gum massage: with clean fingers, gently rubbing your baby's gums can help ease their discomfort. (But massage with caution once those teeth start coming in 😅)
Medication: talk to your child’s pediatrician if you believe they need more than what these other remedies can help. But, use medication sparingly.
What not to use/do for your teething babe:
Rubbing whisky or other alcohol on their gums
Amber necklaces or bracelets: these pose a strangulation risk without scientific evidence of actually helping relieve pain.
Sleep & Teething
Interestingly, the lack of sleep has been shown to increase the experience of pain (because pain receptors are intensified and natural pain-relieving areas of the brain are blocked with sleep deprivation) and, conversely, improved sleep decreases the experience of pain.
Surely this is why many parents of independent sleepers say their babies will “cut teeth” in the night and they never hear a peep - their babes sleep right through it and wake up happy.
Since sleep is a natural analgesic (and has many other benefits), we want to encourage great sleep even with pain.
Here are a few ways to do that:
1. Routine and good sleep hygiene
There is so much power in routine, especially for children that have little control of their environment or concept of time.
Having a nap time and bedtime routine done at the same time before sleep, done in the same order every time, allows your child and their body to know what to expect - sleep.
Extending their routine slightly for extra snuggles (without any drowsiness) and more time to chew on a cool, damp washcloth or teether before sleep can help ease any pain they may be feeling - but no washcloths, teethers, or toys in the crib.
Sleep hygiene is doing things throughout the day that promotes sleep. So, the routine is done right before sleep times and sleep hygiene is done all the time.
Here are 5 things to consider for healthy sleep hygiene:
For children consuming more than just breastmilk or formula, be sure they aren’t consuming heavy, fatty, sugary foods or caffeine too often and especially within 4 hours before bed.
Even for the newborn, it’s important to give them opportunities to move their bodies unhindered. No expensive equipment is needed - a blanket on the floor or in a pack-n-play do just fine!
For older babies and children, provide them with a “yes” space in the house and outside to explore, move freely, and be loud. (A “yes” space, as Janet Lansbury calls it, is where there are nearly zero things you would be telling them “no” about - it’s all a “yes”.)
Increase their exposure to the sunlight during the day, decrease the amount of light exposure in the evening and have total darkness throughout the night and naps. (A table lamp is good to use for night feedings, just preferably not an overhead light.)
The greater the contrast between light and dark from day to night encourages greater production of melatonin, a hormone that promotes sleep.
4. White noise
Providing a cool environment has been shown to promote sleep. Our body temperature, along with our wake-sleep cycle, follows a circadian rhythm and at night our core temperature drops 2-3 degrees. Taking a warm bath before bed can help stimulate this process, too.
2. Associate “bed/crib” with “sleep”
Though there are a few times I do recommend having your baby hang out in their crib outside of their sleep times (like when they’re learning to roll, pull up, crawl, etc. and get frustrated when those happen during sleep times), overall we want their crib or bed to be associated with sleep. This helps establish a sleep association with their bed, making it easier for them to fall asleep in it.
3. Have Baby fall asleep independently and practice “The Pause” for awakening
Having your baby fall asleep independently (not necessarily alone) allows them to use what they'll always have readily available to get back to sleep during their brief awakenings between sleep cycles - themselves.
And for those awakenings, I know it sounds like the best thing to do as a parent to quickly attend to every cry of our child, but, hear me out:
Not every peep, moan, or cry needs a response from us.
Not every noise a child makes is a cry for help.
Yes, babies, especially newborns, need quick responsiveness far more often than adults or even older babies and children, but even still, they’re human and noisy ones at that.
Think about it: How often do we make noises, moans, grunts, sighs to simply release some tension or get comfortable? Could you imagine someone rushing to your aid every time you made even the slightest noise that could be perceived as “negative”? We all need a little space; our children included. Practicing “the Pause” is a helpful practice to give your child space to settle and you time to listen and determine if they need you to intervene.
The name of this technique gives the whole thing away - when you hear your child cry, before responding, pause. Take a few minutes to listen to them and see if they’re able to settle themselves.
For newborns I recommend 3-10 minutes.
For older babies, I recommend 10 minutes.
But, this isn’t an exact science and over time you may be able to determine more quickly if it’s a cry of distress or just a form of soothing or venting.
Teething is unavoidable.
Pain is unavoidable.
Some children will struggle more than others with getting sleep in those few days around the time a new tooth emerges from the gums. But, using these pain management tools along with promoting great, pain-relieving sleep can help you all through those potentially painful days.