Is that fussing for no reason, or could that be a symptom of some tiny teeth getting ready to burst through bums? Baby teething is hard both to detect and predict because babies act the same for many types of discomfort. They cry, they can’t settle down and they might even drool a bit. When teething is at the root of the fussing though, you’ll want to do more than the ordinary soothing and feeding. Here’s how to recognize when baby teeth are making an appearance, along with the best ways to handle this milestone:

How to tell teething from other pain

Tender gums are typically the first sign that your child’s first tooth is getting ready to pop through. If you suspect teething is beginning, check to see if your young child has swollen gums. You may even be able to feel a tooth getting ready to break through the surface by running a finger lightly over your baby’s lower gum. Also, look for impressive amounts of drool, usually accompanied by chafed skin around the baby’s chin or on her cheek from the constant damp. But the best indicators are usually behavior-related. A baby who’s is 4 to 7 months old and suddenly turning down food and sleeping poorly may be teething. Aching gums can also cause a baby to fuss, stop and then start again a few hours later. Of course, this is a baby, who can’t explain what’s at the root of the upset, so rule out other possibilities and tune into the timeline for when babies start teething and it should become clear.

A baby teething timeline

When do babies start teething? If only it were the same for every child. Instead, most get their first teeth between 4 and 7 months. But, it could be as late as 12 to 14 months. And then there is that rare child born with a tooth in its mouth, which happens to about one in 2,000. Babies will end up with a total of 20 primary, or baby, teeth. The front lower teeth ordinarily show up first, giving your baby that adorable Jack o’ Lantern appearance. In the typical progression, the two front teeth come next, then teeth on either side of the top and bottom two, for eight total. Your baby’s first molars ordinarily come in next, followed by the cuspids, the pointed teeth that help humans grip and grind solid food. The secondary molars are usually the last primary teeth to appear.

While the timeline for teeth varies, normally the first teeth come in at 4-7 months, the second pair erupts at 8-12 months, and the lateral incisors who at 9-16 months. The molars may grow in at 13-19 months, right around your child’s first birthday. Most children have their full set of baby teeth ending at about 33 months. But the sequence of teeth emerging can vary a good bit from child to child, even when they’re siblings. So parents should adopt a “wait and see” attitude instead of feeling anxious or competitive because someone else’s kid already has a full set and your baby’s all gums.

Soothing solutions

To help your child through what can be an irritating and even painful experience, tap your best home remedies first. Simply cuddling or rocking can go a long way to soothing a teething baby. Also, consider gently massaging those angry red gums. Use a (very clean) finger and rub the sore gum with a circular motion. A damp washcloth that’s been wrung dry and chilled (not frozen) can also be a teething baby’s best friend. Just make sure your hands, the cloth and the spot in the refrigerator where you store it are all sanitary. Then hand it to the baby when the gums are getting to him. He can chew on it for relief. Don’t leave him alone while this soothing hack is in progress, though, since the cloth can become a choking hazard.

Another homespun teething solution is chilling a clean metal spoon from the silverware drawer in the refrigerator. Then rub the back of the curved portion along your baby’s gums for cool comfort. To keep chafing skin at bay, make sure to dry the drool off baby’s face with a clean, soft cloth (not a diaper wipe) often. The goal is to keep the skin dry without rubbing so hard you create a different kind of rash.

Teething toys

You can also make a special point of purchasing a teething toy specially designed for a baby to gum for relief of teething pain. Make sure any store-bought product is something your baby can hold easily and solid, not filled with liquid or gel. Keep it excruciatingly clean (no five-second rule with an object that will spend that much time in the baby’s mouth) and chill it in the refrigerator before each use.

When should you call the doctor?

Teething is a valuable rite of passage since afterward your child can eat many foods and smile for the camera, Usually the biggest concern is simply how to help your teething baby minimize the anguish. If you feel like none of your tactics are working, though, you might want to speak with your pediatrician about available medications to ease teething pain. This should be a last resort, though.

The only other time you may want to tap expert health is when your child has reached 13 months without any sign of gums erupting into baby teeth. According to Stanford Children’s Health, “if teeth fail to come in a year after the expected time, it would be advisable to check with your child’s dentist to make sure they are developing properly.”