The teething process can be a difficult process for both baby and parents. Baby teeth appear at different ages for different children and can sometimes take quite a while before they appear. By age three, most children have all their primary teeth. If your baby hasn't gotten her first tooth by one year, you might ask your doctor and/or dentist about it.

There are 20 primary or "baby"� teeth that every child has during their lifetime, with ten each in the upper and lower jaw. Usually the process of appearance works this way: the upper and lower incisors come first, then the upper lateral incisors come in a few months later, followed shortly thereafter with the bottom lateral incisors. The top and bottom molars are the next set to come through, usually right around 18 months. The cuspids (or eyeteeth as they are often called), usually soon follow the molars. You will see the second set of molars appear at approximately two to two and one half years of age.

The order in which babies get their teeth can vary widely and no two children will necessarily be alike in their teething schedule. It is very unusual for a child not to eventually get all twenty baby teeth. It is rare (about 1 in 2000) but occasionally a child is born with a front tooth. If this happens it is wise to consult a pediatric dentist as this could affect breastfeeding until you both adjust to it.

Here are some surefire signs to indicate that your baby is about to start teething:

• Increased fussiness
• Nighttime crying
• "Clingy"� behavior
• Bulging red inflamed gums - you'll be able to see the outline of the teeth as they try to push through the gums
• Excessive drooling
• Chewing on fingers, or anything they put in their mouth
• Poor appetite
• Interrupted sleep

There is some debate about this, but it is now generally accepted that teething will not cause fever, sleep issues, diarrhea, diaper rash, or lower immunity to infection. Teething is very painful. A baby that is used to soft smooth gums suddenly has a hard, sharp tooth pushing through her swollen gums. Generally it's the first tooth that will cause the most discomfort.

When babies are going through the teething process, they bring their hands to their mouths often. This brings some relief when the gums have pressure applied to them. Here are some things you can do to help:

• Gently massage the swollen gums with one of your (clean) fingers.
• Take a clean, soft washcloth and soak it in apple juice. Wring it out, tie the cloth in a knot and place it in the freezer for 30 minutes (it will not freeze hard like water does; rather, it will get very cold and nearly frozen). When frozen, give it to your baby, placing it first in his mouth, then his hands. You will see results almost immediately. Your baby will love the apple juice and most doctors approve it for even very young infants. The combination of the cold and the texture o the washcloth will begin to ease your baby's pain almost instantly.
• Give your child something cold to chew on like a teething ring that has been in the freezer, a chilled banana or even a Popsicle.
• If your baby is less than four months, don't use lotions or ointments that are supposed to reduce teething. They wash out of a baby's mouth within minutes. They contain an agent that could numb the throat and cause the baby to choke.
• An old wives tale remedy recommends that you dab some alcohol on your baby's gums. Many well meaning family and friends may suggest a "dab of whisky"� but do NOT do this! NEVER under any circumstances, place alcohol into your baby's mouth. Alcohol can act like a poison to a young baby.
• Acetaminophen may be used for a few days if your baby cannot otherwise be comforted.
• Baby Advil (ibuprofen) can be used as well and can be more effective than acetaminophen because ibuprofen contains an anti inflammatory component and acetaminophen does not.

While permanent teeth will eventually replace these primary teeth, they serve a very important role at this time. They enable your child to chew and are important for speech. They are not just for appearance. They also are reserving the space for the permanent teeth that will eventually follow. Also, even though these teeth will eventually be replaced, it is important to take good care of them as it is important to the proper development of the permanent teeth. Once these primary teeth are in place, clean them with a soft baby tooth brush or at least wipe with a soft gauze.

Once your baby has teeth, be sure not to let her fall asleep with a bottle. This will inevitably lead to tooth decay. Whether your baby is bottle fed or nursed, she will be vulnerable to "baby bottle tooth decay."� Such decay occurs when freshly sprouted baby teeth are exposed to liquids containing sugars (basically, anything other than water) for long periods to time. Bacteria in the mouth will grow in the sugar, which attack the tooth enamel and cause cavities. Actively watch for cavities. Any discoloration or pitting could be signs of cavities starting. Be sure to show these to your dentist.

Of course the best treatment for "baby bottle tooth decay"� is prevention. Just don't let your baby use a bottle as a pacifier or fall asleep with a bottle containing anything but water. Also, be sure to clean her teeth after each feeding. If you follow each meal with water, it will help to wash away most foods and keep them from sticking to your baby's teeth.

Introduce a toothbrush as soon as possible and monitor your baby's fluoride intake as this can help prevent tooth decay. It's also important to schedule a dental check up for your baby around her first birthday. Creating good dental practice form the start will help to ensure that your baby continues good dental hygiene for years into the future.

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