Teething and Terrible Twos Toddler Teeth Tips 1-3 Years

Say that three times fast!

I am still not sure why they are called the Terrible Twos? 

I think it should be called the terrible tweens! Two was a breeze! I loved that age. She did not talk back, was cuddly and inquisitive! 

As far as teeth go, between the age of 12 and 36 months, give or take, most toddlers are growing teeth during this time. While some toddlers make it through teething with no issues, others experience symptoms that might include drooling, pain, crankiness, irritability, sleeplessness, inflamed sore gums, rash, and relentless chewing. Like most things, at this age, it is harder on the parents than the kids. By the age of three, the second set of molars will erupt, giving your toddler a full set of baby teeth, those same symptoms can intensify for some children.

For parents, while it may be difficult dealing with their kiddos with teething pain, teething and chewing toys may be helpful. This process is different for every child, so you may need to try several products before finding the right combination for your child’s wants and needs. 

There are several tools on the market that are geared towards teething toddlers, like this one! Notice how the spoon and fork also have a ring guard on it, to help the baby not to go all the to the back of the mouth? 


These tools work because they put counterpressure on the gum as the new tooth is pushing through the gums. Some of the most effective teething tools are made with silicone. Silicone is soft, so it doesn’t damage teeth or gums, but firm enough to provide sufficient pressure.  Silicone chew beads can be put in the fridge before giving them to your child to provide additional comfort and soothing. If you don’t have teething tools in the house, a washcloth soaked with cold water can do the trick, too.

Caution: Be aware of liquid or gel-filled teething toys. Use supervision with these as they can easily break when chewed on by little ones who already have multiple teeth. If frozen they can become too hard and cause injury to the teeth and/or gums. Don’t take them out of the freezer and give them to your toddle let them thaw a bit first.

Nursing or Breastfeeding

If you are still nursing or offering breast milk in a cup or bottle it can also provide comfort and pain relief. Your toddler’s natural inclination to chew or gnaw while teething may be painful for Mom during nursing. My daughter thought it was funny if I said ouch. So I had to not react or she would bite me for fun!  If this is the case for you, a good option is to provide chilled breastmilk in a sippy cup or even breastmilk popsicles, which can easily be made using pumped milk and a popsicle mold.

Some children suffer in pain,  dealing with sleepless nights, all-day fussiness, and clinginess can take a toll on our own health, as well. Luckily, there are several ways to help ease toddler teething pain and make things a little bit easier for both our children and ourselves.

If you are having pain or your baby is having trouble latching or thriving if you have not done so. Check to see if there are and tethered tissues. Meaning a lip or tongue tie. See my post on this subject for more information.

Gum Massage

Gently massaging their gums with a washcloth or silicone brush can work wonders in relieving their teething pain. Before massaging your child’s gums, be sure to wash your hands and clean underneath your fingernails. Be Careful not to poke your baby’s gums with your fingernail as this can cause a traumatic ulcer or canker sore that will take 7-10 days to heal. Run cool water over your fingers and gently massage the gums in a circular motion with a cool washcloth or gauze. Gum massages or brush that goes over your finger can be most helpful when performed before meals, after meals, and at bedtime

Cold Foods and Drinks

Soft foods and drinks that are cold in temperature may help to soothe and relieve your child’s pain. It’s important to be mindful of nutritious, low-sugar snacks that are vital to preserving your child’s oral health. Some healthy snacks that may help ease teething pain include:

  • Chilled applesauce or mashed bananas
  • Frozen yogurt tubes
  • Ice water in a sippy cup
  • Chilled fruit in a mesh feeder
  • Popsicles

Note: Be careful of items that can be a choking hazard — be sure to offer ice water in a cup with a lid, ice cubes as they can be a choking hazard.

Over the Counter Pain Medications

Over-the-counter pain medications such as children’s ibuprofen and acetaminophen are sometimes the best solution for a toddler who is experiencing extreme teething pain. Be sure to follow the directions on the package when giving medications to your child.

Other Tips to Help Your Teething Toddler

When your toddler is in pain, their stress levels are likely to be increased. It’s crucial to make sure you’re not adding to their stress by changing their routine. Make sure that you stay on the schedule you created and that they’re used to. That means keeping the same bedtime, the same nap time, and continuing to follow the routine they’re used to before bed and nap time. For some parents, fussy and irritable toddlers may be more difficult to settle, and stick to their exact routine may be difficult but keeping things as normal as possible, you might find that their symptoms are easier to soothe with the options listed above.

Giving them plenty of love, cuddles, and emotional support is one of the most important things you can do to help soothe teething pain. It’s important to try to remain calm and patient with your little one. Love and understanding go a long way and can be just the thing they need to calm down and handle the pain that they’re feeling.

Tips For Brushing

  • Children younger than 3 years, start brushing their teeth as soon as they begin to come into the mouth by using fluoride or fluoride-free toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) Supervise children’s brushing to ensure that they use the appropriate amount of toothpaste. I did not use toothpaste once I figured out that was our issue
  • For children 3 to 6 years of age, use can increase to a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night). Supervise children’s brushing to make sure you get all of the teeth inside and out and remind them not to swallow the toothpaste.
  • Until you’re sure that your child can brush on his or her own, and get all of the teeth clean, continue to brush your child’s teeth twice a day with a child-size toothbrush and a pea-sized amount of toothpaste. I recommended using disclosing to stain the teeth and see where they are missing. See the products page for disclosing recommendations. When your child has two teeth that touch, you should begin cleaning between their teeth daily.

The Best Toddler Toothbrushes

This will depend on your individual likes and beliefs

I truly believe a toothbrush is a tool and it is how you use it that makes all the difference. That being said.

Electric brushes are 10x more effective at removing plaque from children’s teeth. … An electric toothbrush can make this easier by performing the brushing action for you. You just angle it toward the gums, hold it for 3-5 seconds then slide it to the next tooth; this disrupts the plaque and biofilm preventing cavities. My go-to is BURST.  Use Promo Code 5ZMZBR

I will usually recommend one especially if your child does not like brushing. Or if a parent leaves it up to the child to do the brushing on their own. Kids need supervision until the age of 8.

I always recommend a parent let the child brush, then you go back in and brush for them. This ensures all the plaque and biofilm are removed. The kid usually misses the outside of the upper teeth and the inside of the lower teeth. So if you have limited time they will allow you in their mouth, brush those areas first. Use a smear or rice size amount of toothpaste. My daughter has sensory issues so I did not use toothpaste until she was 6 and we found Colgate watermelon flavor. 

Establishing a routine at a young age sets your child up for good oral hygiene habits at a young age that will carry into adolescence.

Don’t worry if you don’t manage to brush for 2 minutes at first. It might not take as long when your baby only has a couple of teeth. Make sure you get the front and the back. The important thing is to get your baby used to brush their teeth as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.

Start brushing your baby’s teeth as soon as they get them in. The best way to do this is to sit them on your lap with their head against your chest if you sit in front of a mirror so you and your baby can see what you are doing.

You do not have to use toothpaste. If you choose to, you can use a smear of toothpaste so you don’t need to worry about them spitting. Whether you use fluoride toothpaste or not is up to you and is 100% a personal decision you will make for yourself and your family.

I dry brushed my daughters’ teeth. She did not like toothpaste. After brushing I used Mi Paste, I would smear a small amount on a q-tip or my finger then rub it on her teeth. It depended on the mood she was in if she fought me.

We had a well so there is no Fluoride in our water. MI paste has two kinds one with Fluoride on without. I started without Fluoride. When she was six, I switched to the mi paste with Fluoride. You can ask your Dentist about MI Paste. Do not use it if your child has a milk allergy.


  • Gradually start brushing your child’s teeth more thoroughly, covering all the surfaces of the teeth. Do it at least twice a day: in the morning or another time that fits in with your routine and just before bed.
  • Not all children like having their teeth brushed, so you may have to keep trying. Let them pick the brush and the toothpaste so they feel like they have some say. Turn it into a game or brush your own teeth at the same time and then help your child finish their own. 
  • The easiest way to brush a baby’s teeth is to sit them on your knee, with their head resting against your chest. With an older child, stand behind them and tilt their head backward. 
  • There were days we were on the bathroom floor and I put my daughter in a headlock with one arm asking her to scream louder to get the plaque off the back teeth. Somedays you do what you need to do to get the job done. If I had to do it over again I may have taken a different approach. I did not know about sensory issues back then. BURST toothbrushes are not available yet either. She has very good oral hygiene habits to this day. There are so many more options these days to make brushing fun and easier. 
  • Brush the teeth in small circles at a 45% angle along the gum line, covering all the surfaces, inside, outside, and the top Chewing surfaces, and encourage your child to spit the toothpaste out afterward. There’s no need to rinse with water, as this will wash away the fluoride in the toothpaste. An electric toothbrush will do the correct motion for you you just need to hold it at that angle for 3-5 seconds as I mentioned earlier.
  • Supervise brushing to make sure your child gets the right amount of toothpaste and they’re not eating or licking toothpaste from the tube. If you use the recommended amount for the age of the child, you won’t need to worry about them getting too much Fluoride. Fluoride does make a difference. However, it is a personal choice there are alternatives to using fluoride if it is not for you. It does have its place in remineralizing the enamel and stopping or reversing cavities. But there are alternative options available. Which I used. 


Mouth breathing

For some people, an open mouth is simply a habit — their mouth rests in an open position when they’re not focused on keeping it closed. For other people, the mouth is open and used for breathing. We call this either “open mouth resting posture” or simply “open mouth.” 

The natural position for healthy breathing is always with a closed mouth, inhaling, and exhaling through the nose.

Some adults are very aware of their open mouth habit, while others have never noticed it until they meet me. Most of the time, my adult patients are self-conscious about their open mouth habit and can’t understand why it’s so challenging for them to keep their lips together when they aren’t speaking or eating.

If your child is mouth breathing, she/he can learn to change the habit.  Patients can learn how to change their habits and breathe properly. Learning how to breathe through the nose instead of the mouth prevents patients from a number of serious health issues in adulthood, including sleep apnea, speech impediments, and improper facial growth.

We need to look to see if our toddlers have malocclusion and start to treat it while we can use their growth and development. There are orthodontists that will treat children as early as age 2. We may intervene even early to prevent serious problems later that will need to be treated with surgery instead of less invasive treatment to correct the problem. 

While having an open mouth posture may seem like a silly thing to be concerned about, and even a simple problem to fix, it’s actually neither. 

The serious health effects of mouth breathing

Mouth breathing can be related to and caused by:

  •  A long narrow face
  •  A narrow mouth
  •  A high palate
  •  Crooked teeth (upper or lower)
  •  A gummy smile
  •  A tongue-tie

Other signs of mouth breathing

  •  A blocked sinus
  •  Swollen tonsils & adenoids
  •  A dry mouth in the morning
  •  Sleeping with your mouth open
  •  Snoring
  • Teeth and braces: If your mouth is open, your braces will take longer, and your treatment will be much more challenging for your orthodontist the longer you wait. If your toddler has no spaces between their teeth it may be an issue when they get their permanent teeth. If you wait till the age of 7 to take them to the orthodontist it may be too late. Spaces between your teeth will be more difficult to close and the stability of the alignment of your teeth will be compromised once your braces are removed. This means you are more likely to experience orthodontic relapse and may need braces again in the future. Knowing this before you wear braces will help you make treatment decisions that are right for you or your child.

If you treat a malocclusion early you will be able to reduce and possibly even prevent airway and sleep disorders issues in the future.

Airway – Sleep Apnea

Sleep and oxygen: When adults and children breathe through their mouths during the day, chances are very high that they also breathe through their mouths at night as well. Mouth breathing at night, combined with an obstructed airway, are two symptoms directly connected to sleep apnea and altered levels of carbon dioxide and oxygen in the bloodstream. When less oxygen is able to reach the brain, learning and the ability to focus at school becomes a problem for many children. In adults, chronic fatigue, tiredness, and brain fog, acting out are common symptoms related to these issues.

Airway/ sleep apnea Facial growth and development: It’s important to realize that growth is a very powerful force. A child with an open mouth will very likely grow into an adult with flatter facial features, less prominent cheekbones, a longer face, droopier eyes and lower facial muscle tone, a narrower palate, and even a smaller lower jaw in most cases. By closing the mouth and breathing through the nose, these negative growth patterns can be prevented.

When I look at someone, I can usually tell whether they’re getting enough of one of the MOST important vital nutrients your body and your teeth need to be healthy.

Is this nutrient a vitamin? A mineral?

No. It’s oxygen.

Oxygen is a vital nutrient for healthy teeth and a healthy body.

We can not live without it for more than 6 minutes

When you hear ‘nutrient’, you probably don’t consider oxygen. Yet oxygen is by far your body’s most precious commodity. You simply can’t live without it! Yet many of us live without enough of it. And that’s all due to our breathing habits primary way to see whether you’re breathing properly is to check if you’re breathing through your nasal passage or mouth. Nasal breathing is the way to deliver the maximum amount of oxygen.

Why is breathing through the mouth harmful?

Your nasal passages and sinuses are designed to prepare air for delivery to your lungs. They act much like a humidifier, warming and moistening the air. They are the first line of defense against unfriendly microbes and also remove debris before it enters your lungs.

Nasal breathing helps oxygen flow via a gas called nitric oxide (NO).

Nitric oxide is produced in the nasal sinuses by specific enzymes. When it mixes with air in the lungs, it increases arterial oxygen and helps to reduce blood pressure.

Nitric oxide also has a vital role deep within your body’s cells.

If you or someone you love is mouth breathing, nitric oxide does not get delivered to the lungs. Mouth breathing also provides none of the air-warming and humidifying properties of nasal breathing. Mouth breathing is a survival mechanism when breathing through your nose is not possible.

How can you stop breathing through your mouth?

Your tongue is a good indicator of your breathing health. Proper tongue posture is crucial for palate and jaw growth and straight teeth, but it also holds your airway open.

Stop mouth breathing in three simple steps

  1. Tongue at the top of your mouth 
  2. Lips together 
  3. Breath through your nose

Simple right! It took a while to create the habit and it may take some time to break it.

Proper tongue posture contributes to oxygen delivery and straight teeth in many ways. These include:

  1.   allowing nasal breathing to expand the maxilla
  2.   applying direct upward pressure to expand the palate
  3.   opening airways (due to its muscle connections to the soft palate, spine, and base of the skull)
  4.   activating the neuromuscular pathways that train the airway to stay open during sleep


One of the signs of mouth breathing is low tongue posture. The tongue is kept in a low, downward position that opens up breathing space in the mouth. Normally, the tongue should sit high against the palate to cover and protect the oral cavity.

Low tongue posture can result in further functional problems like an incorrect swallow. The result?  A tongue thrust when you swallow creating an imbalanced force on the teeth that can contribute to them growing crooked. If not addressed, it can cause improper jaw growth and facial development.

Why is breathing through the mouth harmful?

A mouth breathing habit can cause a high arch in your palate, changes to the shape of your face, look of your lips, impact teeth alignment. They are signs of a tongue that is not supporting the airway. Improper growth of dental and jaw structures increases the risk of snoring and sleep apnea.

Mouth breathing and interrupted breathing during sleep are not good for anyone.

In children, mouth breathing can cause interrupted breathing during sleep and can have severe effects on brain growth. Their brain needs uninterrupted periods of oxygen-rich sleep to rest and regenerate. Oxygen deprivation damages cells. Sleep apnea in children is known to increase the risk of hyperactivity, ADHD, tiredness, and poor concentration.

In adults, mouth breathing, snoring, and sleep apnea can progress to obstructive sleep apnea. It’s a condition linked to heart failure, high blood pressure, and Alzheimer’s disease.

The warning signs of mouth breathing show up in the first months of life. Making sure a child breathes the right way is one of the best ways to ensure their brain, jaw, and teeth develop properly. It could be all that’s required to prevent your child from needing braces or being diagnosed with ADHD.

Let’s for the signs of mouth breathing early in your child’s development

Correct breathing in yourself and your child

Remember: Correct breathing is one of the biggest influences for you and your child’s dental health.

The good news is that if the problem is identified early on, a child can be retrained to breathe correctly through their nose. This has great benefits for their development, general health, and teeth. It’s a simple way to prevent braces naturally!

For more information on Dr. Lin’s clinical protocol that highlights the steps parents can take to prevent dental problems in their children.

Want to know more? Dr. Steven Lin’s book, The Dental Diet, is available to order today. An exploration of ancestral medicine, the human microbiome, and epigenetics, it’s a complete guide to the mouth-body connection. Take the journey and the 40-day delicious food program for life-changing oral and whole health.

The underlying causes for mouth breathing include:

Sleep apnea

If you or a loved one had obstructive sleep apnea, the muscles can relax too much and collapse the airway, making it hard to breathe. Enlarged tonsils or adenoids can block the airway during sleep.

Sometimes snoring is interrupted by a complete blockage of breathing which causes gasping and snorting noises associated with awakenings from sleep. …

  • Bed-wetting is frequently seen in children with sleep apnea.
  • Does your child snore?
  • Does your child show other signs of disturbed sleep?
  • Have long pauses in breathing?
  • Tossing and turning in the bed?
  • Has chronic mouth breathing during sleep?
  • Have night sweats or wet the bed?
  • Does your child bring their teeth?

All these, and especially the snoring, are possible signs of sleep apnea, which is more common among children and is not always recognized. It’s estimated 4 percent of children suffer from sleep apnea, many of them being between 1 and 9 years old.

There is a possibility that children with sleep apnea will “grow out” of their sleep disorders, untreated sleep disorders including sleep apnea in children can wreak if allowed to continue.

Studies show as many as 25 percent of children diagnosed with (ADHD)attention-deficit hyperactivity disorder may actually have symptoms of obstructive sleep apnea, the consequence of chronic fragmented sleep contributes to their learning difficulty and behavior problems.

Bed-wetting, sleepwalking, slow growth, even failure to thrive, and other hormonal and metabolic problems, can be related to sleep apnea.

Researchers have shown the impact of sleep disorders and breathing can affect functions of the brain such as cognitive flexibility, self-monitoring, planning, organization, and self-regulation.

Several recent studies show a strong association between pediatric sleep disorders and childhood obesity. Judith Owens, M.D., director of sleep medicine at the National Children’s Medical Center in Washington, DC, believes that adequate healthy sleep is as important as proper diet and sufficient exercise in preventing childhood obesity.

 Finding a Specialist

If you suspect your child may have OSA, you may wish to seek out a pediatrician, dentist or orthodontist who specializes in sleep disorders and malocclusions in children under the age of 6. 

When to treat

Currently, there are no universally accepted guidelines as to when treating

How to proceed is less clear in children between ages 1 and 5. Several recent studies have linked behavioral problems in children who mouth breathe and snore. Each case is different depending on the severity and when it is diagnosed.


Surgical removal of the adenoids and tonsils is the most common treatment. Yet there are things that can be done if we are aware and able to treat sooner rather than later. 

An overnight sleep study does not always show there is a problem at an early age. My recommendation is to look at the bite to determine the next steps for treatment.

Snoring appliances

Children are our most precious resources, and their health and comfort are a top priority for any parent. It comes as no surprise that you may have questions about your child’s snoring and sleep habits.

Is their snoring normal? Snoring like cavities is never a normal part of growing up. We should not just accept that it is inevitable that they will grow out of it.

Causes of Snoring in Children 

Snoring is the sound caused by vibrations in the upper airways of the respiratory system due to obstructed air movement mostly while sleeping. It is possible that their snoring may be a sign of a sleep disorder or malocclusion. Here are a couple of causes that could be the source of snoring.

Narrow or vaulted palate and large tongue the tongue is the most common obstruction in our mouth. Proper position is important for airway and breathing.  It may appear the tongue is too big for the mouth when in realtor it is the upper jaw that is too small.

  • Enlarged tonsils and adenoids are a leading cause of snoring in children, and a strong contributing factor of potential obstructive sleep apnea. Swollen glands block the airway making it difficult for your child to breathe comfortably at night when lying down. 
  • Respiratory Infection. If your child has a stuffy nose from a cold or allergies, it is likely that their snoring is caused by a blockage in the sinuses. Nasal blockage forces them to breathe through their mouth which can also lead to snoring.
  • Deviated septum. A deviated septum occurs when the airway of the two nostrils is offset or displaced. This makes breathing through the nose more difficult; one nostril’s passage is smaller than the other, reducing airflow and making it difficult to breathe.
  • Obstructive Sleep Apnea (OSA)-  OSA makes breathing extremely difficult. Children (and adults as well) who suffer from untreated OSA can have many other associated health problems. Treating malocclusion can create more space making it easier to breathe.

What to look for at night

  • Does your child snore constantly (3 or more nights per week)?
  • Does your child have interrupted breathing or gasps, snorts, or pauses longer than 10 seconds?
  • Does your child often wake them from sleep due to  Interruptions in their breathing?
  • Does your child sweat profusely or wet the bed during sleep.
  • Does your child have restless sleep in which they move frequently at night or sleep in abnormal positions with their head in unusual positions, or the sheets are on the floor?

 What to look for during the day

  • Does your child have difficulty waking up in the morning
  • Does your child speak nasally and breathe primarily through their mouth?
  • Does your child have learning, behavioral, or social problems?
  • Is your child often irritable, cranky, agitated, or aggressive?
  • Does your child seem excessively sleepy during the day?
  • Does your child fall asleep frequently during the day?

What Can You Do if Your Child Snores? 

The most important thing you can do is to observe their daily and nightly habits and report all of your concerns to your Dentist or pediatrician. Depending on the cause recommendations may include one or more of the following :

  • Remove possible allergen triggers such as stuffed animals, pets, or feathery-down pillows and comforters.
  • Prescribe sinus congestion and allergy medications.
  • Suggest that you elevate your child’s head or mattress at night with a special pillow that can help relieve congestion and clear up their nasal passages.
  • Refer you to an Ear Nose and Throat specialist to see if your child’s tonsils and adenoids need to be removed.
  • Refer you to a sleep specialist for a possible overnight sleep study to determine if your child suffers from obstructive sleep apnea


When to See Your Dentist

As soon as your child gets their first couple of teeth or by their first birthday it’s time to see the dentist. You will want to establish a dentist before there is a problem, As most offices will get you in faster if you are a patient of record. The sooner you get your child into the dentist the more comfortable they will be in going. You will be able to catch problems when they are easier to treat. 

 Sometimes toddlers can develop an open bite or crossbite. Both can be treated early to help correct them with a change in habits while they are simpler to fix using their growth and development to your advantage.  You may need to see a pediatric dentist or orthodontist who specializes in seeing only young children.

Thoughts Values and beliefs

I am a huge believer that our own thoughts, values, and beliefs impact our decisions.

Those beliefs impact the value we place on everything. They impact whether we even go to a doctor or dentist for treatment in the first place.

The impact the choices we make. If you choose to go to a doctor or dentist and you do not agree with the treatment they have presented, you have the right to refuse treatment.   Do your research and find a provider that is in line with your beliefs.

Keep in mind that each doctor and dentist have their own belief system based on their experiences in life which affects the way they establish their practice.  It is not fair for you to dictate what Treatment the doctor or dentist provides if it is not in line with their beliefs.

Picking the right provider is key to a mutually respectful relationship.

Finding a dentist is like dating! It may take kissing a few frogs before you find the right one. Listen to your gut instinct they will almost never lead you down the wrong path. 

As a general rule, if you see or feel anything that seems unusual,  see a  dentist. We are always happy to answer any questions or see your child with a telehealth visit. If you have any concerns and are not sure who to see you can schedule a free 15-minute consultation. We will be happy to answer questions and get you to a local dentist if needed. 

Peace of mind is helpful. I know I had a lot of questions about my daughter’s sensory issues as to what I should worry about and what I should not. Facebook groups helped me. You can join our Healthy mouth movement and search topics others may have had similar issues. It takes a community to raise kids these days. I had an amazing support system but not everyone has that. 

We are here for you. The more information we can share there, the more kids we can save from cavities,  and other diseases. 

Parents are busy providing for and loving their children.  Let our experience help you and your little one through one of the biggest milestones of their little lives – teething, so you can spend more happy time together.

A Healthy Mouth is A Healthy Body and a Healthy Happy Life!