Teething is the process of baby teeth pushing through the gums. It usually starts between 4 and 7 months, most often with a lower front tooth, and continues on and off until the last molars arrive around age 2 to 3. Typical symptoms are drooling, chewing, fussiness, mildly swollen gums, and disturbed sleep for a few days around each tooth. Teething does not cause high fever, diarrhoea, or a rash. A chilled teething ring, gum massage, and, for a bad night, the correct dose of infant acetaminophen or ibuprofen are the safe remedies; benzocaine gels, homeopathic tablets, and amber necklaces are not.
When teething starts and how long it lasts
The first tooth typically appears between 6 and 10 months, though anywhere from 4 to 12 months is normal. Symptoms often begin a few days before the tooth is visible and settle within a few days of it breaking through. Because teeth arrive in pairs and groups, teething tends to come in waves rather than one long stretch: the front teeth between 6 and 16 months, the first molars around 13 to 19 months, the canines around 16 to 23 months, and the second molars, which are the largest and often the worst, around 2 to 3 years. Our baby teeth chart has the full tooth-by-tooth timeline.
Some babies sail through with nothing but drool; others are clearly miserable for a few days per tooth. Both are normal.
Symptoms that are teething
- Drooling, sometimes enough to cause a rash on the chin and chest
- Chewing on hands, toys, furniture, you
- Fussiness and clinginess, worse in the evening
- Red, swollen, or tender gums, sometimes with a visible bump or a bluish blister (an eruption cyst, harmless)
- Mildly disrupted sleep
- Slightly reduced appetite for solids (sucking can be uncomfortable)
- A slightly raised temperature, under 100.4°F (38°C)
Symptoms that are not teething
Parents and, historically, doctors have blamed teething for almost everything. Studies following babies through tooth eruption found that teething does not cause:
- Fever of 100.4°F (38°C) or higher. A true fever means infection. Teething and a viral illness often coincide simply because both are common at 6 to 12 months, when maternal antibodies wane.
- Diarrhoea or vomiting. Extra drool does not cause loose stools.
- Rashes beyond a drool rash on the chin.
- A runny nose or cough.
- Refusing all fluids.
If your baby has any of these, treat them as ill, not teething, and call the pediatrician if you are concerned.
What helps
Cold, not frozen. A teething ring chilled in the refrigerator, a clean washcloth wet and chilled, or a chilled (not frozen) spoon. Frozen items are hard enough to bruise gums.
Pressure. Rub the gums firmly with a clean finger. Many babies find this the most soothing thing of all.
Something to chew. Solid silicone or rubber teethers. Avoid liquid-filled rings, which can leak, and anything small enough to be a choking hazard. For babies on solids, a chilled piece of cucumber in a mesh feeder.
Pain relief for a bad night. Infant acetaminophen (from 3 months, dosed by weight) or infant ibuprofen (from 6 months, dosed by weight). Use the syringe that comes with the bottle and follow the label or your pediatrician’s dose. This is for a genuinely rough night, not routine daily use.
Comfort. Extra cuddles, a slightly earlier bedtime, and patience. It passes.
Wipe the drool. Keep the chin dry and use a barrier cream to prevent a drool rash.
What to avoid
Benzocaine teething gels (Orajel and similar). The FDA has warned against them for children under 2 because benzocaine can cause methemoglobinemia, a rare but serious condition that reduces oxygen in the blood. They also wash off within minutes and numb the tongue, which can interfere with swallowing.
Lidocaine gels. Prescription-only for good reason; overdose in infants has caused seizures.
Homeopathic teething tablets and gels. The FDA found inconsistent, sometimes dangerous levels of belladonna in some products and has issued warnings. There is no evidence they work.
Amber teething necklaces. No evidence of any benefit. Documented strangulation and choking deaths. The FDA and AAP both advise against them.
Frozen teethers, frozen fruit, and ice. Hard enough to injure gums.
Rubbing alcohol, whisky, or brandy on the gums. An old remedy that is genuinely dangerous for an infant.
Teething biscuits and rusks. Sugar sits on new teeth; choking risk once a piece breaks off.
Caring for the new teeth
From the first tooth, brush twice a day with a soft infant brush and a smear of fluoride toothpaste the size of a grain of rice. Do not put the baby to bed with a bottle of milk or juice; pooling liquid on new teeth causes early decay. Book a first dental visit by the first birthday or within six months of the first tooth. Our pediatric dentist guide explains what that visit involves.
When to see a dentist
For teething itself, you rarely need a dentist. See one, or your pediatrician, if there are no teeth at all by 14 months; if a tooth comes through discoloured, misshapen, or broken; if a gum swelling is large, growing, or bleeding rather than a small bluish eruption blister; or if you have any concern about how a tooth looks. Call the pediatrician, not the dentist, for fever of 100.4°F or higher, diarrhoea, vomiting, refusal to drink, a rash beyond the chin, unusual drowsiness, or inconsolable crying that does not settle with comfort and pain relief. Those are not teething.
Frequently asked questions
Does teething cause fever?
Not a true fever. A slight rise under 100.4°F (38°C) can happen; anything at or above that is an infection and should be treated as such. Teething and illness often overlap because both are common at 6 to 12 months.
How long does teething last for each tooth?
Symptoms usually last two to five days around each tooth, starting a few days before it appears. The molars around ages 1 and 2 can be uncomfortable for a little longer.
Can I give my baby Tylenol or Motrin for teething?
Yes, for a genuinely bad night. Infant acetaminophen from 3 months and infant ibuprofen from 6 months, dosed by weight using the included syringe. Do not use them daily for weeks, and ask your pediatrician if unsure of the dose.
Are teething gels safe?
Not the common ones. The FDA warns against benzocaine gels for children under 2 and against homeopathic teething products. Chilled teethers, gum massage, and correctly dosed pain relievers are the safe alternatives.
Is it normal for teething to affect sleep?
Yes, for a few nights around each tooth. If sleep is badly disrupted for more than a week, something else is usually going on; check for illness or a sleep-routine change.
