Teething gets blamed for almost everything that goes wrong in a baby's first two years, from a fever to a loose stool to a sleepless week. Most of that blame is misplaced. This article covers what teething actually causes, what genuinely helps, what to avoid, and why it matters to stop assuming "it's just teeth" too quickly.
When teething typically happens
The first tooth usually appears somewhere between 6 and 12 months of age, though the exact timing varies widely between babies. It is not unusual for a first tooth to arrive as late as 15 months, and this on its own is not a cause for concern. The lower front teeth are typically first, followed gradually by the rest over the following two to three years.
Signs that are genuinely from teething
- Increased drooling
- Frequent chewing or gnawing on fingers, toys, or anything within reach
- Mildly swollen, tender gums
- A mild rash around the mouth or chin from constant contact with saliva
- Some fussiness or irritability, generally mild rather than severe
These signs can appear on and off for days around the time a tooth is actually coming through, and settle again once it has broken the surface.
What teething does NOT cause
This is worth being direct about, because it affects how a parent responds when a baby is unwell. Teething does not cause fever, diarrhea, vomiting, a runny nose, or a weakened immune system. If a baby has one of these alongside sore gums, the sensible assumption is that something else, most often an ordinary viral illness, is happening at the same time, not that the teething itself is the cause. Attributing a real fever or diarrhea to teething risks missing an infection that actually needs attention. See our Fever in Children article for how to think about fever properly rather than explaining it away. Broken or disrupted sleep is also commonly blamed on teething; it can be a minor factor during an active flare, but persistent sleep difficulty deserves its own look rather than an automatic teething explanation, see our Sleep Problems in Children article for the broader picture.
What helps
- Gentle gum massage: a clean finger rubbed firmly along the gum line is simple and genuinely soothing for many babies
- Teething rings and toys: firm rubber or silicone rings give a baby something safe to chew on; chill them in the refrigerator rather than the freezer, since a frozen-hard ring can bruise the gums
- A cool, damp washcloth: chilled (not frozen) and given to chew on works similarly to a teething ring
- Cold water in a sippy cup, for babies already old enough to use one
- Extra comfort and closeness, which helps more than most parents expect during a fussy stretch
What to avoid
- Benzocaine-containing gels (including common over-the-counter teething gels): these carry a real, rare but serious risk of methemoglobinemia, a blood disorder that reduces the amount of oxygen the blood can carry, and current guidance is to avoid them in young children altogether
- Lidocaine-containing products: these have their own separate risks in young children, including effects on the heart and, in overdose, seizures, and are not recommended for teething
- Amber, wood, or marble teething necklaces and bracelets: these are a genuine choking and strangulation hazard, and there is no reliable evidence they relieve teething pain in the first place; a baby should not be left wearing any jewelry, including while sleeping or unsupervised
- Frozen (rather than chilled) teething rings, which can injure the gums
- Alcohol-based remedies or home remedies applied to the gums without checking with your pediatrician first
Pain relief, if needed
For a baby who is genuinely uncomfortable despite the measures above, age-appropriate pain relief such as paracetamol can be used, but only as advised by your pediatrician for your child's specific weight and age, not from a general online guide. Most teething discomfort does not need medication at all.
When to see a doctor
Teething itself rarely needs a medical visit, but the symptoms it gets blamed for sometimes do. See your pediatrician rather than assuming teething if your baby has:
- A measured fever, particularly in a baby under 3 months (see our Fever in Children article for age-specific guidance)
- Diarrhea, vomiting, or a rash beyond mild drool irritation around the mouth
- Persistent, inconsolable crying that is different from ordinary fussiness
- Poor feeding or unusual sleepiness alongside any of the above
Regular check-ups are also a good time to have your baby's teeth briefly looked at as part of general care; see our Newborn and Infant Care service page for what these visits generally cover, our Newborn Care guide for the broader picture of the first months, and our Starting Solids article for how teething fits alongside introducing textured foods.
Frequently asked questions
Does teething really cause a high fever? No. This is one of the most persistent myths in early parenting. A baby with teething and a genuine fever has two separate things happening, not one causing the other, and the fever deserves its own evaluation.
Are amber teething necklaces safe if I supervise closely? No. Supervision does not remove the risk, since a bead can break off and be swallowed or inhaled in seconds, and strangulation risk exists even during sleep when no one is actively watching. These are not recommended regardless of how carefully they're used.
My baby seems fussier in the evenings when a tooth is coming in. Is that normal? Yes, mild fussiness that comes and goes around the time a tooth is emerging is common and expected. What's not expected is fever, diarrhea, or symptoms that are clearly beyond ordinary fussiness.
Further reading
- Teething: 4 to 7 Months (HealthyChildren.org, AAP)
- Teething Necklaces and Beads: A Caution for Parents (HealthyChildren.org, AAP)
- Guideline for Dental Care, Diapers, and Clothing (IAP Guidelines for Parents)
General, current guidance for educational purposes, not individualized medical advice. Always confirm specific care decisions for your baby with your own pediatrician.