Teething: Symptoms, Relief, and What to Expect

Those little teeth coming in can cause big discomfort—for baby and for you. But there's also a lot of myth mixed with reality when it comes to teething. Let's sort out what's actually caused by teething, what helps, and what's just a coincidence of timing.

When Teething Begins

Every baby is different, but here's the typical timeline: AAP

First teeth:

• Average age: 6-7 months
• Range: 4-12 months
• Some babies are born with teeth (rare)
• Some don't get teeth until after age 1 (also normal)

Order of appearance (typical):
1. Bottom front teeth (central incisors): 6-10 months
2. Top front teeth (central incisors): 8-12 months
3. Top lateral incisors (beside front teeth): 9-13 months
4. Bottom lateral incisors: 10-16 months
5. First molars: 13-19 months
6. Canines: 16-23 months
7. Second molars: 23-33 months

By age 3, most children have all 20 primary teeth.

Real Teething Symptoms vs. Myths

This is important: teething is blamed for many things it doesn't actually cause. AAP

Symptoms actually linked to teething:

• Sore, tender gums
• Drooling (though drooling also peaks around 3-4 months regardless of teething)
• Gnawing and chewing on objects
• Fussiness and irritability
• Disturbed sleep (usually the night or two around tooth eruption)
• Slightly elevated temperature (under 100.4°F/38°C)
• Decreased appetite for solid foods
• Rubbing face or ear on the same side as the emerging tooth

NOT caused by teething (despite popular belief):

• High fever (over 100.4°F/38°C)
• Diarrhea
• Vomiting
• Severe or prolonged illness
• Rashes all over the body
• Runny nose/congestion

Why the confusion:
Teething happens during the same developmental window (6-24 months) when babies are losing maternal antibodies, mouthing everything, and catching more infections. It's correlation, not causation.

If your baby has high fever or seems sick, don't assume it's "just teething." Call your pediatrician.

What's Happening in Those Gums

Understanding the process helps you sympathize: AAP

The teething process:

• Teeth develop in the jaw before birth
• Around 4-7 months, teeth begin moving toward the gum surface
• Gums may swell and appear bluish or red
• The tooth pushes through the gum (eruption)
• Once through, discomfort typically resolves quickly

Why it hurts:

• Pressure from teeth pressing against gums
• Inflammation as gum tissue stretches and breaks
• The actual eruption itself

Duration of discomfort:
Each tooth typically causes several days of discomfort—usually the few days before and during eruption. Contrary to popular belief, teething doesn't cause months of continuous symptoms.

Safe and Effective Relief

Here's what actually helps: AAP

### Counter-Pressure

Babies instinctively want to press on their gums because it provides relief:

• Teething toys: Solid silicone or rubber rings baby can gnaw on
• Chilled teething ring: Cold (not frozen) provides numbing relief
• Cold washcloth: Wet, wring out, and chill—great for gnawing
• Your clean finger: Gentle pressure on gums
• Mesh feeder with frozen fruit: For babies eating solids

Safety notes:

• Never freeze teething toys solid (can damage gums)
• Avoid liquid-filled teethers (can break and leak)
• Always supervise with any teething object
• Check regularly for wear and tear

### Cold and Cool

Cold numbs the gums and reduces inflammation:

• Cold washcloth
• Chilled spoon
• Chilled teething toy (not frozen)
• Cold fruit in a mesh feeder
• Cold water in a sippy cup (for older babies)

### Pain Relief Medication

When comfort measures aren't enough: AAP

Acetaminophen (Tylenol):

• Appropriate for babies over 2 months
• Follow package dosing by weight
• Can help with pain and low-grade fever
• Ask your pediatrician about dosing

Ibuprofen (Motrin/Advil):

• For babies 6 months and older
• Also reduces inflammation
• Follow package dosing by weight

Use medication thoughtfully: Save it for when baby is clearly uncomfortable, especially at night. Don't medicate constantly for weeks.

What NOT to Use

Some traditional remedies are unsafe: AAP

Avoid:

Benzocaine gels/liquids (like Orajel):

• FDA warns against use in children under 2
• Risk of methemoglobinemia (serious blood condition)
• Can numb throat and affect swallowing

Lidocaine products:

• Can be toxic to babies
• Has caused serious harm

Teething tablets:

• Some contain belladonna (toxic in large doses)
• FDA has warned against certain brands
• Unregulated dosing

Amber teething necklaces:

• No evidence they work
• Strangulation and choking hazard
• AAP recommends against them

Whiskey or alcohol on gums:

• Never do this
• Even small amounts can harm babies

Caring for New Teeth

Once teeth appear, they need care: AAP

Cleaning:

• Wipe gums and new teeth with a soft, damp cloth
• When more teeth appear, use a soft baby toothbrush
• Use a tiny smear of fluoride toothpaste (rice-grain size)

First dental visit:

• By age 1 or within 6 months of first tooth
• Establishes dental home
• Catches problems early

Bottle and breast care:

• Don't put baby to bed with a bottle of milk or juice
• Avoid prolonged nighttime nursing once teeth appear
• These habits can cause early childhood cavities

When to Call the Doctor

Contact your pediatrician if: AAP

• Fever over 100.4°F (38°C)
• Diarrhea, vomiting, or rash
• Baby seems truly sick
• Symptoms last more than a few days
• Baby refuses to eat or drink and seems dehydrated
• A tooth appears discolored or malformed
• You see signs of infection (pus, extreme swelling)
• Teething pain seems severe or doesn't respond to typical remedies

Common Teething Questions

"Why does my baby drool so much?"
Drooling increases around 3-4 months due to salivary gland development—often before teething even starts. It continues during teething because babies can't swallow all the extra saliva efficiently.

"Can teething cause diaper rash?"
This is controversial. Some parents swear drool-related diarrhea causes rash. Research doesn't strongly support a link, but if you notice a pattern, keep the diaper area clean and use barrier cream.

"Do late teethers have a problem?"
Usually not. Some babies don't get teeth until 12-14 months. As long as teeth appear by 18 months, it's typically not a concern. Discuss with your pediatrician if no teeth by 18 months.

"Does teething order matter?"
Not really. While there's a typical order, variations are normal and don't indicate problems.

"Should I be worried about teeth coming in crooked?"
Baby teeth spacing and positioning often don't predict adult teeth alignment. Primary teeth typically have gaps—that's normal and makes room for larger permanent teeth.

The Bottom Line

Teething is uncomfortable but temporary. Each tooth causes only a few days of symptoms, even though it may feel like it goes on forever when you're in the middle of it.

Use safe relief methods—counter-pressure, cold, and appropriate pain medication when needed. Avoid products that claim miraculous results or have safety warnings. And remember: high fever and illness aren't teething—they need medical attention.

You'll get through this, one tiny tooth at a time. Clara is here if you need help troubleshooting teething troubles.