Teething is the process of an infant’s first teeth erupting through the gums, typically beginning between four and seven months of age. This developmental milestone often brings discomfort. One frequently cited concern is the link between tooth emergence and digestive upset, specifically diarrhea. Clarifying this belief requires separating the physical process of teething from coincidental factors occurring during the same period.
Addressing the Correlation Between Teething and Diarrhea
Medical consensus rejects a direct causal link between a tooth breaking the gum line and clinical diarrhea. Diarrhea is defined as a sudden increase in the number of stools, usually three or more, that are watery or very loose. The trauma of a tooth pushing through gum tissue does not trigger the intestinal inflammation necessary for this severe digestive event. While many parents observe loose stools during teething, pediatricians consider this a coincidence rather than a cause-and-effect relationship. Severe or prolonged diarrhea, especially when accompanied by other symptoms, is almost always an indication of an unrelated illness or infection.
The Mechanisms Behind Loose Stools During Teething
Although teething does not directly cause diarrhea, the behaviors associated with it can indirectly lead to looser or slightly more frequent stools. Infants produce excessive amounts of saliva during teething to help soothe their irritated gums. When this increased volume of drool is swallowed, the excess fluid and digestive enzymes can alter the consistency of the stool, making it appear looser than normal. This is distinct from true, watery diarrhea caused by a gastrointestinal infection.
Teething infants also have a strong urge to chew on any available object to relieve gum pressure. This increased hand-to-mouth and object-to-mouth activity introduces a higher volume of germs and bacteria into the digestive system. Exposure to these new pathogens can lead to minor gastrointestinal distress or a mild, short-lived infection. The timing of teething (4 to 24 months) also overlaps with introducing new foods and the natural decline of maternal antibodies. These simultaneous developmental changes are much more likely to cause mild changes in bowel movements than the eruption of a tooth itself.
Definitive Physical Signs of Teething
The physical signs definitively caused by the erupting tooth are localized to the mouth and surrounding areas. These include gums that appear swollen, red, or tender at the site where the tooth is emerging. Infants typically exhibit an increased need to chew on hands, toys, or other objects to counteract the pressure beneath the gum surface. Excessive drooling is one of the most common and earliest signs, often leading to a moisture-related rash around the chin and mouth.
Fussiness and irritability are characteristic of teething as the infant experiences discomfort and mild pain. The pain may sometimes radiate, causing a baby to rub their cheek or pull at their ear on the affected side. A slight elevation in body temperature (low-grade fever) can occur, but this temperature remains below 100.4°F (38.3°C). Any fever higher than this is not associated with teething and suggests an unrelated illness requiring medical attention.
Recognizing Severe Diarrhea and Dehydration
Severe diarrhea is not a typical symptom of teething and requires careful monitoring for potential illness. Severe diarrhea is characterized by ten or more watery stools in 24 hours, or stools containing blood or mucus. The primary risk of persistent diarrhea is dehydration, which is concerning for infants. Signs of mild to moderate dehydration include having fewer than six wet diapers per day, a parched or dry mouth, and fewer tears when crying.
More serious indicators of dehydration include sunken eyes, a sunken soft spot on the top of the head, and excessive sleepiness or lethargy. A pediatrician should be consulted immediately if an infant shows these signs, or if diarrhea lasts more than a few days. Medical attention is also necessary if diarrhea is accompanied by vomiting, a high fever over 100.4°F (38°C), or if the infant refuses to drink fluids.