The process of teething is a significant developmental milestone, but it often brings discomfort. Molars, in particular, can be challenging because they are the largest teeth and typically emerge later in childhood, often between 13 and 33 months of age. The first molars usually appear between 13 and 19 months, followed by the second molars between 23 and 33 months. Understanding which symptoms are normal and which signal a need for medical attention is crucial during this stage.
Addressing the Fever Question
The question of whether molar eruption causes a fever is a common concern. Medical consensus provides a clear distinction: teething can cause a mild elevation in body temperature, sometimes described as a low-grade temperature. This slight rise is attributed to localized inflammation in the gums as the tooth presses through the tissue.
However, a true fever, medically defined as 100.4°F (38°C) or higher, is not caused by teething alone. Studies indicate that while a slight temperature increase may occur, it rarely reaches the fever threshold. If a child exhibits a temperature above 100.4°F, they likely have an underlying illness, such as a cold or ear infection, coinciding with the teething period. Toddlers frequently put objects into their mouths to relieve gum pressure, which can inadvertently lead to picking up germs that cause illness.
Typical Discomfort During Molar Eruption
The eruption of molars often results in noticeable discomfort compared to smaller front teeth, primarily because molars have a larger surface area. A common symptom is increased drooling, which can lead to a mild rash or irritation around the mouth and chin. The pressure from the teeth pushing through the gum tissue causes localized soreness and swelling, sometimes appearing as redness or a slight bulge at the back of the mouth.
Behavioral changes are also typical, including irritability, fussiness, and difficulty sleeping. The pain tends to intensify at night when there are fewer distractions, disrupting sleep patterns. Many toddlers attempt to relieve the pressure by gnawing or chewing on objects, fingers, or clothing. The discomfort can also make chewing painful, leading to a temporary decrease in appetite for solid foods.
Safe Ways to Soothe Sore Gums
Managing the discomfort associated with molar eruption focuses on safe, non-medicinal, and approved over-the-counter methods. Applying gentle pressure directly to the affected area can offer relief, accomplished by rubbing the gums with a clean finger or a moist gauze pad. The cooling sensation helps to temporarily numb the area and reduce inflammation.
Chilled items are particularly effective, such as firm, clean teething rings that have been refrigerated, not frozen. Freezing a teether can make it too hard, posing a risk of bruising or damaging the tender gum tissue. A clean, damp washcloth twisted and chilled in the refrigerator is another safe option for the child to chew on. If discomfort is severe, approved pain relievers like acetaminophen or ibuprofen can be used temporarily, strictly following age- and weight-based dosage instructions provided by a healthcare professional.
It is important to avoid applying topical numbing gels or liquids containing benzocaine to a child’s gums. The U.S. Food and Drug Administration (FDA) has warned against benzocaine products for teething pain, especially in children under two years old. This is due to the risk of methemoglobinemia, a rare but serious blood disorder. These gels are often ineffective because saliva quickly washes the product away, and they can potentially numb the back of the throat, interfering with the swallowing reflex.
Recognizing Symptoms That Need Medical Care
Differentiating between normal teething discomfort and signs of illness is paramount for a child’s safety. While teething may cause a low-grade temperature, a true fever (100.4°F or higher) should not be automatically attributed to the erupting molar. This level of fever indicates an infection or other medical condition requiring professional evaluation.
Parents should seek immediate medical consultation if the child exhibits symptoms not associated with teething, such as diarrhea, vomiting, or a widespread rash. Other concerning signs include refusal to drink fluids, which risks dehydration, or extreme lethargy and inconsolable crying. If fussiness and discomfort persist for more than a few days, or if a fever lasts longer than 24 hours, consult a pediatrician to rule out a separate illness.