The Teething Process and Common Symptoms
Teething is a natural developmental stage for infants, as teeth erupt through the gums. While timing varies significantly, the first molars typically emerge between 13 and 19 months, and the second molars usually appear between 23 and 33 months. These larger back teeth can cause discomfort as they push through the gums.
Common teething signs include increased drooling (sometimes causing a rash around the mouth) and a strong urge to chew on objects. Babies may also be irritable, fussy, or cry due to sore gums. Eating and sleeping patterns often change, with some babies showing decreased appetite or disrupted sleep.
Teething and Fever: The Medical Consensus
A common concern among parents is whether teething, especially the eruption of molars, causes a fever. Medical consensus clarifies that teething itself does not cause a true fever, which is defined as a temperature of 100.4°F (38°C) or higher. While some babies may experience a slight elevation in body temperature during teething, this rise is low-grade and does not reach the threshold of a fever. This distinction is important because attributing a true fever to teething might lead to overlooking an underlying illness that requires medical attention.
The misconception often arises because infants commonly begin teething around 6 to 12 months, a period when their immune systems are changing, and they are more susceptible to common childhood illnesses. As babies explore their environment by putting objects into their mouths, they are exposed to new pathogens, which can lead to infections and, consequently, a fever. Therefore, a fever occurring during the teething period is more likely a symptom of an infection rather than a direct result of the tooth erupting.
Recognizing When a Fever Needs Medical Attention
When a child develops a fever during a teething phase, it is important to assess whether it warrants medical attention. A fever should not be automatically attributed to teething. For infants younger than 3 months, a rectal temperature of 100.4°F (38°C) or higher requires immediate medical consultation.
For children 3 months or older, medical attention is advised if the fever exceeds 102.2°F (39°C) or persists for more than 24 hours without an obvious cause. Additional concerning symptoms that, when present with a fever, indicate a need to consult a healthcare provider include:
Lethargy, unusual sleepiness, or irritability.
Refusal to drink liquids.
Persistent vomiting or diarrhea.
Signs of dehydration (e.g., reduced urination, lack of tears).
Rash, stiff neck, or difficulty breathing.
Any signs the child appears very ill.
Comfort Measures for Teething
To alleviate teething discomfort, several safe measures can be employed. Gentle gum massage with a clean finger or soft, wet cloth can provide relief. Offering chilled (not frozen) teething rings or a cool, damp washcloth to chew on can also soothe swollen gums. Freezing objects solid should be avoided as they can harm tender gums.
For intense discomfort, over-the-counter pain relievers like infant acetaminophen or ibuprofen can be considered, following age and weight-appropriate dosage guidelines. Consult a pediatrician before administering any medication to ensure correct dosage and suitability. Products containing benzocaine or lidocaine, often found in teething gels, are not recommended for young children due to potential safety concerns.