Most babies start teething between 4 and 7 months old, and the signs usually show up a few days before a tooth actually breaks through the gum. The earliest clues are a combination of physical changes in the mouth and shifts in your baby’s behavior. Once you know what to look for, teething is fairly easy to spot.
The Most Reliable Signs of Teething
The clearest indicator is what you’ll see and feel inside your baby’s mouth. The gums where a tooth is about to come through will look red and swollen, and they’ll feel firm or bumpy if you run a clean finger along them. Sometimes you can see the faint white outline of a tooth just beneath the surface. In some babies, a small bluish blister called an eruption cyst forms over the spot where the tooth is pushing through. These look alarming but are harmless and resolve on their own once the tooth breaks the surface.
Beyond the gums, you’ll likely notice several behavioral changes happening at the same time:
- Increased drooling. Teething triggers a noticeable jump in saliva production. Some babies drool enough to soak through bibs and shirts.
- Chewing on everything. Your baby will gnaw on fingers, toys, the edge of the crib, your shoulder. The pressure feels good against sore gums.
- Fussiness and irritability. The discomfort is mild but persistent, and babies who are normally easygoing may become clingy or harder to settle.
- Changes in eating. Some babies refuse the breast or bottle because sucking puts pressure on inflamed gums. Others want to nurse more for comfort.
- Disrupted sleep. Teething discomfort doesn’t pause at night. You may notice more wake-ups or difficulty falling asleep.
- Ear pulling or cheek rubbing. The nerves in the gums, jaw, and ears are closely connected, so babies often tug at their ears or rub the side of their face when a tooth is coming in.
All that extra drool can also cause a rash around the mouth, chin, or neck. Keeping the skin dry with a soft cloth and applying a thin layer of petroleum jelly helps prevent it.
When Teeth Typically Appear
The two bottom front teeth are almost always the first to arrive, usually between 6 and 10 months. The top front teeth follow a month or two later. From there, the teeth on either side of those front four fill in, then the first molars appear around 12 to 16 months. The canines (the pointy ones between the front teeth and molars) come in around 16 to 20 months, and the second molars, all the way in the back, arrive between 20 and 30 months. By age 3, most children have a full set of 20 baby teeth.
Some babies get their first tooth as early as 3 months. Others don’t see one until after their first birthday. Both are normal. The timeline varies widely, and a later start doesn’t signal a problem.
How Long the Discomfort Lasts
Teething symptoms for each individual tooth typically last about a week: a few days of discomfort as the tooth pushes toward the surface, then a day or two of peak soreness as it breaks through, followed by quick relief once it’s out. The process isn’t continuous. You’ll get stretches of calm between teeth, though some babies have multiple teeth coming in at once, which extends the fussy period.
Molars tend to cause more discomfort than front teeth because they’re larger and have a broader surface pushing through the gum.
Teething vs. Illness
One of the trickiest parts of teething is that some symptoms overlap with common illnesses, especially ear infections. Both can cause irritability, sleep problems, and ear pulling. A few key differences help you tell them apart.
Teething can raise your baby’s body temperature slightly, but it does not cause a true fever. A temperature under 100.4°F is consistent with teething. Anything at or above 100.4°F, particularly in a baby younger than 3 months, points to an infection or illness and needs medical evaluation. Teething also doesn’t cause fluid or pus draining from the ear, persistent crying that doesn’t ease with comfort measures, or unusual lethargy. If your baby has a high fever, seems to be in significant pain, or has symptoms lasting more than a few days without an emerging tooth to show for it, something else is going on.
Diarrhea and vomiting are commonly blamed on teething but aren’t actually caused by it. Babies in the teething age range are also putting everything in their mouths, which increases their exposure to germs. The timing is a coincidence, not a connection.
Safe Ways to Ease Teething Pain
Cold and pressure are the two most effective, safest tools you have. A chilled (not frozen) teething ring or a clean, damp washcloth that’s been in the refrigerator for 15 minutes gives your baby something cool to gnaw on, which numbs the gum slightly and reduces swelling. Gently rubbing your baby’s gums with a clean finger provides direct counter-pressure that many babies find soothing.
For babies already eating solid food, chilled foods like cold applesauce or a refrigerated banana in a mesh feeder can do double duty as a snack and a teething tool. If your baby is clearly uncomfortable and none of the non-drug options are helping, infant-appropriate doses of acetaminophen or ibuprofen (for babies 6 months and older) can take the edge off. Your pediatrician can confirm the right dose based on your baby’s weight.
Products to Avoid
Several products marketed for teething pain are genuinely dangerous. The FDA warns that gels and creams containing numbing agents like benzocaine or lidocaine should never be used on infants or young children. Benzocaine can trigger a rare but life-threatening condition that severely reduces the blood’s ability to carry oxygen. Lidocaine solutions can cause seizures, heart problems, and brain injury if too much is absorbed or accidentally swallowed. These products also provide very little actual relief because saliva washes the medication off the gums within minutes.
Homeopathic teething tablets and gels have also been flagged by the FDA after reports of serious adverse events in children. The agency found inconsistent amounts of active ingredients in some products, meaning doses could be unpredictably high.
Amber teething necklaces are another popular product with no evidence of benefit. They pose real choking and strangulation risks. The claim that amber releases a pain-relieving substance when warmed by body heat has never been supported by any credible research.