The first signs that a baby tooth is on its way usually appear a few days before it breaks through the gum. You’ll notice red, swollen gums, increased drooling, and a baby who wants to chew on everything in reach. Most babies start teething around six months, though some begin earlier and others later.
What Teething Gums Actually Look Like
The clearest way to confirm teething is to look inside your baby’s mouth. Before a tooth erupts, the gum tissue directly above it swells and turns redder than the surrounding area. You may feel a small, firm bump along the gum line if you run a clean finger over it. Right before the tooth breaks through, a small white spot often appears on the surface of the gum. That’s the tip of the tooth pushing its way out.
These visual changes are the most reliable indicator, more so than behavioral shifts alone. Not every fussy baby is teething, but a red, swollen ridge on the gum with a visible bump or white spot almost certainly means a tooth is coming.
Common Symptoms and How Long They Last
Each tooth tends to cause about three to eight days of symptoms, starting a few days before the tooth pierces the gum and tapering off shortly after. The discomfort is real but temporary. Here’s what to watch for:
- Sore, red gums where the tooth is pushing through
- Extra drooling, sometimes enough to soak through bibs and shirts
- Chewing on hands, toys, or anything nearby because pressure on the gums provides relief
- Disrupted sleep, especially during the night or two before a tooth appears
- Fussiness or irritability that doesn’t seem connected to hunger, tiredness, or illness
Some parents notice their baby pulling at one ear on the same side as an incoming tooth. This happens because the gums, ears, and jaw share nerve pathways, so pain in one area can feel like it’s coming from another.
The Teething Timeline
Baby teeth come in gradually over about two and a half years, and the order is fairly predictable. The four front teeth, two on top and two on the bottom, usually arrive first, beginning around six months. From there, the teeth fill in outward and toward the back of the mouth. Most children have all 20 primary teeth by age three.
Here’s the general sequence:
- Central incisors (bottom, then top): around 6 to 12 months
- Lateral incisors (top, then bottom): around 9 to 16 months
- First molars: around 13 to 19 months
- Canines: around 16 to 23 months
- Second molars: around 23 to 33 months
These ranges are wide because normal variation is huge. Some babies are born with a tooth already visible, while others don’t get their first until after their first birthday. If your child has no teeth by nine months, it’s worth mentioning at their next checkup, but delayed eruption on its own is rarely a sign of a serious problem.
Teething Does Not Cause a True Fever
This is one of the most common misconceptions. Teething can raise a baby’s temperature slightly, but not above 100.4°F (38°C). Anything at or above that threshold is a fever, and fevers are the body’s response to infection, not to a tooth coming in.
The timing is confusing because babies start teething around the same age they lose the immune protection they got during pregnancy. That means more infections and more teething happen in the same window. If your baby has a temperature of 100.4°F or higher, diarrhea, a rash on parts of the body other than the chin, or vomiting, something else is going on besides teething.
Safe Ways to Ease the Pain
The simplest relief is pressure on the gums. A clean finger rubbed gently along the sore area works well, and so does a solid teething ring that’s been chilled in the refrigerator (not the freezer, which can make it hard enough to hurt). A cold, wet washcloth for your baby to gnaw on provides both pressure and mild numbing from the cold.
For babies who are clearly uncomfortable, especially overnight, infant-appropriate pain relievers like acetaminophen or ibuprofen (for babies over six months) can help. Follow the dosing guidance on the package based on your baby’s weight.
Products to Avoid
Numbing gels and creams sold for teething look like an obvious solution, but the FDA has issued strong warnings against them. Products containing benzocaine, a common numbing agent found in many over-the-counter oral gels, can cause a rare but potentially fatal condition where red blood cells lose their ability to carry oxygen effectively. Prescription-strength lidocaine solutions are equally dangerous for infants, with risks including seizures, heart problems, and severe brain injury.
Homeopathic teething tablets fall into the same category. The FDA warns that these products have been linked to serious adverse events in children and should not be used. The bottom line: if a product is designed to numb your baby’s gums, skip it. The risks far outweigh the benefits, which studies show are minimal to begin with.
Teething necklaces made of amber, wood, or silicone also carry choking and strangulation hazards. There’s no credible evidence that amber releases any pain-relieving substance through skin contact.
When to Schedule the First Dental Visit
Your child should see a dentist for the first time between the appearance of their first tooth and their first birthday, whichever comes first. This visit is less about finding problems and more about establishing a baseline, getting guidance on cleaning those new teeth, and catching any early concerns with development or bite alignment. A soft-bristled infant toothbrush with a rice-grain-sized smear of fluoride toothpaste is all you need for daily care once that first tooth appears.