Most babies start teething between 4 and 7 months old, and the signs are usually a combination of fussiness, drooling, and swollen gums that show up a few days before a tooth breaks through. The tricky part is that teething looks a lot like other things, from ear infections to common colds, so knowing exactly what to watch for can save you a lot of unnecessary worry.
The Most Reliable Signs of Teething
The clearest signal is what’s happening inside your baby’s mouth. The gums where a tooth is about to erupt will look red and swollen, and they’ll feel tender to the touch. If you run a clean finger along the gum line, you may feel a hard bump just below the surface. Sometimes you’ll see a bluish-purple blister on the gum, which is a small pocket of fluid that forms as the tooth pushes upward. This looks alarming but is harmless and usually resolves on its own once the tooth pokes through.
Beyond the gums, you’ll likely notice a cluster of behavioral changes happening together:
- Increased drooling. Teething triggers extra saliva production. Your baby’s chin and chest may stay damp, and some babies develop a mild rash around the mouth or chin from the constant moisture.
- Chewing on everything. Babies instinctively press objects against their gums because the counterpressure helps relieve the aching sensation underneath.
- Irritability and fussiness. The discomfort is worst in the days right before a tooth cuts through, so you may notice your baby is crankier than usual during that narrow window.
- Disrupted sleep. Gum soreness doesn’t pause at bedtime. Babies who were sleeping well may start waking more frequently or have trouble settling down.
- Changes in eating. Some babies refuse the breast or bottle because sucking puts pressure on inflamed gums. Others want to nurse more for comfort. Both patterns are normal.
Ear Pulling and Other Confusing Signals
Babies often tug or rub at their ears while teething, which immediately makes parents think “ear infection.” The reason is referred pain: the nerves in the jaw and ear are closely connected, so gum soreness can radiate to the ear area. Some babies also just discover their ears around this age and grab at them out of curiosity. According to pediatricians at the University of Utah, ear pulling on its own isn’t a major concern unless your baby also has a fever or has recently had a cold. If those other signs are present, it’s worth having the ears checked.
You may also notice your baby rubbing their cheeks or jaw on the same side where a tooth is coming in. This is the same referred-pain mechanism and a useful clue for pinpointing which tooth is on its way.
What Teething Does Not Cause
One of the most persistent myths is that teething causes fever. It doesn’t. Teething can produce a very slight rise in body temperature, but it will not push your baby’s temperature to 100.4°F (38°C) or higher. That threshold is the clinical definition of a fever, and reaching it means something else is going on, whether it’s a virus, an ear infection, or another illness. If your baby has a true fever, don’t write it off as teething.
Teething also doesn’t cause diarrhea, severe vomiting, or a widespread body rash. These symptoms overlap with the teething timeline simply because babies start teething around the same age they’re losing maternal antibodies and picking up more infections. The timing is coincidental, not causal.
When Teeth Typically Appear
The two bottom front teeth (lower central incisors) almost always come in first, usually between 6 and 10 months. The two upper front teeth follow shortly after. From there, the teeth tend to fill in from front to back: the lateral incisors on either side of the front teeth, then the first molars, the canines, and finally the second molars. Most children have all 20 baby teeth by age 3.
Some babies are early starters and show teething signs as young as 3 or 4 months, while a few don’t cut their first tooth until after their first birthday. Both ends of the range are normal. The timing is largely genetic, so if you or your partner were late teethers, your baby may be too.
How Long the Discomfort Lasts
Teething pain isn’t constant. For each tooth, symptoms tend to peak in the few days before the tooth breaks through the gum and ease off fairly quickly once it does. The whole uncomfortable window per tooth is roughly 3 to 5 days on either side of the eruption. Between teeth, your baby will likely return to their usual temperament. The molars, which have a larger surface area pushing through the gums, tend to cause more discomfort than the smaller front teeth.
Safe Ways to Ease the Pain
The simplest and most effective option is pressure on the gums. You can gently rub or massage the swollen area with a clean finger. Many babies find this immediately soothing. A firm rubber teether (not the liquid-filled kind, which can break and leak) gives your baby something safe to chew on and provides that same counterpressure on their own terms.
Chilling helps too. A clean, damp washcloth placed in the refrigerator for 15 to 20 minutes makes a cold, textured surface your baby can gnaw on. Keep it refrigerator-cold, not frozen, because a frozen teether or cloth can be hard enough to bruise already-tender gums.
Products to Avoid
The FDA warns against using any teething gels or liquids containing benzocaine or lidocaine on infants. These numbing agents, found in products like Orajel, Anbesol, and similar over-the-counter gels, provide little actual benefit for teething pain and carry serious risks. Benzocaine can cause a condition that dramatically reduces the blood’s ability to carry oxygen, which can be fatal. Lidocaine solutions can cause seizures, heart problems, and severe brain injury if too much is swallowed, which is hard to control in a drooling baby.
Amber teething necklaces are another product to skip. There’s no evidence that amber releases any pain-relieving substance through the skin, and the necklaces pose choking and strangulation hazards. The same applies to teething bracelets and anklets made of small beads.
Signs That Point to Something Else
Because teething overlaps with the age when babies start getting frequent infections, it’s easy to mistake illness for teething or vice versa. A few signals suggest your baby’s discomfort isn’t just a new tooth coming in. A temperature of 100.4°F or higher is not teething. Persistent diarrhea or vomiting isn’t teething. A runny nose with thick, colored mucus lasting more than a few days points to an infection, not gum irritation. And if your baby seems inconsolable for more than a day or two, or their symptoms don’t match the short, tooth-by-tooth pattern described above, something else may be at play.
The best way to check at home is to wash your hands, gently press along the gum line, and look for redness, swelling, or the visible edge of a tooth. If you can see or feel a tooth on its way and the symptoms are mild, you’re almost certainly dealing with garden-variety teething.