Most babies start teething around 6 months of age, and the signs are usually a combination of swollen gums, extra drooling, and a sudden urge to chew on everything in sight. The tricky part is that teething symptoms overlap with normal baby fussiness, colds, and other illnesses, so knowing exactly what to look for (and what doesn’t actually come from teething) can save you a lot of worry.
When Teething Typically Starts
Babies are born with all 20 primary teeth already formed beneath the gums. Those teeth usually begin pushing through around 6 months, though some babies start as early as 4 months and others don’t see a first tooth until closer to their first birthday. The lower front two teeth (central incisors) almost always come in first, followed by the upper front two. From there, teeth tend to work outward, with molars arriving last, usually between 12 and 30 months.
Not every tooth causes the same level of discomfort. The first few teeth and the large molars tend to produce the most noticeable symptoms, while others may slip through with barely a fuss.
The Most Reliable Signs
No single symptom confirms teething on its own. Instead, you’re looking for a cluster of changes that show up together:
- Swollen, red gums. The gums directly over an erupting tooth will look puffy and may appear redder than the surrounding tissue. Run a clean finger along the gum ridge and you may feel a hard bump just beneath the surface.
- Increased drooling. Saliva production ramps up significantly during teething. You may notice your baby soaking through bibs faster than usual, or see drool running down their chin throughout the day.
- Chewing and gnawing. Babies instinctively press objects against their gums because the counter-pressure helps relieve the aching sensation. Fingers, toys, the edge of a crib rail, your shoulder: anything within reach becomes a chew toy.
- Fussiness and irritability. The dull, persistent pressure of a tooth pushing through tissue is uncomfortable. Babies who are normally easygoing may become clingy or cry more easily, especially in the late afternoon and evening.
- Sleep disruption. Discomfort that’s manageable during the day, when your baby is distracted, often becomes harder to ignore at night. Waking more frequently or resisting naps is common.
- Pulling at ears or rubbing cheeks. The nerves in the gums, jaw, and ears are closely connected. Babies sometimes tug at the ear on the same side as an erupting tooth, which can easily be mistaken for an ear infection.
- Changes in eating. Some babies refuse the breast or bottle because sucking puts pressure on sore gums. Others want to nurse more for comfort. Both reactions are normal.
What Teething Gums Actually Look Like
Healthy baby gums are pale pink and smooth. When a tooth is close to breaking through, the gum tissue directly above it will swell and turn a deeper pink or red. In some cases, you’ll see a small, whitish bump where the tooth tip is just barely visible beneath the surface. Occasionally a bluish blister, called an eruption cyst, forms over the tooth. This looks alarming but is harmless and resolves on its own once the tooth pushes through.
If the gums appear bright red, bleed easily, or have white patches that don’t look like a tooth tip, something other than teething may be going on.
Drool Rash: A Common Side Effect
All that extra drool can irritate your baby’s skin when it sits on the face for extended periods. Drool rash shows up as flat or slightly raised red patches around the mouth, chin, cheeks, and neck. The skin may also look dry or chapped. It’s not contagious and isn’t a sign of anything serious.
Keeping the area dry helps the most. Gently pat (don’t rub) your baby’s face with a soft cloth throughout the day, and apply a thin layer of petroleum jelly or a barrier cream around the mouth and chin before naps and bedtime. This creates a shield between the saliva and the skin.
What Teething Does Not Cause
One of the biggest misconceptions is that teething causes fever. It doesn’t. Teething may raise your baby’s body temperature slightly above the normal baseline of about 98.6°F, but it won’t push a thermometer to 100.4°F or higher. That threshold defines a true fever, and a fever signals an infection, not a new tooth. If your baby’s temperature hits 100.4°F or above, treat it as a separate issue rather than blaming teething.
Teething also doesn’t cause diarrhea, vomiting, or widespread body rashes. The timing of teething (roughly 6 to 24 months) overlaps with the period when babies lose their maternal antibodies and start picking up viruses. It’s easy to attribute a runny nose or loose stools to a new tooth, but those symptoms deserve their own attention.
How Long Each Tooth Takes
Symptoms tend to flare in the days before and just after a tooth cuts through the gum, then fade quickly once the tooth is fully visible. Most parents notice a window of roughly 3 to 7 days of peak fussiness per tooth. Because teeth often arrive in pairs (the two bottom front teeth, then the two top ones), you may experience overlapping rounds of discomfort with brief breaks in between.
The entire process of getting all 20 primary teeth stretches from about 6 months to around age 2.5 or 3. It’s not continuous misery, though. Many teeth emerge with little to no fuss, and the most intense stretches are usually short-lived.
Safe Ways to Ease the Pain
The simplest remedies are the most effective. A clean finger pressed gently against the swollen gum provides counter-pressure that many babies find immediately soothing. Wash your hands well, then rub or let your baby gnaw on your finger or knuckle. This works especially well at bedtime when fussiness peaks.
Rubber or silicone teething toys give your baby something safe to chew independently. For extra relief, chill a damp washcloth in the freezer for 15 to 20 minutes and let your baby gnaw on the cold fabric. The combination of texture and cold helps numb sore gums. Avoid freezing the cloth solid, as that can be too hard on tender tissue.
If your baby seems genuinely uncomfortable and home remedies aren’t enough, an occasional dose of infant acetaminophen can help, particularly at night when pain disrupts sleep. Moderate use is considered safe, though frequent or prolonged use is not. Your pediatrician can confirm the right amount based on your baby’s weight.
Products to Avoid
Several popular teething products carry real safety risks. Numbing gels containing benzocaine (sold over the counter for mouth pain) should not be used on infants. Benzocaine can trigger a rare but serious condition that reduces the blood’s ability to carry oxygen, which can be fatal. Prescription-strength numbing solutions containing lidocaine are equally dangerous for babies and have been linked to seizures, heart problems, and death when accidentally swallowed or over-applied.
Amber teething necklaces, marketed with claims that amber releases a natural pain reliever when warmed by the skin, pose strangulation and choking hazards. The FDA has received reports of infant deaths from teething jewelry. No credible evidence supports the idea that amber provides any pain relief.
Stick with the basics: cold, pressure, and chewing. They address the actual source of discomfort without introducing unnecessary risk.