Teething is a major milestone in an infant’s development, typically beginning around six months of age, though the timing varies significantly. It is a time associated with discomfort, fussiness, and changes in behavior as the first teeth begin to erupt through the gums. Parents frequently report various accompanying symptoms, and a common concern is whether nasal stuffiness or a runny nose is a direct result of this process. While many infants experience symptoms concurrently with tooth eruption, scientific evidence suggests a more nuanced answer. True nasal congestion is rarely a medically recognized symptom of teething itself.
The Origin of the Teething-Congestion Belief
The widespread belief that teething causes nasal congestion stems largely from a coincidence of timing. Teething commonly occurs in the second half of the first year, precisely when an infant’s passive immunity from the mother begins to wane. As babies become more mobile and interact with their environment, they are increasingly exposed to new germs. This exposure leads to a higher frequency of common colds and minor viral infections, which are the true cause of most infant congestion.
Parents naturally associate the stuffy nose with the discomfort of teething because the two symptoms appear simultaneously. A contributing factor is the substantial increase in drooling, a verified symptom of teething. This excessive saliva production can sometimes trickle down the back of the throat, leading to a mild cough or a gurgly sound that mimics congestion. The congestion is typically an independent event, not a physiological reaction to the tooth pushing through the gum line.
Verified Physical Signs of Teething
Symptoms scientifically attributed to tooth eruption are generally localized to the mouth and surrounding areas. The most noticeable sign is increased drooling (hypersalivation), which can be profuse enough to cause a rash on the chin or face. The gum tissue surrounding the erupting tooth may appear red, swollen, and tender to the touch.
Behavioral changes are also common, including increased irritability, fussiness, and a strong urge to chew on objects to relieve gum pressure. Some infants may experience a slight elevation in temperature, though studies indicate this is almost always a low-grade rise, remaining below 100.4°F (38°C). These symptoms confirm the discomfort is related to tooth eruption, distinguishing it from a true illness. A large study confirmed that congestion, high fever, and vomiting were not significantly associated with tooth emergence.
Actual Reasons for Infant Congestion
Since teething is not the direct cause of nasal stuffiness, infant congestion usually points to other common occurrences. The most frequent culprit is the common cold, a viral infection that triggers inflammation and increased mucus production in the nasal passages. This is a normal part of building the immune system, as infants may experience six to eight colds per year.
Infant nasal passages are naturally much narrower than those of older children and adults, meaning even small amounts of mucus cause significant audible congestion. Environmental factors like dry air, especially during winter months with indoor heating, can irritate the nasal lining and prompt the body to produce more mucus. Exposure to irritants such as pet dander, dust, or smoke can also cause inflammation and swelling in the small airways.
Simple measures can often provide relief, such as using a cool-mist humidifier in the baby’s room to moisten the air or applying a few drops of saline solution to thin the mucus before gently suctioning the nose.
Recognizing When to Seek Medical Care
While most mild congestion and teething discomfort can be managed at home, parents must recognize specific signs that indicate the need for professional medical attention. Congestion accompanied by a fever higher than 100.4°F (38°C) is a red flag, as this temperature is not caused by teething alone.
Any signs of difficulty breathing should prompt an immediate consultation with a pediatrician. These signs include rapid breathing, wheezing, or the skin pulling in between the ribs.
Further concerning symptoms include persistent thick, discolored nasal discharge lasting several days, refusal to feed over multiple attempts, or signs of dehydration. Signs of dehydration include significantly fewer wet diapers. If the infant appears unusually lethargic or drowsy, or if symptoms are severe enough to significantly disrupt sleeping and feeding patterns, contact a healthcare provider. These symptoms suggest an underlying illness requiring diagnosis and treatment separate from the normal developmental process of teething.