If your baby is between 4 and 12 months old, drooling more than usual, and chewing on everything in sight, there’s a good chance teething has started. Those are the two hallmark signs: excessive drooling and an urgent need to rub or press things against the gums. Most babies cut their first tooth between 6 and 10 months, though some start earlier and others later.
The Classic Signs of Teething
The earliest and most reliable sign is drooling, often weeks before you can see or feel anything on the gums. Your baby will also start gnawing on fingers, toys, the edge of the crib, or anything within reach. This isn’t random mouthing. It’s targeted pressure on the gums, and it looks purposeful.
Beyond drooling and chewing, your baby may be crankier than usual or have a harder time settling down for sleep. Some babies develop a slight rise in temperature, but this is key: a true fever (over 101°F) is not caused by teething. If your baby has a fever above that threshold, a runny nose, diarrhea, or vomiting, something else is going on, most likely a virus or infection.
You may also notice swollen or puffy gums in the area where a tooth is about to break through. Sometimes the gum looks slightly bruised or bluish in one spot. That’s normal and temporary.
What Teething Does Not Cause
Teething has a reputation for causing just about every symptom a baby can have, but the medical consensus is much narrower. Teething does not cause diarrhea, significant diaper rash, high fevers, or heavy crying. The American Academy of Pediatrics is direct on this point: blaming fevers on teething can delay care for real infections like ear infections, urinary tract infections, or even meningitis.
Diarrhea is a common one that parents attribute to teething. Studies looking at this connection have found no reliable link. Babies who happen to have loose stools during teething are just as likely to become dehydrated as any baby with diarrhea, so it shouldn’t be dismissed as “just teething.”
Does Teething Actually Disrupt Sleep?
This one may surprise you. A longitudinal study that used overnight video recordings to compare teething nights with non-teething nights found no significant differences in total sleep time, number of awakenings, or how often parents needed to visit the crib. More than half of the parents in the study believed teething was disrupting their baby’s sleep, but the objective recordings didn’t back that up.
That doesn’t mean your baby is sleeping great. It means the sleep disruption you’re noticing may have a different cause: a growth spurt, a developmental leap, separation anxiety, or a mild illness. Knowing this matters because it can prevent you from reaching for pain medication night after night when the real issue might be something else entirely.
Which Teeth Come In and When
Teeth almost always arrive in pairs, one on each side of the jaw. Here’s the typical order:
- Bottom front teeth (central incisors): 6 to 10 months
- Top front teeth (central incisors): 8 to 12 months
- Top lateral incisors (next to the front teeth): 9 to 13 months
- Bottom lateral incisors: 10 to 16 months
- First molars: 13 to 19 months
- Second molars: 23 to 33 months
These ranges are wide for a reason. A baby who doesn’t have a single tooth at 10 months is still within the normal window. By age 3, most children have all 20 primary teeth.
Safe Ways to Ease the Discomfort
The best relief is the simplest: give your baby something safe to chew on. A solid teething ring (not liquid-filled, which can leak or break) that’s been chilled in the refrigerator works well. A clean, cold washcloth is another reliable option. The combination of pressure and cool temperature helps numb the gums naturally. Don’t freeze teething rings, as extreme cold can hurt tender gum tissue.
Gently rubbing your baby’s gums with a clean finger provides direct pressure and can be surprisingly effective. Many babies calm down quickly with this alone.
If your baby seems genuinely uncomfortable and non-medicated approaches aren’t helping, infant acetaminophen is an option for babies over 2 months old. Infant ibuprofen is another option but only for babies 6 months and older. Dosing is based on your baby’s weight, not age, so check the label carefully. Neither should be used routinely or for more than a day or two without good reason.
Products to Avoid
The FDA has issued explicit warnings against several popular teething products. Numbing gels and creams containing benzocaine or lidocaine should not be used on infants. Benzocaine can cause a rare but potentially fatal condition that reduces the blood’s ability to carry oxygen. Lidocaine, even in prescription form, can cause seizures, heart problems, and brain injury in young children when too much is swallowed or absorbed.
Homeopathic teething tablets fall under the same FDA warning. Despite their natural-sounding ingredients, these products have been linked to serious adverse events in children.
Amber teething necklaces are another product to skip. They pose a strangulation risk when worn and a choking risk if the beads break off. The American Academy of Pediatrics recommends that infants not wear any jewelry. There is no scientific evidence that amber releases any pain-relieving substance through the skin.
When Something Else Is Going On
Because the real symptoms of teething are limited to drooling, gum rubbing, and mild fussiness, any symptom beyond that deserves a closer look. A fever over 101°F, persistent diarrhea, a runny nose, rash on the body, unusual crying that doesn’t respond to comfort, or refusing to eat for more than a day are all signs that your baby may be dealing with an illness, not just a new tooth.
Babies in the 6 to 12 month age range are losing the passive immunity they got from the womb, which means they start catching more infections right around the same time they’re teething. The overlap makes it easy to blame everything on teeth.
Scheduling the First Dental Visit
Both the American Academy of Pediatric Dentistry and the American Dental Association recommend scheduling your baby’s first dental visit within 6 months of the first tooth appearing, and no later than 12 months of age. This visit is short and simple. It’s mainly a quick look at the gums and emerging teeth, a chance to discuss fluoride, and an opportunity to catch any early issues with tooth development.