Teething typically causes swollen or tender gums, increased drooling, and a strong urge to chew on anything within reach. Most babies cut their first tooth between 6 and 12 months of age, and the process repeats as all 20 baby teeth gradually come in by around age 3. The symptoms are usually mild and short-lived for each tooth, but they can make both babies and parents miserable in the moment.
The Most Reliable Teething Symptoms
The hallmark sign is gum swelling and tenderness right where a tooth is pushing through. You may notice the gum looking slightly red or puffy, and in some cases a small fluid-filled bump (called an eruption cyst) appears over the incoming tooth. This is harmless and usually resolves on its own once the tooth breaks through the surface.
Other well-established symptoms include:
- Increased drooling. Babies produce noticeably more saliva during teething, sometimes enough to soak through bibs and shirts.
- Chewing and gnawing. Pressure on the gums feels soothing, so babies will put fingers, toys, and anything else they can grab into their mouths.
- Irritability and fussiness. The discomfort is real, even if it’s mild. Some babies are crankier than usual for a few days around each new tooth.
- Rubbing ears or cheeks. Babies sometimes pull at their ears or rub the side of their face on the same side as the emerging tooth. The gums, ears, and cheeks share nerve pathways, so discomfort in one area can feel like it’s coming from another.
- Mild decrease in appetite. Sore gums can make feeding less comfortable, especially with a spoon or on harder foods.
Drool Rash: A Secondary Symptom
All that extra saliva often causes a rash around the mouth, chin, or neck. It typically looks like red, slightly raised patches of skin with some dryness or chapping, and sometimes small bumps. The rash isn’t caused by teething directly but by constant moisture sitting on delicate skin.
To prevent or treat it, gently pat the area dry with a soft cloth throughout the day and apply a barrier cream like Aquaphor or lanolin to protect the skin. Stick with mild, fragrance-free soap at bath time to avoid making the irritation worse.
Does Teething Really Disrupt Sleep?
Many parents report that teething wrecks their baby’s sleep, but the evidence is surprisingly thin. A longitudinal study that used video monitoring to objectively track infant sleep found no significant differences in total sleep time, nighttime awakenings, or how often parents had to visit the crib between teething and non-teething nights. Over half the parents in the study believed their baby’s sleep was disrupted during teething, but the camera data didn’t back that up.
This doesn’t mean your baby won’t have a rough night here and there. But if sleep problems persist for more than a few days, teething probably isn’t the explanation, and it’s worth looking at other causes like illness, a growth spurt, or a schedule change.
Fever, Diarrhea, and Other Symptoms That Aren’t Teething
One of the most important things to understand about teething is what it does not cause. Fever, diarrhea, vomiting, and body rashes are commonly blamed on teething, but there is no scientific proof linking these symptoms to tooth eruption. In one study of parental beliefs, 70% of mothers attributed fever to teething and nearly 69% blamed diarrhea on it.
The timing is what creates the confusion. Babies start teething around 6 months, which is the same age they begin crawling, putting random objects in their mouths, and losing the protective antibodies they received from their mother. Infections become more common right when teeth start showing up, so parents naturally connect the two. A slight rise in temperature (under 100.4°F or 38°C) around the day a tooth erupts has been observed in some research, but anything above that threshold is a true fever and points to illness, not teething.
Attributing serious symptoms to teething can delay treatment. Pediatric emergency departments have documented cases where parents waited to seek care for high fevers or dehydration from diarrhea because they assumed teething was responsible. If your baby has a fever above 100.4°F, persistent diarrhea, vomiting, or seems genuinely unwell, those symptoms deserve their own evaluation.
When Each Tooth Typically Appears
The two bottom front teeth usually come in first, typically between 6 and 10 months. The top four front teeth follow between 8 and 13 months. After that, teeth fill in roughly in pairs, one on each side of the jaw. Here’s the general timeline:
- Lower central incisors (bottom front): 6 to 10 months
- Upper central incisors (top front): 8 to 12 months
- Upper lateral incisors (flanking the front): 9 to 13 months
- Lower lateral incisors: 10 to 16 months
- First molars: 13 to 19 months (upper), 14 to 18 months (lower)
- Canines: 16 to 23 months
- Second molars: 23 to 33 months
These ranges are wide because the variation between babies is enormous. Some infants are born with a tooth already visible; others don’t get their first one until after their first birthday. Both extremes are normal. Lower teeth generally come in before their upper counterparts, and teeth almost always arrive in pairs on each side of the jaw.
Safe Ways to Ease Teething Discomfort
The simplest and safest approach is pressure and cold. A clean, wet washcloth chilled in the refrigerator (not the freezer) gives your baby something to gnaw on that soothes the gums. Solid, one-piece teething rings that have been refrigerated work well too. Avoid liquid-filled teethers, which can break and leak. You can also gently rub your baby’s gums with a clean finger to provide counter-pressure against the incoming tooth.
If your baby is old enough for solid foods, chilled (not frozen) items like a cold spoon or a refrigerated piece of fruit in a mesh feeder can help. For babies in significant discomfort, ask your pediatrician about an age-appropriate dose of infant pain reliever.
Products to Avoid
The FDA has issued explicit warnings against several popular teething products. Topical gels and creams containing benzocaine (found in many over-the-counter teething gels) offer little to no benefit and carry the risk of a rare but serious condition that reduces the blood’s ability to carry oxygen. Prescription lidocaine solutions are even more dangerous for infants, with risks including seizures, heart problems, and brain injury.
Homeopathic teething tablets have also drawn FDA warnings. Testing of products marketed by major brands found that levels of belladonna, a toxic plant extract, varied wildly between tablets and in some cases far exceeded what was stated on the label. Several of these products were recalled, and the FDA advises parents not to use homeopathic teething tablets or gels at all.
Amber teething necklaces, another popular remedy, pose a strangulation and choking hazard with no proven benefit. No evidence supports the idea that amber releases pain-relieving compounds through skin contact.