The safest and most effective remedies for a teething baby are also the simplest: chilled teething rings, gentle gum massage with a clean finger, and age-appropriate doses of acetaminophen or ibuprofen when the discomfort is more than mild. A clinical trial comparing non-drug approaches found that teething rings produced the best results for both symptom recovery time and parent satisfaction, followed by comforting and gum rubbing. The challenge for most parents is not finding something that works but filtering out the many products and folk remedies that either do nothing or carry real risks.
Why Teething Hurts and What Actually Helps
When a tooth pushes through the gum, the tissue stretches, swells, and becomes tender. Cold objects placed against the gums cause blood vessels to narrow locally, which reduces that swelling. At the same time, firm pressure on the gum gives the infant something to push back against, and that counterpressure temporarily overrides the pain signal. This is why a chilled teething ring works on two fronts at once: the cold dampens inflammation while the biting provides pressure relief.
A clinical trial published in BMC Oral Health tested several non-drug methods head-to-head and found teething rings were the most effective at relieving drooling, gum irritation, sleep disruption, and crying. Comforting the baby (sometimes called “cuddle therapy” in the research) came in second, followed by rubbing the gums directly with a clean finger or damp gauze.1PubMed Central. Signs and symptoms associated with primary tooth eruption: a clinical trial of nonpharmacological remedies A systematic review covering the same evidence confirmed those rankings.2Braz. oral. res. Efficacy of treatments used to relieve signs and symptoms associated with teething: a systematic review
A few practical pointers make these remedies work better. Teething rings should be cooled in the refrigerator, not the freezer. A frozen ring can be hard enough to bruise sensitive gums. Solid silicone or rubber rings are preferable to liquid-filled ones, which can crack and leak. When using your finger, a piece of wet gauze wrapped around the fingertip gives a slightly rougher texture that many babies seem to prefer. And if the baby simply wants to be held and rocked, that is not a consolation prize. The research suggests comforting genuinely helps with symptom relief, not just mood.
When Over-the-Counter Pain Relievers Make Sense
If a baby is visibly uncomfortable despite chewing on a ring or being soothed, infant acetaminophen or infant ibuprofen are the standard pharmacological options. A meta-analysis pooling data from multiple trials found the two drugs to be comparably effective for pain relief in children, with no meaningful difference at two or four hours after a dose.3PubMed. Efficacy and safety of acetaminophen vs ibuprofen for treating children’s pain or fever: a meta-analysis Ibuprofen was modestly better at reducing fever over six hours, though teething rarely produces a true fever anyway (more on that below). The same meta-analysis found no significant difference in minor or major side effects between the two drugs across safety trials involving over 1,800 children.
The important age distinction: ibuprofen should not be given to babies younger than six months. Acetaminophen can be used from about two months onward, which covers the earliest teething. Dosing is always by weight, not age, so check the product label or call your pediatrician if you are unsure. The goal is short-term, as-needed use for flare-ups of discomfort, not round-the-clock dosing for weeks.
What You Should Not Put on a Baby’s Gums
Over-the-counter teething gels containing benzocaine are one of the most common products parents reach for, and one of the riskiest. Benzocaine is a topical anesthetic found in many oral gels at concentrations between 7.5% and 20%. In young children, exposure to these concentrations can trigger methemoglobinemia, a condition where hemoglobin loses its ability to carry oxygen effectively. A review of pediatric benzocaine exposures reported to a statewide poison control system found cases with methemoglobin levels as high as 55%, requiring emergency treatment with intravenous methylene blue and supplemental oxygen.4PubMed Central. Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System The U.S. FDA issued warnings specifically about benzocaine-containing teething products and asked manufacturers to stop marketing them for children under two.
Lidocaine-based teething gels carry a similar overdose risk in infants. The problem with any topical numbing agent applied inside a baby’s mouth is that the baby swallows most of it almost immediately, making it hard to control the dose. Even when the gel stays on the gum briefly, drool dilutes it and the numbness wears off within minutes, so the practical benefit is fleeting while the risk is not.
Homeopathic teething tablets have also drawn FDA scrutiny. Some products tested by the agency contained inconsistent and sometimes elevated levels of belladonna alkaloids. Regardless of the specific ingredient, the broader concern with any tablet or gel marketed for teething is that these products often bypass the level of safety testing that prescription drugs undergo, and the youngest patients have the narrowest margin for error.
Amber Necklaces and Other Products That Do Not Work
Amber teething necklaces are marketed with the claim that body heat releases succinic acid from the beads, which then absorbs through the skin and reduces inflammation. There is no clinical evidence supporting this mechanism or the claim that the necklaces reduce teething pain. What the research does show is that they are a strangulation and choking hazard. A study that tested amber necklace clasps found that about half failed to open at the force level used in the standard safety test for children’s jewelry. Eighty percent failed to release at the level of force that published research has shown can compress a young child’s airway.5PubMed Central. Fad over fatality? The hazards of amber teething necklaces
Beyond the strangulation risk, individual beads can break free and be swallowed or aspirated, and the necklaces can harbor bacteria against the skin. A review in Revista Paulista de Pediatria concluded that the necklaces carry risks of choking, strangulation, bead ingestion, and skin or oral infections, with no demonstrated clinical benefit to offset any of them.6PubMed Central. Use of the amber teething necklace by the child population: risks versus benefits The same logic applies to silicone bead necklaces worn by the parent for the baby to chew on: any jewelry around or near a baby’s neck is a potential hazard, and safer chewing options exist.
Teething Probably Does Not Cause What You Think It Causes
One of the most persistent beliefs in parenting is that teething causes fevers, diarrhea, runny noses, and rashes. The evidence behind these beliefs is surprisingly thin. A cohort study that tracked children from 6 to 30 months compared symptoms on days a tooth actually emerged versus non-tooth days. Body temperatures were virtually identical. No significant association was found between tooth eruption and fever, mood changes, sleep disruption, diarrhea, or rashes when assessed by trained staff. The only marginally significant link was parent-reported loose stools on the day of eruption itself, and that association disappeared when the window was widened to include the days surrounding eruption.7Pediatrics. Teething and Tooth Eruption in Infants: A Cohort Study
The researchers noted a striking disconnect: every parent in the study retrospectively reported that their child had experienced a range of teething symptoms, even though the prospective daily data did not bear that out. This mismatch matters because it can lead parents to dismiss genuine illness. A baby running a real fever of 38.3°C (101°F) or higher, or with persistent diarrhea, deserves medical evaluation regardless of whether a tooth happens to be coming in. Chalking it up to teething can delay the diagnosis of ear infections, urinary tract infections, or viral illnesses that happen to coincide with the teething timeline.
Research in different cultures has confirmed this tendency. A study of mothers in Qatar found that symptoms commonly attributed to teething were reported by mothers across all educational backgrounds, including those with medical training. Younger mothers and those with only one child were the most likely to blame common illness symptoms on teething.8PubMed Central. Mothers’ false beliefs and myths associated with teething Similarly, a study of mothers in Ethiopia documented widespread misconceptions about teething symptoms and called for health education from dentists and child-care professionals to correct them.9PubMed Central. Misconceptions and traditional practices towards infant teething symptoms among mothers in Southwest Ethiopia
Does Teething Actually Disrupt Sleep?
Ask any parent and they will tell you teething wrecked their baby’s sleep for a week. The objective data tells a different story. A longitudinal study that used video recording to measure infant sleep found no significant differences in sleep duration, wake frequency, or sleep efficiency between teething nights and non-teething nights. More than half of the parents in the study reported sleep disturbances during teething periods, but those subjective reports were not supported by what the cameras captured.10PubMed. Does Teething Disrupt Infant Sleep? A Longitudinal Auto-Videosomnography Study
This does not mean your baby is not fussier than usual. It means the sleep disruption many parents observe during teething periods may be driven more by the normal developmental upheaval happening at the same ages teeth appear, coinciding with separation anxiety phases, growth spurts, and changing nap schedules. Teething spans roughly from 6 to 30 months, which is the same window during which nearly every major infant sleep regression occurs. The overlap makes it almost impossible for a parent to separate the two without a video camera and a spreadsheet, and even the researchers needed both.
Dealing with the Drool
Whether or not drooling is truly caused by teething or simply peaks during the same developmental window, the practical reality is that many babies produce impressive amounts of saliva between about four and twelve months. Prolonged wetness on the chin, cheeks, and neck folds can irritate the skin, leading to a red, slightly bumpy rash sometimes called drool rash.
Managing it is straightforward. Keep the area as dry as possible by gently blotting with a soft cloth throughout the day rather than wiping, which can further irritate raw skin. A thin layer of petroleum jelly or a fragrance-free barrier cream on the chin and cheeks before naps and bedtime protects the skin from sustained moisture contact. Bibs help keep the chest dry but should be removed during sleep to avoid a suffocation risk. If the rash becomes cracked, oozy, or does not improve with basic barrier care within a few days, a pediatrician can rule out a secondary infection or eczema flare.
Food and Frozen Items as Teething Aids
Once a baby is eating solid foods, usually around six months, many parents offer chilled fruit in a mesh feeder or a cold washcloth to chew on. These can work on the same cold-plus-pressure principle as a teething ring. A few cautions are worth noting. Whole frozen items like frozen fruit chunks or bagels are potential choking hazards, especially before a baby has developed strong chewing skills. Mesh or silicone feeders that hold the food while letting the baby gnaw at it are a safer option. Hard vegetables like raw carrots are risky for the same reason: a piece can break off and block the airway before the baby has molars to grind it down.
Cold washcloths, dampened and placed in the refrigerator for a few minutes, are a low-tech and nearly free alternative. Some parents knot one end to give the baby something to grip. As with teething rings, refrigerator-cold is the target, not freezer-cold.
Starting Oral Hygiene with the First Tooth
Teething is not just a pain-management problem. It is also the start of your baby’s dental health story. The American Academy of Pediatrics recommends beginning fluoride toothpaste with the eruption of the very first tooth. For children under three, the recommended amount is a smear about the size of a grain of rice. After age three, a pea-sized amount is appropriate.11Pediatrics. Fluoride Use in Caries Prevention in the Primary Care Setting
Many parents assume baby teeth do not need much attention because they will fall out anyway. But decay in primary teeth can cause pain, infection, and problems with the spacing of permanent teeth. Wiping the gums with a damp cloth before teeth appear, then switching to a soft infant toothbrush with a rice-grain smear of fluoride toothpaste once the first tooth is visible, sets up good habits early. The first dental visit is generally recommended by age one or within six months of the first tooth, whichever comes first.
How Teething Treatments Have Changed Over the Centuries
If you think teething remedies today sound questionable, the historical record is far worse. For several hundred years, the standard medical recommendation for a teething infant was to lance the gums with a sharp instrument. The physician John Arbuthnot, who treated Queen Anne in the early 1700s, claimed that more than a tenth of infants died from teething complications. He and the sixteenth-century surgeon Ambroise Paré both advocated cutting the gums to help teeth emerge. American medical journals were still publishing the same advice well into the 1850s.12Pediatrics. ON THE IMPORTANCE OF LANCING THE TEETHING INFANT’S GUMS, AS VIEWED IN 1857
The belief that teething could kill a baby was not fringe. It was mainstream medicine for centuries, and it led to interventions that themselves caused infection, bleeding, and suffering. The reason this history matters is that it puts modern misconceptions into perspective. Believing teething causes fever is incorrect, but it is a far cry from slicing open an infant’s gums with an unsterilized lancet. The arc of teething treatment has been one of gradually replacing dramatic interventions with gentler ones, and the evidence now points toward the gentlest approaches being the most effective: a chilled ring, a clean finger, a cuddle, and an appropriate dose of pain reliever when needed.
When to Call the Pediatrician
Most teething discomfort is manageable at home. But a few situations warrant a call to your pediatrician or a visit to the clinic:
- Fever over 38.3°C (101°F): Teething does not produce fevers this high. A real fever needs evaluation for an underlying cause.
- Persistent diarrhea or vomiting: These are not teething symptoms. Dehydration in infants can escalate quickly.
- Refusal to eat or drink for more than a day: Some fussiness with feeding is normal, but prolonged refusal may indicate something beyond teething.
- A visible abscess or swelling on the gum: An eruption cyst, which looks like a bluish bump on the gum, is usually harmless and resolves on its own. But a red, swollen, or pus-filled area needs professional evaluation.
- Rash that spreads beyond the chin and cheeks: Drool rash stays where the drool touches. A spreading rash may be viral or allergic.
The safest mindset is to treat teething as a minor discomfort that needs only minor interventions, and to evaluate any significant symptom on its own merits rather than attributing it to a tooth. Babies teethe for roughly two years. In that time, they will inevitably catch colds, ear infections, and stomach bugs. Treating each illness appropriately, rather than waiting it out because “it’s just teething,” is one of the most important things you can do for a teething-age baby.