Teething is the natural process where a baby’s first set of teeth (primary or deciduous teeth) push through the gums. This developmental milestone typically begins when an infant is between four and seven months old, though timing varies significantly. The eruption of these teeth is often accompanied by discomfort and noticeable changes in the baby’s behavior and physical appearance. Understanding the visual signs and accompanying physical symptoms helps parents navigate this often-fussy period.
The Distinct Look of Teething Gums
The most direct indication that a tooth is preparing to emerge is a localized change in the gum tissue. The area directly above the incoming tooth often appears puffy, swollen, and inflamed. This swelling is typically accompanied by a change in color, becoming a deeper pink or red at the site of eruption.
Parents may observe a small, dome-shaped bubble on the gum that can be translucent, bluish-purple, or dark red. This is known as an eruption cyst or hematoma, which forms when fluid or blood collects in the tissue above the emerging tooth. While this look can be alarming, these cysts are usually harmless and painless, typically rupturing on their own as the tooth breaks through. Just before the tooth cuts through, a small, white line or edge may become visible beneath the stretched gum surface.
Recognizing Other Physical Symptoms
Teething causes a variety of physical symptoms beyond visual changes in the mouth. Excessive drooling (hyper-salivation) is common and can lead to a rash on the chin, cheeks, or neck due to constant moisture exposure. The discomfort often triggers an intense urge to chew, causing babies to gnaw on toys, fingers, or any object they can reach.
General irritability and fussiness are reliable indicators, as the pressure and pain in the gums can cause discomfort and disrupted sleep. A common misconception is that teething causes a high fever. While inflammation may lead to a slight elevation in body temperature, it rarely causes an actual fever, defined as 100.4°F (38°C) or higher. A true fever is generally a sign of a coexisting illness, not teething alone.
Effective Ways to Soothe Discomfort
Relief for teething discomfort often involves applying gentle pressure and cold temperatures to the inflamed gums. Providing a chilled (but not frozen) teething ring or a clean, wet washcloth for the baby to chew on can temporarily numb the area and reduce swelling. The coolness helps constrict blood vessels, minimizing inflammation and pain.
Massaging the gums with a clean finger is another effective method, as the gentle counter-pressure can alleviate the deep ache. If physical methods are insufficient, a pediatrician may recommend an appropriate dose of over-the-counter pain relievers, such as acetaminophen or ibuprofen. Parents should strictly avoid topical numbing gels containing benzocaine. The FDA has warned that this ingredient can cause methemoglobinemia, a potentially serious blood condition. These gels offer little benefit since saliva quickly washes them away.
When to Contact Your Pediatrician
While teething is a normal process, certain symptoms warrant medical attention to rule out a more serious issue. A temperature reading of 100.4°F (38°C) or above is not typically caused by teething and requires a call to the doctor, especially if accompanied by other signs of illness.
Parents should also seek medical advice if the baby experiences persistent, unexplained diarrhea or vomiting, or refuses to drink fluids for an extended period, risking dehydration. Minor bleeding from an eruption cyst is normal, but significant, uncontrolled bleeding or the appearance of pus or severe redness suggesting an infection requires prompt evaluation. Consulting a healthcare provider ensures symptoms are correctly attributed to teething rather than an underlying illness.