Teething is the natural biological process where a baby’s first set of teeth, known as primary or deciduous teeth, gradually push through the gums. This developmental milestone typically occurs in infancy and is often accompanied by noticeable changes in a baby’s behavior and physical state. Caregivers frequently inspect the mouth to visually confirm a new tooth is on its way, as physical changes in the gums are a telltale sign of eruption. Understanding these changes helps parents anticipate discomfort and provide appropriate relief.
Visual Characteristics of Teething Gums
When a tooth moves toward the surface, the overlying gum tissue undergoes a localized inflammatory response. This causes the gum to appear visibly swollen and puffy compared to the surrounding tissue. The affected area often displays a color change, shifting from the normal pale pink to a brighter red or a deeper pink hue. This redness is due to increased blood flow as the tooth applies pressure from beneath.
The gum may also look taut and stretched. When touched gently, the area feels firm and tender, indicating the pressure exerted by the underlying tooth. Occasionally, the gum tissue can take on a bruised appearance, manifesting as a slightly purplish or dark red spot, which is a normal result of the physical force involved in eruption.
Normal Appearance as a Baseline
Before teething begins, an infant’s gums serve as a smooth, consistent baseline. Healthy, non-teething gums are uniformly pale pink throughout the mouth, though the exact shade varies based on the baby’s natural pigmentation. The surface texture is smooth, without any visible ridges, bumps, or spots. When gently touched, the gums feel firm and soft without showing tenderness or sensitivity. Recognizing this healthy state makes it easier to identify the subtle swelling and color changes that signal the start of tooth eruption.
Progression of the Gums During Eruption
As the tooth progresses and nears the gum line, visual changes become more specific and localized. Initially, a distinct, hard bump or ridge may be felt or seen beneath the surface of the gum. This firmness indicates the crown of the tooth is pressing upward.
Just before the tooth breaks through, a thin, pale white line or translucent spot may become visible along the gum line. This white mark is the enamel tip of the tooth, moments away from cutting through the tissue. In some instances, the emerging area may develop a small, fluid-filled swelling that appears blue or purple, known as an eruption hematoma or cyst. While this is generally harmless, it resolves naturally once the tooth fully erupts.
Signs That Require Medical Attention
While the visual signs of teething are generally limited to localized swelling and redness, certain red flags warrant immediate medical evaluation. Severe, persistent bleeding from the gums that does not quickly stop should be assessed by a healthcare professional. The presence of visible pus, a thick, whitish-yellow fluid, suggests a localized infection that requires treatment. Deep, open sores or ulcerations on the gum tissue are also atypical for normal teething and should be examined. Extreme, widespread swelling of the face or gums, especially when accompanied by a high fever above 100.4°F (38°C) or signs of lethargy, indicates a condition more serious than routine tooth eruption.