When a baby is teething, the gums where a tooth is pushing through will look red, swollen, and puffy compared to the surrounding tissue. You may also notice a visible whitish bump or ridge just beneath the surface of the gum where the tooth’s edge is working its way up. These changes can appear days or even weeks before the tooth actually breaks through, and each stage looks slightly different.
What the Gums Look Like Before a Tooth Appears
Even before teething begins in earnest, you can often see lighter-colored areas on your baby’s gums that mark where teeth will eventually come in. These pale spots sit along the gum ridge and are simply the tooth buds visible through the thin tissue. They’re completely normal and don’t cause any discomfort.
As a tooth gets closer to erupting, that area of the gum changes noticeably. The tissue becomes red, swollen, and sometimes slightly shiny from being stretched. If you run a clean finger along the gum, you can usually feel a firm, raised bump where the tooth is pressing upward. For the front teeth, this bump is a thin ridge. For molars, it’s a broader, rounder lump. The redness and swelling are most intense in the day or two before the tooth cuts through.
What the Tooth Looks Like Breaking Through
The first sign of the actual tooth is a thin white line or small white point poking through the gum surface. For the bottom front teeth (typically the first to arrive, around 6 months), this looks like a tiny sliver of white enamel peeking out of a red, puffy cushion of gum tissue. For upper front teeth, the swelling is often more visible because the gum tissue there is thicker.
It’s common for the gum to look slightly torn or uneven right at the eruption site. You might see a small amount of bleeding, which is normal. The gum tissue around the newly emerged tooth can stay red and raised for several days as the tooth continues to push further out. Once the crown is mostly visible, the surrounding gum gradually returns to its normal pink color and flattens back down.
Eruption Cysts: Bluish Bumps on the Gums
Some babies develop what’s called an eruption cyst, a fluid-filled bump that forms on the gum directly over a tooth that’s about to come in. These cysts look bluish, purplish, or sometimes clear, and they can be startling to see. They form when fluid collects in the space between the tooth and the gum tissue as the tooth pushes upward.
Eruption cysts are harmless in most cases. They typically resolve on their own once the tooth breaks through the cyst and emerges. If one lasts longer than two weeks, it’s worth mentioning to your child’s dentist. In rare cases where a cyst persists for a month or more, a dentist may recommend a minor procedure to help the tooth come through, but this is uncommon.
Drool Rash Around the Mouth
Teething doesn’t just change how the inside of the mouth looks. The excess drool that comes with teething often causes a characteristic rash on the skin around the mouth, chin, and sometimes the neck and chest. This drool rash shows up as red, slightly raised patches of skin that may look dry, chapped, or dotted with small bumps. It can come and go as drooling increases and decreases with each new tooth.
The rash is caused by constant moisture sitting on the skin, not by anything in the saliva itself being harmful. Keeping the area dry by gently patting away drool and applying a thin layer of petroleum jelly as a barrier helps prevent it. If the rash develops pimples or honey-colored, crusty lesions, that suggests a skin infection rather than simple irritation.
Other Visible Signs During Teething
Beyond the gums and drool rash, you’ll likely notice your baby putting everything in their mouth, from their own fists to toys to the edge of your shirt. This chewing behavior is a response to the pressure and discomfort in the gums, and the counter-pressure of biting down can actually feel soothing to them. Their cheeks may look flushed or pink, particularly on the side where a tooth is coming in.
You might also notice your baby’s gums bleeding slightly during teething, especially if they’ve been gnawing on something firm. Minor bleeding around an eruption site is normal. Widespread or persistent bleeding is not typical of teething and should be evaluated.
What Teething Doesn’t Look Like
It’s easy to blame teething for every symptom a baby has between 4 and 30 months, but some things that get attributed to teething are actually signs of illness. Teething can cause a very slight rise in body temperature, but a true fever is not a teething symptom. Likewise, severe diarrhea, widespread body rashes (not limited to the chin and neck area), and inconsolable crying that doesn’t improve with comfort measures point to something else going on.
Inside the mouth, white patches that coat the tongue or inner cheeks aren’t teething. That’s more likely oral thrush, a common yeast infection in babies. Blisters or sores on the gums, tongue, or inner lips also aren’t part of normal teething and may indicate a viral infection.
Soothing the Gums Safely
A chilled (not frozen) teething ring or a clean, cold washcloth gives your baby something safe to chew on and helps reduce gum swelling. Gently rubbing the swollen area with a clean finger also provides counter-pressure that many babies find comforting.
Topical numbing gels containing benzocaine are not recommended for infants. The FDA has also warned against homeopathic teething tablets, particularly those containing belladonna. Testing found that some products from major brands contained inconsistent and sometimes dangerously high levels of toxic compounds. The safest approaches are the simplest: cold pressure, clean teething toys, and, if your pediatrician agrees it’s appropriate for your baby’s age, an infant pain reliever for particularly rough nights.