Teething is the process of a baby’s first teeth pushing through the gums, typically starting around 6 months of age. It happens when the 20 primary (baby) teeth that formed beneath the gums during pregnancy begin moving upward through the jawbone and break through the gum tissue. The process usually continues until around age 3, when most children have a full set of baby teeth.
What Happens Inside the Gums
Teeth don’t simply push their way out. The process involves active bone remodeling: specialized cells break down bone tissue above the developing tooth while other cells build new bone beneath it. This coordinated activity creates a pathway that allows each tooth to rise passively toward the surface. The process begins once the crown of the tooth has fully formed, triggered by chemical signals from the surrounding tissue.
Once the tooth reaches the gum line, it breaks through the soft tissue and becomes visible. This is the moment most parents notice, but the tooth has actually been moving for weeks or months before that. The lower front teeth (central incisors) usually appear first, followed by the upper front teeth, then the molars and canines over the next two years.
Common Signs of Teething
The most recognizable sign is increased drooling, which often starts before any tooth is visible. Your baby’s gums may look red, swollen, and tender in the area where a tooth is about to come through. Other typical signs include:
- Gnawing or chewing on objects: Babies instinctively press hard things against their gums for relief.
- Fussiness and irritability: Especially in the days right before a tooth breaks through.
- Difficulty sleeping: Gum discomfort can disrupt naps and nighttime sleep.
- Loss of appetite: Sucking or chewing on food may feel uncomfortable when gums are inflamed.
Not every baby experiences the same level of discomfort. Some teeth arrive with barely any fuss, while molars, which have a larger surface area, tend to cause more soreness.
Teething Does Not Cause Fever
One of the most persistent misconceptions is that teething causes fever. It may raise your baby’s temperature slightly above the normal baseline of about 98.6°F (37°C), but it will not push it to 100.4°F (38°C) or higher. That threshold defines an actual fever, which is a sign of infection, not teething. If your baby’s temperature reaches 100.4°F or above, something else is going on and it shouldn’t be dismissed as a teething symptom.
This matters because the 6- to 24-month window when teeth are erupting also overlaps with the period when babies lose some of the immune protection they received from their mothers and begin encountering common infections. It’s easy to blame teething for symptoms that actually need medical attention, like high fever, diarrhea, or rash.
Safe Ways to Ease Teething Pain
The safest options are simple and non-medical. A chilled (not frozen) teething ring or cold washcloth gives your baby something firm to press against sore gums. Gently rubbing the gums with a clean finger can also provide relief. Some parents find that chilled fruit in a mesh feeder works well for babies who have started solids.
What you should avoid is more important than what you try. The FDA has issued clear warnings against using topical numbing products containing benzocaine or lidocaine on infants. Benzocaine can cause a rare but serious condition that reduces the blood’s ability to carry oxygen. Lidocaine, even in prescription form, has been linked to seizures, heart problems, and severe brain injury in young children when accidentally swallowed or applied in excess. These products offer little benefit for teething pain and carry significant risk.
Homeopathic teething tablets have also drawn FDA warnings. Testing of products marketed by major brands found that belladonna-derived ingredients were present at levels far exceeding what the labels stated, with inconsistent amounts from tablet to tablet. The FDA urged parents to stop using these products entirely and dispose of any they had at home.
Caring for New Teeth
Oral hygiene should start as soon as the first tooth appears. Use a soft, infant-sized toothbrush twice a day with a rice-grain-sized smear of fluoride toothpaste. At this age, you’re doing all the brushing yourself. Once two teeth sit side by side and a toothbrush can’t clean between them, gentle flossing becomes necessary too.
Your baby’s first dental visit should happen by 12 months of age. This early appointment isn’t about treatment. It establishes a baseline, lets the dentist check that teeth are developing normally, and gives you a chance to ask questions about feeding habits, fluoride, and what to expect as more teeth come in.