The start of teething typically shows up as red, swollen gums where a tooth is pushing through, usually around 6 months of age. Before any tooth appears, you may notice your baby drooling more than usual and trying to chew on everything within reach. These are often the very first signals that a tooth is on its way.
What Teething Gums Look Like
Even before teething begins, you can spot lighter-colored areas on your baby’s gums that mark where teeth will eventually break through. When a tooth starts moving toward the surface, the gum tissue over that spot becomes visibly red and swollen. The surrounding area may look puffy compared to the rest of the gum line, and in some cases the tissue can appear slightly inflamed or even bleed a little.
The lower two front teeth are almost always the first to come in, followed by the upper two front teeth. As a tooth gets closer to breaking through, you might see a small whitish bump on the gum ridge. Occasionally, a bluish fluid-filled blister called an eruption cyst forms over the tooth. These look alarming but are harmless and resolve on their own once the tooth cuts through.
Behavioral Signs That Come First
The visual changes in the gums often come alongside a shift in your baby’s behavior. Heavy drooling is one of the earliest and most reliable signs. Your baby will also start rubbing or gnawing on anything available: toys, fingers, the edge of a crib, your shoulder. This chewing isn’t random. Pressure on the gums provides relief from the discomfort of a tooth pushing upward.
Fussiness and irritability tend to increase, especially in the days right before a tooth breaks through. Some babies have trouble sleeping or wake more frequently at night. Appetite changes are common too. Your baby might refuse a bottle or breast because sucking creates pressure on sore gums, or they might want to nurse more for comfort. None of these behaviors alone confirm teething, but when you see several of them together with swollen gums, a tooth is likely coming.
Drool Rash Around the Mouth
All that extra saliva can cause a secondary symptom that catches many parents off guard: a red, bumpy rash around your baby’s mouth, chin, or neck. This happens when skin stays wet with drool for extended periods. The constant moisture breaks down the skin’s protective barrier and causes irritation.
To prevent or manage drool rash, keep a soft burp cloth nearby and gently blot (not rub) saliva from your baby’s face throughout the day. Once the skin is completely dry, apply a thin layer of petroleum jelly or a healing ointment like Aquaphor to create a barrier between the drool and the skin. Skip scented lotions and medicated soaps, which can make the irritation worse. If your baby uses a pacifier, take occasional breaks to let the skin around the mouth air out. Replacing damp bibs with clean, dry ones also helps.
Teething Does Not Cause a Real Fever
One of the most persistent myths about teething is that it causes fever. Research shows that while a baby’s body temperature can rise slightly around the time a tooth erupts, the increase isn’t enough to qualify as an actual fever. A fever is defined as a temperature of 100.4°F or higher. Most teething babies stay below that threshold.
If your baby’s temperature hits 100.4°F or above, something else is going on. Babies in the 6- to 12-month age range are losing the immune protection they received during pregnancy, so they’re more susceptible to infections right around the same time teeth start coming in. It’s easy to blame teething for what’s actually a mild illness. Diarrhea, vomiting, and high fevers are not teething symptoms.
Safe Ways to Ease the Discomfort
The simplest and safest relief is something firm for your baby to chew on. A solid rubber teething toy, a cool (not frozen) teething ring, a clean damp washcloth that’s been chilled in the refrigerator, or even a soft infant toothbrush all work well. The key is choosing something too large to be a choking hazard and firm enough to provide real counterpressure on the gums. Gentle gum massage with a clean finger can also help.
Remedies to Avoid
Some widely marketed teething products are genuinely dangerous. The FDA has warned against using topical gels or liquids containing benzocaine or lidocaine for teething pain in infants. Benzocaine can trigger a rare but potentially fatal condition where red blood cells lose much of their ability to carry oxygen. Lidocaine solutions can cause seizures, severe brain injury, heart problems, and death if too much is applied or accidentally swallowed.
Amber teething necklaces and other teething jewelry also carry serious risks. The FDA has received reports of infant deaths and injuries from strangulation and choking caused by these products. No credible evidence supports the claim that amber releases pain-relieving compounds through the skin. The safest approach is to stick with chilled teething toys, gentle gum pressure, and patience. Most of the discomfort passes within a few days once the tooth finally breaks through the surface.