The most effective ways to help a teething baby are simple: gentle gum massage with a clean finger, chilled (not frozen) teething toys, and cold damp washcloths. Most babies start teething around 6 months, and the discomfort comes and goes as each new tooth pushes through. The good news is that you don’t need much to keep your baby comfortable, and the best remedies are ones you probably already have at home.
When Teething Starts and What to Expect
The lower front teeth usually appear first, typically between 6 and 10 months. The upper front teeth follow at around 8 to 12 months. From there, teeth come in roughly in pairs: lateral incisors between 9 and 16 months, first molars between 13 and 19 months, canines between 16 and 23 months, and second molars between 23 and 33 months. By age 3, most children have all 20 baby teeth.
Not every tooth causes the same amount of fuss. The first few teeth and the molars tend to be the worst, since molars have a larger surface area breaking through the gum. Some babies barely react at all. Others are irritable for days before a tooth appears. Each child handles it differently, and even the same child may breeze through one tooth and struggle with the next.
Real Teething Signs vs. Illness
The telltale signs of teething are drooling more than usual, constantly putting fingers or fists in the mouth, a swollen or puffy spot on the gum, and general fussiness. That’s the full list. Teething does not cause colds, rashes, diarrhea, or fever. This is a common misconception, and it matters because blaming a real fever on teething can delay treatment for an actual infection. If your baby has a temperature above 100.4°F (38°C) or is having loose stools, something else is going on.
Drooling often starts around 3 or 4 months, well before any teeth appear, so drool alone isn’t a reliable signal that a tooth is imminent. The most specific sign is a visible bump or swelling on the gum where a tooth is about to break through.
Cold and Pressure: The Two Best Remedies
Almost everything that works for teething pain relies on cold, pressure, or both. These are the methods recommended by the American Academy of Pediatrics.
Gum massage. Wash your hands, then use your fingertip or knuckle to gently rub the sore spot on your baby’s gum. A light, steady pressure is soothing because it counteracts the sensation of the tooth pushing upward. This is especially helpful at bedtime or during nighttime wake-ups when you don’t want to reach for a toy or teether.
Cold washcloth. Twist a clean, damp washcloth and put it in the freezer for 15 to 30 minutes. The combination of cold and texture gives your baby something satisfying to gnaw on. Just make sure the cloth is damp, not soaking wet, so it doesn’t freeze into a solid block.
Rubber or silicone teething toys. Solid rubber or plastic teethers are safe and effective. Avoid liquid-filled teething toys, which can tear open and leave sharp edges. Cooling a solid teether in the refrigerator (not the freezer) adds extra relief without making it hard enough to hurt tender gums.
Cold water in a sippy cup. For babies over 6 months, a sippy cup filled with cold water does double duty. The cold soothes, and many sippy cups have soft, rubbery spouts that are satisfying to chew on.
Dealing With Drool Rash
All that extra saliva often causes a red, bumpy rash around the mouth, chin, neck folds, and chest. The key to preventing it is keeping the skin dry. Keep a soft burp cloth nearby and gently blot drool throughout the day, especially after feedings and naps. Check the folds of your baby’s neck where saliva pools unnoticed. Use a bib, and swap it out for a dry one as soon as it gets damp.
If a rash has already developed, wash the area gently with warm water twice a day (no soap needed) and pat dry with a soft cloth. Once the skin is completely dry, apply a layer of petroleum jelly or a healing ointment like Aquaphor. This creates a barrier between the skin and the constant moisture, letting the rash heal underneath. Avoid scented soaps, lotions, or essential oils on or near the rash. Wash bibs, burp cloths, and sheets in mild, unscented detergent.
When Pain Relief Medicine Makes Sense
For babies under 2, talk to your pediatrician before giving any pain reliever. If your doctor gives the go-ahead, infant acetaminophen is the standard option. It comes in a liquid concentration of 160 mg per 5 mL, and dosing is based on your baby’s weight rather than age. You can give it every 4 hours as needed, with a maximum of 5 doses in 24 hours. Your pediatrician can confirm the right dose for your child’s weight.
Ibuprofen is only appropriate for babies 6 months and older. If your baby is old enough, your pediatrician can advise on the correct weight-based dose for that as well. Neither medication should become a daily habit during teething. Save it for the rough patches, particularly nights when pain is keeping everyone awake.
Products to Avoid
Several popular teething products carry real risks, and the FDA has issued specific warnings about them.
Benzocaine gels and liquids. Over-the-counter numbing gels containing benzocaine (sold under brand names like Orajel) should not be used on children under 2. Benzocaine can cause a life-threatening condition called methemoglobinemia, where the blood’s ability to carry oxygen drops dramatically. The FDA asked manufacturers to stop marketing these products for infant teething entirely because they “carry serious risks and provide little to no benefit.”
Homeopathic teething tablets. The FDA warned consumers to stop using homeopathic teething tablets containing belladonna after testing revealed that some products had wildly inconsistent amounts of toxic compounds. Some tablets from major brands contained far more belladonna alkaloids than stated on the label. These products are not regulated the way conventional medicines are, and the inconsistency makes them unpredictable.
Amber teething necklaces. These are marketed with the claim that body heat releases pain-relieving substances from the amber. There is no scientific evidence supporting that claim. More importantly, they pose strangulation and choking hazards. The FDA issued a formal warning in 2018 after receiving reports of children choking on broken-off beads and an 18-month-old who died from strangulation during a nap. The American Academy of Pediatrics recommends that infants not wear any jewelry.
Caring for New Teeth
Start brushing as soon as the first tooth appears. Use a soft-bristled baby toothbrush with a tiny smear of fluoride toothpaste, about the size of a grain of rice. Brush at least twice a day: once before bed and once at another time that works for your routine. This thin layer of fluoride toothpaste is safe to swallow at this age and helps protect enamel from the start.
The American Academy of Pediatric Dentistry recommends scheduling your baby’s first dental visit by age 1 or within 6 months of the first tooth appearing, whichever comes first. This early visit is mostly about establishing a baseline, checking for any issues with how teeth are coming in, and getting your child used to the dentist’s chair before any real work needs to happen.