Very often, even when infants have classic “teething symptoms,” they will not get their first tooth for a few more months and sometimes not until they are more than a year old. In fact, sometimes symptoms that parents think are signs of teething are actually signs of illness or infection. That’s why it’s important for parents to learn how to interpret their baby’s symptoms so that they can tell whether it’s just a first tooth or something else that might warrant attention.
Teething Symptoms
Most babies start teething between 4 and 7 months, but your child could start as early as 3 months. In fact, some experts don’t believe that teething causes any symptoms for most infants. Yet, it’s common for parents to blame teething for lots of different symptoms between 6 and 24 months of age. If teething does cause symptoms, those symptoms usually only start four days before the tooth comes in (erupts) and last for about three days after. Teething-related symptoms you might see in your baby include:
Biting toys, fingers, and nipples if breastfeedingDecreased appetite for solid foodsDroolingDry or chapped skin around the mouthEar rubbingGum rubbingIrritabilitySucking on fingers, toys, or clothingWaking up at night
Keep in mind, the more bothersome symptoms—such as decreased appetite, difficulty sleeping, or ear rubbing—are most common in the days before the tooth erupts, declining over time. Contrary to popular belief, teething does not last for weeks or months on end unless your child has multiple teeth coming in one after another.
Teething and Fever
Teething doesn’t cause fevers. If your baby has a temperature that exceeds 100.4 F, they should be evaluated by their doctor. It is true that gum inflammation related to teething can cause a slightly elevated temperature, but the spike in temperature will be small and not enough to constitute a fever. If your baby does have a fever, it is most likely the result of an unrelated illness or infection, such as an ear or urinary tract infection (UTI). Babies around the age of 6 months are at increased risk for infection because they begin to lose the immune protection from antibodies they were born with. Most babies are also putting everything in their mouths at this age, which can expose them to bacteria and viruses that might make them sick.
When to Call the Doctor
If your baby has a fever above 100.4 F, diarrhea, or a rash, call your pediatrician to have their symptoms evaluated. Your child could have a respiratory illness, an ear infection, or another unrelated condition. A delay in treatment, especially with fevers or diarrhea, can result in dehydration or other severe complications. Teething also doesn’t cause rashes, though it is possible for excessive drooling to irritate the skin on your baby’s mouth, making it look red, dry, or chapped. You should also call your doctor if your baby is inconsolable, isn’t eating or sleeping well, or if their symptoms last longer than a week. Ultimately, you know your child best. Although most pediatricians don’t blame many symptoms on teething, if your child has the same symptoms every time they get a new tooth, teething is the likely culprit—especially if the symptoms seem relatively mild and your baby otherwise seems to be well.
Treatments for Teething Symptoms
Not all babies need treatment for teething. If your baby doesn’t seem to be uncomfortable, you don’t need to do anything. If they do seem to be in pain, however, there are a few things you can do that might provide some relief:
Offer them a teething aid, such as a wet washcloth or teething rings. Just make sure that any teether you offer meets current safety standards and if you chill the teether, make sure it is just cold but not frozen solid. Serve them a teething biscuit, cold food (such as yogurt or purees), or chilled vegetables and fruit in a mesh baby feeder. Gently rub or massage your baby’s gums with your finger. If your child is over 6 months old, you might be able to offer a pain reliever, such as acetaminophen or ibuprofen, but be sure to check with your doctor first to make sure that you give your child the correct (and safe) dose.
Teething Treatments to Avoid
There are a number of treatments that are not recommended by pediatricians or the FDA because they pose safety risks. These include:
Benzocaine teething gels, sprays, ointments, or lozenges (such as Anbesol, Baby Orajel, or Orabase). Not only is topical anesthetic easily swallowed, but it can also lead to a serious, and sometimes fatal, condition called methemoglobinemia, which causes too little oxygen to be delivered to the body’s cells. Prescription lidocaine gels. Infants are prone to swallowing lidocaine gels. Lidocaine can be toxic, affecting your child’s nervous system and heart. Teething bracelets, necklaces, or other teething jewelry. Anything that can be worn poses a strangulation risk, especially if your baby can put it around their own neck. In addition, most teething jewelry contains amber, wood, marble, or silicone beads, which could break or chip off and lead to choking. Others use string or elastic bands that can snap and your baby could swallow or choke on a bead. Some of these materials also pose a risk of possible injury to your little one’s sensitive gums, increasing the risk of infection.
A Word From Verywell
Parents often worry that their baby is in a lot of pain when teething begins, but the good news is that for most children, the process is relatively painless. If your baby does seem to be in discomfort, there are things you can do to help soothe their temporarily inflamed gums. Just be sure you know the signs of something more serious, and if you’re ever unsure, check in with your baby’s doctor for advice.
