Teething, the process where an infant’s first set of teeth erupt through the gums, is a universal developmental milestone. This period is frequently associated with discomfort and changes in a baby’s behavior, leading many caregivers to link the process with a high body temperature. The widespread belief that teething causes a fever persists, often creating confusion about when to seek medical care. It is important to separate established facts from common folklore by examining the scientific evidence regarding this developmental stage.
Understanding Common Teething Symptoms
The physical process of a tooth breaking through the gum tissue causes localized inflammation, which is responsible for teething symptoms. One of the most noticeable signs is sialorrhea, or excessive drooling, which begins around the time teeth are expected to emerge. This increased saliva production often leads to a facial rash or irritation around the chin and mouth if the area is not kept dry. The pressure and soreness cause a baby to exhibit increased fussiness and a persistent desire to chew on objects to relieve the discomfort.
The gums around the erupting tooth may appear mildly swollen or red due to the local inflammatory response. This discomfort can disrupt sleep patterns, causing a baby to wake more frequently or struggle to settle down for naps. While these symptoms are transient, they are direct results of the biomechanical pressure and tissue changes. A slight elevation in body temperature may also occur, but this temperature is notably mild and remains well below the threshold of a true fever.
The Scientific Consensus on Fever
Scientific and medical bodies maintain a clear position that teething does not cause a true fever. A temperature of 100.4°F (38°C) or higher is the established clinical definition of a fever, and this level of heat is almost universally indicative of an underlying illness. Teething is a localized, non-infectious inflammatory process that does not trigger the systemic immune response required to produce a high fever. Studies examining the body temperature of infants during tooth eruption have found only a negligible increase, typically remaining between 99°F and 100°F.
Attributing a high temperature to teething can be dangerous, as it may delay the diagnosis of a genuine infection. The slight temperature rise sometimes observed is likely a result of mild inflammation and increased metabolic activity, but it fails to meet the accepted diagnostic criteria for a fever. This distinction is important because the period of peak teething (six to twenty-four months) coincides with the time when infants lose maternal antibodies and are more susceptible to common viral and bacterial infections.
When to Worry: Distinguishing Teething from Illness
Symptoms that extend beyond localized gum discomfort and mild irritability should not be attributed to teething and warrant a medical evaluation. A temperature that reaches or exceeds 100.4°F (38°C) is the most significant indicator that an infection is present, not just a tooth eruption. Other red-flag symptoms include vomiting, persistent diarrhea, and a non-localized skin rash.
Teething does not cause respiratory symptoms like a persistent cough or a runny nose that contains thick mucus. Similarly, signs of systemic distress, such as significant lethargy, refusal to drink fluids, or inconsolable crying, signal a need for prompt medical attention. When these symptoms accompany tooth eruption, caregivers should consult a healthcare provider to rule out conditions like ear infections or other illnesses.
Strategies for Soothing Discomfort
Fortunately, the mild discomfort associated with teething can often be managed effectively with simple, non-pharmacological interventions. Applying gentle pressure to the affected gums provides immediate relief, which can be accomplished by rubbing the area with a clean finger. Providing the baby with a chilled teething ring or a knot tied in a damp washcloth helps to numb the sore tissue. Ensure these items are chilled in the refrigerator, not the freezer, as frozen objects can be too hard for tender gums.
The excessive drooling should be managed by regularly wiping the baby’s mouth and chin to prevent a moisture-related rash. If a baby is particularly fussy, an over-the-counter pain reliever like acetaminophen or ibuprofen may be used, but only after consulting a pediatrician for appropriate dosing. Caregivers should avoid topical teething gels containing benzocaine, as they pose a safety risk and their numbing effect is quickly washed away by saliva.