Babies can scream during teething, but most don’t. The typical teething baby is fussier than usual, drools more, and chews on everything in reach. Intense, prolonged screaming is less common and, when it does happen, tends to cluster in a short window: roughly 3 to 5 days before a tooth breaks through the gum, resolving once the tooth emerges. If your baby is screaming inconsolably for long stretches, teething alone may not be the explanation.
Why Teething Hurts
A tooth doesn’t just slide through the gum. Before it surfaces, the body launches a small-scale inflammatory process to clear a path. Cells in the tissue surrounding the developing tooth release signaling proteins that recruit other cells to dissolve tiny amounts of bone. This activity triggers the same inflammatory chemicals your body produces during any tissue injury, which is why the gum over an emerging tooth becomes red, swollen, and tender to the touch.
A study published in Pediatric Dentistry measured these inflammatory markers in the gum fluid around erupting baby teeth and found significantly elevated levels compared to non-erupting sites. That localized inflammation is real, and it can genuinely hurt. But it’s confined to a small area of gum tissue, which is why teething pain is usually more of a nagging discomfort than an acute, screaming-level crisis.
What Teething Fussiness Actually Looks Like
The hallmark signs of teething are increased drooling, a strong urge to bite or chew on objects, slightly swollen gums, and general irritability. Some babies lose interest in feeding briefly because sucking changes the pressure around the sore spot. Others sleep a bit worse than usual, waking more during the night. The fussiness typically begins about 3 to 5 days before the tooth erupts and stops once it breaks through.
Most babies cycle through 20 rounds of this over their first two and a half years. Some teeth seem to cause more trouble than others. The first teeth (usually the lower front two, around 6 months) and the first molars (larger, flatter teeth that come in around 12 to 16 months) tend to produce the most discomfort because the sensation is new or the tooth surface is bigger.
When Screaming Points to Something Else
Because teething happens during the same months that babies are losing maternal antibodies and getting exposed to new infections, it’s easy to blame teething for symptoms that actually come from illness. A baby who is screaming persistently, especially with a true fever, likely has something else going on.
Teething can nudge a baby’s temperature slightly above normal, but it does not cause a real fever. The Cleveland Clinic defines fever as 100.4°F (38°C) or higher and is clear that teething won’t push a baby’s temperature to that level. If your baby has a fever alongside the screaming, an infection is the more likely cause.
Ear infections are one of the most commonly confused conditions. Babies with ear infections also tug at their ears, cry more than usual, and have trouble sleeping, all of which overlap with teething symptoms. A few signs can help you tell the difference:
- Lying down makes it worse. Ear infections cause a pressure shift when a baby lies flat, making the pain spike. Teething pain doesn’t change with position.
- Fluid from the ear. Thick, yellow, or bloody drainage from the ear canal signals a ruptured eardrum and has nothing to do with teeth.
- Fever above 100°F. A temperature that high suggests the body is fighting an infection.
- Reduced response to sounds. Fluid buildup in the middle ear can temporarily dampen hearing.
- Vomiting or diarrhea. The virus behind many ear infections also affects the gut. Teething does not cause gastrointestinal symptoms.
Pediatricians have tools to examine the eardrum directly, which is why having a screaming baby checked is reasonable even if you suspect teething. As one clinician put it, teething can only be confidently diagnosed once ear infections and other causes have been ruled out.
Relieving Teething Pain at Home
The most effective approaches are simple pressure and cold. Rubbing your baby’s gums firmly with a clean finger or a piece of damp gauze for about two minutes can ease discomfort noticeably, and you can repeat it as often as needed. The counter-pressure seems to offset the aching sensation from the swollen tissue underneath.
Chilled (not frozen) teething rings made of solid rubber also work well. You can refrigerate a clean washcloth or pacifier for the same effect. Freezing these items makes them too hard and can actually bruise tender gums, so keep them refrigerator-cold only. For babies older than 12 months, the Mayo Clinic suggests placing a chilled piece of soft fruit like banana or berries inside a mesh feeder for the baby to gnaw on.
What doesn’t work, and what can be dangerous, is numbing gels and teething tablets. The FDA has issued explicit warnings against products containing benzocaine or lidocaine for teething pain in children. 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, serious brain injury, and heart problems in infants if too much is applied or accidentally swallowed. Research hasn’t shown these products provide meaningful relief anyway.
Amber teething necklaces and similar jewelry also carry real risks. The FDA has received reports of infant deaths and serious injuries from strangulation and choking related to teething jewelry. The American Academy of Pediatrics recommends sticking with gum massage and firm rubber teethers.
How Long the Worst of It Lasts
The reassuring reality is that teething discomfort is short-lived per tooth. That 3-to-5-day window before eruption is the peak, and once the tooth cuts through, the gum heals quickly. Even babies who are especially sensitive to the process get a break between teeth. If your baby has been screaming or highly irritable for more than a week without a visible tooth coming in, it’s worth looking for another cause rather than assuming a drawn-out teething episode.