Teething is a standard developmental process where an infant’s first teeth emerge through the gums. Molar eruption, which often causes the most intense discomfort, typically occurs much later than the front teeth. The primary second molars are the last baby teeth to appear, usually erupting between 20 and 33 months of age, though the timing can vary widely. Parents frequently worry about whether the pain and irritability associated with this milestone can lead to a significant rise in body temperature.
Teething Does Not Cause High Fever
Medical consensus confirms that while the teething process involves localized inflammation, it does not cause a true fever. A true fever is medically defined as a temperature of 100.4°F (38°C) or higher. Teething may result in a very slight elevation of the body temperature, often referred to as a low-grade temperature rise, but this reading remains below the clinical fever threshold.
This slight warmth is likely a localized inflammatory response in the gum tissue as the large, blunt molars push toward the surface. Scientific studies have consistently noted this minor temperature increase but found no correlation with temperatures reaching 100.4°F. Attributing a high temperature to molar eruption can be risky, as it may mask an underlying illness that requires medical attention.
Typical Symptoms of Molar Eruption
Molar eruption is often more challenging than the emergence of smaller teeth due to the size and shape of these back teeth. The most apparent physical sign is swelling and tenderness in the posterior gum tissue, sometimes appearing red or bruised. The pressure from the large molars pushing through the bone and gum can cause significant, localized pain.
Behavioral changes are also common, with children exhibiting increased irritability and fussiness that can disrupt established routines. Excessive drooling is nearly universal, often leading to a temporary rash around the mouth or chin. The child will have an overwhelming urge to chew or bite on objects, as the counter-pressure provides temporary relief from the deep gum discomfort. This continuous pain can also lead to disrupted sleep patterns and a temporary refusal of solid foods.
Recognizing Fevers That Need Medical Evaluation
When a true fever is present during the molar teething period, it is almost certainly a sign of a concurrent illness, not the eruption of the tooth itself. The timing often coincides with an age when toddlers are more susceptible to common infections. Infants and toddlers frequently put objects into their mouths to soothe irritated gums, which increases their exposure to pathogens that cause infections.
Parents should monitor temperatures closely, as a reading of 100.4°F (38°C) or higher indicates an infection that needs attention. A temperature exceeding 102°F (39°C) is particularly concerning and warrants immediate medical consultation. The fever is often accompanied by other symptoms that confirm an illness, such as vomiting, diarrhea, a persistent cough, or a widespread rash.
Parents must seek medical advice if a fever lasts longer than 24 hours or if the child exhibits signs of severe illness, such as lethargy, extreme irritability, or a refusal to drink fluids. Conditions like ear infections, common colds, or other viral illnesses are frequently mistaken for “teething fever” because they commonly occur in this age group. Believing the fever is solely due to teething can delay necessary treatment for a separate, potentially serious infection.
Home Care and Pain Relief for Teething Discomfort
Managing the discomfort of molar eruption involves safe and effective strategies focused on reducing gum inflammation and pain. Non-pharmacological methods are the first line of defense and include offering chilled, but not frozen, teething rings or toys. A clean, cold washcloth soaked in water and wrung out provides a larger, softer surface for the toddler to chew on, which helps apply pressure to the sore gums.
Gentle massage of the affected gum area with a clean finger can help temporarily alleviate the pressure and discomfort. For children experiencing significant pain or irritability, approved over-the-counter pain relievers such as acetaminophen or ibuprofen can be administered. It is imperative to follow the correct dosage based on the child’s weight and age, and to only use these medications for a short period.
A mandatory warning applies to several products marketed for teething pain, which should be strictly avoided. The Food and Drug Administration advises against topical numbing agents containing benzocaine, as they carry a risk of methemoglobinemia, a serious blood condition that reduces oxygen. Homeopathic teething remedies, including those containing belladonna, are also discouraged due to inconsistent ingredient amounts and potential toxicity.