The earliest and most reliable sign of teething is swollen, puffy gums where a new tooth is pushing through, usually starting with the two bottom front teeth between 6 and 10 months of age. But most parents notice the behavioral changes first: extra drooling, fussiness, and a sudden urge to chew on everything in reach. Here’s how to tell what’s happening and what to expect.
The Most Common Signs of Teething
Teething looks a little different in every baby, but there’s a core set of signs that show up consistently. Increased drooling is often the first thing parents notice, sometimes weeks before a tooth actually appears. Your baby may start gnawing on fingers, toys, or anything firm they can get into their mouth. This isn’t random; the pressure of biting down on something hard actually helps relieve the aching sensation in their gums.
Fussiness and irritability tend to come and go, often peaking in the day or two before a tooth breaks through and then easing off. Some babies want to nurse or bottle-feed more frequently but for shorter stretches, almost as if they’re using the breast or bottle for comfort but finding the sucking uncomfortable after a minute or two. Others temporarily lose interest in eating altogether, especially solid foods that press against sore gums.
Sleep disruption is common. Pain and discomfort can wake a baby who previously slept through the night, and naps may get shorter or harder to start. This phase is usually brief for each tooth, lasting a few days rather than weeks.
What the Gums Actually Look Like
If you gently pull your baby’s lip down (or up, for upper teeth), you may see a ridge of swollen, reddened gum tissue right where a tooth is about to come in. Sometimes you can even spot a white line or a hard bump just beneath the surface. That’s the tooth itself sitting right at the gumline.
Occasionally, a fluid-filled bump appears on the gum. This is called an eruption cyst, and it looks bluish or translucent. It’s most common toward the back of the lower jaw, where molars come in later. These cysts look alarming but are almost always harmless and resolve on their own once the tooth pushes through.
When Teeth Typically Appear
Baby teeth arrive in a fairly predictable order, though the exact timing varies by several months from child to child. Teeth generally emerge in pairs, one on the left and one on the right, and lower teeth tend to come in before the matching upper ones.
- Bottom front teeth (central incisors): 6 to 10 months
- Top front teeth (central incisors): 8 to 12 months
- Top lateral incisors (next to the front teeth): 9 to 13 months
- Bottom lateral incisors: 10 to 16 months
- First molars: 13 to 19 months (upper), 14 to 18 months (lower)
- Canines (the pointy ones): 16 to 23 months
- Second molars: 23 to 33 months
By roughly age 2.5 to 3, all 20 primary teeth are usually in place. Some babies get their first tooth as early as 4 months; others don’t see one until after their first birthday. Both ends of that range are normal.
Teething Does Not Cause a Real Fever
This is one of the most important things to understand. Teething can nudge your baby’s temperature slightly above the normal baseline of about 98.6°F (37°C), but it does not cause a true fever. A fever is defined as 100.4°F (38°C) or higher. If your baby hits that number, something else is going on, most likely an infection, and it shouldn’t be dismissed as “just teething.”
The timing trips a lot of parents up. Babies start teething right around the same age that protection from maternal antibodies begins to fade, so they’re catching more colds and ear infections at the exact same time teeth are coming in. It’s easy to blame the tooth.
Teething vs. Ear Infection
Ear tugging is a classic example of a symptom that gets misread. Teething pain can radiate along the jaw toward the ear, so babies will sometimes rub or pull at their ears during teething. On its own, with otherwise mild symptoms, this is not a concern.
An ear infection looks different. Babies with ear infections tend to cry more intensely and persistently, especially when lying down, because the position increases pressure in the ear. A fever above 100.4°F, fluid draining from the ear, trouble hearing or responding to sounds, and significant loss of appetite all point toward infection rather than teething. If your baby has ear tugging plus any of those additional signs, it’s worth a call to the pediatrician rather than waiting it out.
What Actually Helps With Teething Pain
The simplest and safest relief is pressure on the gums. A clean, chilled (not frozen) teething ring or a cold, wet washcloth gives your baby something firm to gnaw on while the cool temperature helps reduce swelling. You can also rub a clean finger gently along the swollen gum ridge. Many babies find this immediately soothing.
If your baby seems truly uncomfortable and the chewing and cold aren’t enough, infant-appropriate pain relief is an option. Talk to your pediatrician about what’s suitable for your baby’s age and weight.
Products to Avoid
Some widely sold teething products carry real risks. The FDA has warned that topical gels and liquids containing benzocaine or lidocaine provide little to no benefit for teething pain and can cause serious harm in infants, including seizures, heart problems, and severe brain injury. These products should not be used on teething babies, whether they’re prescription or over-the-counter.
Homeopathic teething tablets have also drawn FDA warnings. Testing of products marketed by major brands found that tablets labeled as containing belladonna had wildly inconsistent levels of the active compounds, with some tablets containing far more than the label stated. The FDA has urged parents not to use homeopathic teething tablets and to dispose of any they already have.
Scheduling a First Dental Visit
The American Academy of Pediatric Dentistry, the American Dental Association, and the American Academy of Pediatrics all recommend that children have their first dental visit during the first year of life, ideally around the time the first tooth comes in. This early visit isn’t about treatment. It’s a chance for a dentist to check that teeth are developing normally, talk through oral hygiene basics, and catch any early signs of decay before they become a problem.