Most babies start teething between 6 and 12 months old, and the earliest signs are swollen gums, extra drooling, and a sudden urge to chew on everything in reach. These symptoms typically appear about four days before a tooth breaks through and fade within three days after, so the whole episode for a single tooth lasts roughly a week. Knowing what’s normal teething and what signals something else can save you a lot of unnecessary worry.
The First Signs to Look For
The gums are where teething announces itself most clearly. You’ll notice red, swollen, tender tissue right where a tooth is about to push through. If you gently run a clean finger along your baby’s gums, you may feel a hard bump just below the surface. Some babies let you do this without fussing; others will pull away because the area is sore.
Beyond the gums, the most reliable signs include:
- Increased drooling. Saliva production ramps up noticeably, sometimes soaking through bibs and shirts.
- Chewing and biting on objects. Counter-pressure on the gums feels good, so your baby will gnaw on fingers, toys, the crib rail, or anything within reach.
- Fussiness and irritability. This tends to come and go rather than being constant, peaking right before the tooth emerges.
- Difficulty sleeping. Nighttime waking is common because there are fewer distractions from the discomfort.
- Loss of appetite. Sucking or chewing on food can aggravate sore gums, so some babies temporarily eat less.
Symptoms tend to be strongest just before the tooth cuts through the gum line, then taper off quickly once it’s visible. The fussiness associated with any single tooth rarely lasts more than eight days total.
Which Teeth Come In First
The two bottom front teeth (lower central incisors) usually lead the way, arriving between 6 and 10 months. The upper front teeth follow at 8 to 12 months. After that, the upper lateral incisors appear at 9 to 13 months, and the lower laterals come in at 10 to 16 months. First molars, which tend to cause more discomfort because of their larger surface area, show up between 13 and 19 months on top and 14 to 18 months on the bottom.
These ranges are wide for a reason. Some babies sprout a first tooth at 4 months; others don’t see one until after their first birthday. Both are normal. The order matters more than the exact timing, and even that can vary without being a concern.
Drool Rash and Other Skin Changes
All that extra drool can irritate the skin around your baby’s mouth, chin, and neck. A drool rash looks like red, slightly raised patches that may be dry, chapped, or dotted with small bumps. It’s not an allergic reaction or infection. Gently wiping the area and applying a thin layer of petroleum jelly or a barrier cream keeps moisture off the skin and helps it heal.
You might also notice a bluish or clear bump on the gums, which can look alarming. This is called an eruption cyst, a small pocket of fluid that forms between the emerging tooth and the tissue covering it. It’s harmless and typically resolves on its own once the tooth pushes through. If it bleeds, oozes pus, or sticks around for more than two weeks, that’s worth a call to your pediatrician or dentist.
Teething vs. Illness
One of the biggest myths about teething is that it causes fevers. Teething can nudge your baby’s body temperature slightly above normal, but it does not produce 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.”
This distinction matters because the 6 to 12 month window when teething begins is also when babies lose the passive immunity they got during pregnancy. They start catching more colds and viral infections right around the same time teeth appear, which is why the two get tangled together. Diarrhea, rashes on the body, and persistent congestion are not caused by teething, even though they often show up at the same age. If your baby seems particularly miserable or has a temperature above 101°F (38.3°C), teething is unlikely to be the explanation.
Safe Ways to Ease the Discomfort
The simplest and most effective relief is pressure on the gums. A clean finger, a cold washcloth, or a solid teething ring made of soft silicone or rubber all work well. You can chill the teething ring in the refrigerator (not the freezer, which makes it too hard and can hurt the gums). Avoid teething toys filled with liquid or gel, as babies can chew holes in them. Also avoid any teething toy with small loose pieces that could break off and become a choking hazard.
Never tie or clip a teether around your baby’s neck or clothing. The cord or clip can wrap around the neck during movement. Amber teething necklaces carry the same strangulation risk, and there is no evidence they relieve pain.
For nights when nothing else seems to help, infant acetaminophen is an option, but it should not be given to children under 2 without guidance from a pediatrician. Your doctor can tell you the right dose based on your baby’s weight. If you do use it, give it no more than every four hours and no more than five doses in a 24-hour period.
Products to Avoid
The FDA warns against using benzocaine or lidocaine gels and creams on a baby’s gums. These numbing agents are found in several over-the-counter oral pain products and offer little benefit for teething while carrying serious risks. Benzocaine can cause a condition called methemoglobinemia, which severely reduces the blood’s ability to carry oxygen. This is rare but potentially fatal.
Homeopathic teething tablets fall under the same FDA warning. Despite being marketed as natural, some have been linked to serious adverse events in children. The safest approach sticks to physical soothing methods like chilled teethers and gum massage, with doctor-approved pain relief when needed.
How Sleep Is Affected
Sleep disruptions from teething are real but temporary. The discomfort tends to feel worse at night because your baby has fewer distractions and is lying down, which can increase pressure in the gums. You may notice more frequent waking, shorter naps, or difficulty settling down in the first place.
This phase typically follows the same roughly eight-day window per tooth: a few rough nights leading up to the tooth’s appearance, a peak right as it breaks through, then a gradual return to normal. Molars, which arrive in the second year, tend to cause more sleep disruption than the smaller front teeth. Keeping your usual bedtime routine consistent helps your baby resettle into normal sleep patterns once the tooth is through.