Most babies start teething between 6 and 12 months old, with the first tooth typically appearing around 6 months. The earliest signs are usually swollen, tender gums and a noticeable increase in drooling, often starting a few days before a tooth actually breaks through. Here’s how to recognize what’s happening and what you can do about it.
The First Signs to Watch For
Teething usually announces itself through your baby’s gums before you ever see a tooth. The gum line where a tooth is about to erupt will look red and swollen, and your baby may fuss or pull away when you touch that spot. Drooling picks up significantly, sometimes weeks before the tooth appears. You’ll likely go through more bibs than usual.
Beyond the gums, teething tends to change your baby’s behavior in predictable ways:
- Biting and chewing on everything. Hands, toys, your fingers. The counter-pressure on the gums feels good to them.
- Fussiness and irritability, especially in the hours before bed.
- Difficulty sleeping. Babies who were sleeping through the night may start waking again.
- Loss of appetite. Sore gums can make eating uncomfortable, particularly with a spoon or bottle nipple pressing on the swollen area.
These symptoms tend to come and go. They’re usually worst in the few days right around when a tooth breaks through, then settle down until the next one starts moving.
What a Teething Fever Actually Looks Like
Parents often associate fever with teething, and there is a real but very small temperature bump. Research tracking infants daily found that body temperature rises slightly in the three days before a tooth erupts, peaking on the day it breaks through at an average of about 99.7°F (37.6°C). That’s barely above normal and well below what doctors consider a true fever.
If your baby’s temperature reaches 100.4°F (38°C) or higher, that’s not teething. It points to an illness that happens to coincide with the teething window. Because babies teethe on and off for months, it’s easy to blame any fever on a new tooth. Doing so can delay catching an ear infection, a virus, or something else that needs attention.
The Drool Rash
All that extra drooling can irritate the skin around your baby’s mouth, chin, cheeks, and neck. A drool rash looks like flat or slightly raised red patches that may appear chapped or dry, sometimes with small bumps. It’s harmless but uncomfortable.
To prevent it, gently pat (don’t rub) your baby’s face dry throughout the day. Once the skin is completely dry, apply a layer of petroleum jelly or a healing ointment like Aquaphor. This creates a barrier between the skin and the moisture. Skip regular lotions on the rash, as they can make it worse.
Which Teeth Come In First
The two bottom front teeth (lower central incisors) almost always arrive first. The two top front teeth follow. After that, the teeth tend to fill in from front to back: the lateral incisors on either side, then the first molars, canines, and finally the second molars at the back. Most children have all 20 baby teeth by age 3.
The molar stages, which usually hit between 13 and 19 months and again around age 2, tend to be the most uncomfortable. Molars are larger and flatter, so they put more pressure on the gums as they push through. Don’t be surprised if your baby handles the front teeth easily but struggles more with the back ones.
Safe Ways to Ease the Pain
The simplest relief is pressure on the gums. A clean finger rubbed gently along the swollen area works well, and many babies find it immediately soothing. Teething rings made of firm rubber, with or without textured bumps, give your baby something safe to chew on independently. You can chill a teething ring in the refrigerator for extra relief, but don’t freeze it. Frozen rings become hard enough to bruise tender gums. Avoid fluid-filled teethers, which can leak. Clean all teething toys after each use.
For babies older than 8 months who are eating solids, cold foods can help. Chilled applesauce, cold yogurt, or pureed peaches straight from the fridge soothe from the inside. Some parents offer frozen banana pieces or a cold bagel to gnaw on. Keep the pieces small enough to swallow safely, and always stay close while your baby eats.
If your baby is clearly in pain and nothing else is working, infant acetaminophen is an option for babies 8 weeks and older, dosed by weight every 4 to 6 hours as needed, up to 5 doses in 24 hours. Infant ibuprofen is another option for babies 6 months and older, dosed by weight every 6 to 8 hours, up to 4 doses in 24 hours. The dosing is always based on your baby’s weight, not age, so check the package carefully.
Products to Avoid
Numbing gels and teething tablets may seem like obvious solutions, but the FDA has issued serious warnings against them. Products containing benzocaine (found in many over-the-counter oral pain gels) can cause a rare but potentially fatal condition where red blood cells lose their ability to carry oxygen effectively. Prescription lidocaine gels are equally dangerous for infants, with risks including seizures, heart problems, and severe brain injury. Homeopathic teething tablets have also been linked to harm in young children. None of these should be used for teething pain.
Your Baby’s First Dental Visit
The American Academy of Pediatrics recommends scheduling your child’s first dental visit by their first birthday or within six months of their first tooth, whichever comes first. This visit is mostly about establishing a baseline and catching any early issues with how the teeth are coming in. It’s also a good opportunity to ask about fluoride, cleaning routines, and what to expect as more teeth arrive.