Teething feels like a dull, aching pressure in the gums as each tooth pushes its way toward the surface. Babies can’t describe it, but the biological process involves real inflammation and tissue changes that cause genuine discomfort. The sensation is most intense in the four days before a tooth breaks through and typically lingers for about three days after, making each tooth roughly an eight-day event.
What Happens Inside the Gums
A tooth doesn’t simply slide through the gum. Before it can emerge, the body has to dissolve bone to create a pathway. Cells in the tissue surrounding each developing tooth release inflammatory signaling molecules, which recruit specialized cells that break down the thin layer of bone sitting above the tooth. This is the same type of inflammation you’d feel with a minor injury: swelling, warmth, tenderness, and pressure.
The key inflammatory molecules involved are the same ones your body produces during an infection or wound. At moderate levels, they cause tissue swelling and localized bone breakdown. One of these molecules is also the body’s main trigger for raising temperature, which explains why teething can nudge a baby’s body temperature slightly higher than normal. It does not, however, cause a true fever. A temperature of 100.4°F (38°C) or above is a fever and signals an infection, not teething.
What It Likely Feels Like
The closest adult comparison is the pressure and soreness you feel when a wisdom tooth pushes through. The gums become swollen and tender in the area where the tooth is emerging. Babies experience a combination of constant dull pressure from below the gum line and sharper sensitivity at the surface where the tissue is stretching and thinning. This is why babies instinctively bite down on things: counter-pressure on the gums temporarily overrides the aching sensation, much like pressing on a sore muscle provides brief relief.
Before a tooth breaks through, you might notice the gum in that area looks puffy, red, or slightly swollen. In some cases, a fluid-filled bump appears on the gum right where the tooth is about to emerge. These eruption cysts look bluish or clear and are most common toward the back of the lower jaw. They’re painless on their own and usually resolve once the tooth comes through.
How Babies Show You It Hurts
Since babies can’t point to their gums and tell you what’s wrong, their behavior is the main signal. The most common signs include:
- Increased drooling, often the earliest clue, sometimes starting weeks before a tooth appears
- Fussiness and irritability, especially in the days just before a tooth emerges
- Biting and chewing on fingers, toys, or anything within reach
- Disrupted sleep, including more frequent night waking or shorter naps
- Reduced appetite, particularly reluctance to nurse or take a bottle, since sucking puts pressure on sore gums
These symptoms tend to come and go in waves rather than staying constant. A baby might have a rough couple of days, then seem completely fine for a week before the next tooth starts moving.
Which Teeth Hurt More
Not all teeth cause the same level of discomfort. The lower central incisors, which usually arrive first between 6 and 10 months, are small and thin. They cut through relatively easily. The upper central incisors follow around 8 to 12 months and are slightly broader, so they can cause a bit more soreness.
The first molars are a different story. These are wide, flat teeth that arrive between 13 and 19 months, and they have to push through a larger area of gum tissue. Parents often report that molar eruption causes noticeably more irritability and sleep disruption than the front teeth did. The second molars, arriving closer to age two, can be similarly uncomfortable. The canine teeth (the pointy ones between the incisors and molars) also tend to cause more discomfort than the front teeth because of their shape and the thicker gum tissue they push through.
Safe Ways to Ease the Pain
The most effective relief is also the simplest. A clean finger pressed gently against the swollen area of your baby’s gums provides focused counter-pressure that temporarily dulls the aching. A chilled (not frozen) teething ring works on the same principle, with the added benefit of mild numbing from the cold. Frozen teething toys can actually be too intense and may hurt more than they help.
For nights when discomfort is clearly disrupting sleep, infant acetaminophen is an option for babies of any age, while ibuprofen can be used for babies six months and older. Both are dosed by weight, not age, so check the packaging or ask your pediatrician for the right amount.
What to Avoid
The FDA has issued specific warnings against using numbing gels or liquids containing benzocaine or lidocaine on teething babies. Benzocaine can cause a rare but serious condition that reduces the blood’s ability to carry oxygen. Lidocaine, if accidentally swallowed or applied in too large an amount, can cause seizures, heart problems, and brain injury. These products offer little actual benefit for teething pain, and the risks far outweigh any temporary relief.
Homeopathic teething tablets have also drawn safety concerns. And amber teething necklaces, marketed as natural pain relief, pose strangulation and choking hazards. The FDA has received reports of infant deaths linked to teething jewelry. There is no evidence that amber releases any meaningful amount of pain-relieving substance through skin contact.
The Full Timeline
Most babies get their first tooth around 6 months, though anywhere from 4 to 12 months is normal. The process follows a fairly predictable sequence: lower front teeth first, then upper front teeth, followed by lateral incisors on both jaws. First molars typically show up between 13 and 19 months, canines fill in the gaps, and second molars bring up the rear. By roughly age three, all 20 baby teeth are usually in place.
That means teething is not one event but a series of roughly 20 separate eruptions spread over about two and a half years. Some teeth arrive with barely any fuss. Others, particularly molars, can cause several difficult days. The good news is that the worst discomfort is always temporary, peaking right around the moment each tooth breaks through the surface and fading quickly after.