Most babies start teething around 6 months old, and the simplest, safest relief comes from cold pressure on the gums. A chilled (not frozen) teething ring, a clean wet washcloth kept in the refrigerator, or gentle gum massage with a clean finger can ease discomfort within minutes. Beyond those basics, there are a few more tools worth knowing about and several popular products you should avoid entirely.
When Teeth Typically Appear
The bottom front teeth usually arrive first, between 5 and 8 months. The top front teeth follow around 6 to 10 months, with the upper and lower side teeth (lateral incisors) filling in between 7 and 12 months. The first molars, which tend to cause the most discomfort because of their larger surface area, come through between 11 and 18 months. These ranges are averages. The American Academy of Pediatric Dentistry notes that many otherwise normal infants don’t follow the typical schedule, so a late or early first tooth is rarely a concern on its own.
Signs Your Baby Is Teething
The most reliable signs are redness, swelling, and tenderness along the gums, especially toward the back of the mouth as molars come in. Increased drooling and general fussiness are also common. You may notice your baby chewing on anything within reach: fingers, toys, the edge of a bib.
One thing teething does not cause is a true fever. Research shows that while body temperature can rise slightly around the time a tooth erupts, it stays below 100.4°F, which is the threshold for a fever. If your baby’s temperature hits 100.4°F or higher, something else is likely going on, and it’s worth looking into illness rather than blaming the teeth.
Cold Pressure and Gum Massage
Cold numbs the gums gently and reduces swelling. The easiest options:
- Chilled teething rings. Place a solid teething ring in the refrigerator for about 30 minutes before giving it to your baby. Don’t freeze it. A frozen ring becomes hard enough to bruise or damage tender gum tissue.
- Cold washcloth. Wet a clean washcloth, wring it out, and refrigerate it. The texture gives your baby something satisfying to gnaw on, and the cold soothes the area.
- Finger massage. Wash your hands, then rub your baby’s gums firmly with a clean finger. The counterpressure against the emerging tooth often provides immediate relief, and many babies calm down quickly with this alone.
For babies who are already eating solids (generally 6 months and older), a chilled piece of peeled cucumber or a cold spoon can work well, though you should always stay close to watch for choking.
When to Consider Pain Medication
If cold and pressure aren’t enough, especially during molar eruptions, infant pain relievers can help. Acetaminophen is safe for babies of any age when dosed by weight. Ibuprofen is an option only after 6 months of age. Both are given every 6 to 8 hours as needed, with a maximum of four doses in 24 hours. Always use the syringe or dropper that comes with the product and dose according to your baby’s weight, not age, since weight-based dosing is more accurate.
Pain medication is best reserved for the worst moments, like bedtime on a particularly rough night, rather than used around the clock for days. Most teething episodes involve only a few days of noticeable discomfort around each tooth’s eruption.
Products to Avoid
Several widely marketed teething products carry serious risks that outweigh any benefit.
Numbing gels containing benzocaine or lidocaine. The FDA warns that these offer little to no benefit for teething pain and can cause a rare but potentially fatal condition in which red blood cells lose much of their ability to carry oxygen. Lidocaine-based products can also cause seizures, heart problems, and severe brain injury in infants if too much is swallowed, which is hard to control with a drooling baby. These products should not be used for teething.
Amber teething necklaces and bracelets. Both the FDA and the American Academy of Pediatrics have warned against teething jewelry of any kind. Infants have been strangled by these necklaces, and beads that break off are a choking hazard. An 18-month-old died after being strangled by an amber necklace during a nap. The AAP’s position is clear: infants should not wear any jewelry.
Teething and Sleep
Parents often blame teething for rough nights, and that instinct makes sense. But the evidence is more nuanced than you might expect. A study published in The Journal of Pediatrics used video monitoring to track infant sleep around tooth eruptions and found no significant differences in sleep duration, number of awakenings, or parental visits on teething nights compared to non-teething nights. More than half of parents in the study reported sleep disturbances during teething, but the objective recordings didn’t back that up. An earlier study of 475 tooth eruptions found only marginal, clinically insignificant changes in sleep around eruption days.
This doesn’t mean your baby isn’t uncomfortable. It does mean that if your baby suddenly starts waking frequently for several nights in a row, teething may not be the primary cause. Ear infections, growth spurts, and developmental leaps can all disrupt sleep around the same ages that teeth are coming in.
Caring for New Teeth
Once that first tooth breaks through, it needs cleaning. Use a small, soft-bristled toothbrush with a rice-grain-sized smear of fluoride toothpaste. That tiny amount is safe if swallowed and provides enough fluoride to protect the new enamel. Continue using this amount until your child turns 3, when you can increase to a pea-sized dab.
Brush twice a day, paying special attention to the gum line where plaque collects. Multiple major pediatric and dental organizations, including the AAPD, ADA, and AAP, recommend scheduling a first dental visit before your child’s first birthday. That visit is mostly about guidance: the dentist will check for early signs of decay, assess your baby’s fluoride exposure, and talk through feeding habits that affect oral health. It’s brief, low-key, and sets a baseline for everything that follows.