The earliest and most reliable sign that your baby is teething is swollen, tender gums, often with visible redness where a tooth is pushing through. Most babies start teething around 6 months of age, though symptoms can begin as early as 4 months. The good news: teething is predictable once you know what to look for, and the discomfort from each tooth is temporary, typically lasting 3 to 8 days.
The Most Common Signs of Teething
Teething produces a cluster of mild symptoms that tend to show up together. No single sign confirms teething on its own, but when you see several at once, a new tooth is the likely explanation.
- Swollen or puffy gums. This is the most direct sign. Run a clean finger along your baby’s gum line. You may feel a hard bump or ridge where the tooth is pressing upward. The tissue around it often looks red or slightly bluish.
- Excessive drooling. Teething triggers a noticeable increase in saliva production. You may find yourself changing bibs or wiping your baby’s chin far more often than usual. The extra moisture can also cause a mild rash around the mouth, chin, or neck.
- Chewing on everything. Babies instinctively press objects against their gums to counter the pressure of an incoming tooth. Hands, toys, the edge of a crib rail, your fingers: anything firm becomes a chew target.
- Fussiness, especially at night. Teething discomfort tends to come and go in waves. Many parents notice their baby is crankier in the evening and during the night, when there are fewer distractions. It’s normal for teething babies to wake more frequently or have trouble settling down to sleep.
- Mild ear pulling. Babies sometimes tug at the ear on the same side as an erupting tooth. The gums, jaw, and ear share nerve pathways, so the sensation can radiate. This pulling is usually gentle and one-sided.
- Slight rise in body temperature. Teething can push your baby’s temperature up slightly, but it stays below 100.4°F (38°C). A meta-analysis published in a major medical journal confirmed that true fever is not a symptom of teething. If your baby’s temperature reaches 100.4°F or higher, something else is going on.
What Teething Gums Actually Look Like
Before a tooth breaks through, the gum tissue over it becomes swollen and may look shiny or stretched. You might see a whitish bump just beneath the surface, which is the crown of the tooth pressing upward. In some cases, a small fluid-filled blister (sometimes called an eruption cyst) appears over the spot. These look alarming but are harmless and resolve on their own once the tooth comes through.
The lower front teeth are almost always the first to arrive, so check the center of the bottom gum line first. Once the tooth cuts through, you’ll see a thin white edge poking out. At that point, the worst of the discomfort is usually over for that particular tooth.
How Long Each Tooth Takes
Each teething episode lasts roughly 3 to 8 days, with symptoms peaking in the few days before the tooth actually breaks the surface. Pain typically starts a few days before eruption and tapers off within a day or two after the tooth appears. That means even though your baby has 20 primary teeth to get through, they’re not in constant discomfort for months. The symptoms come in short bursts with breaks in between.
Some teeth seem to cause more trouble than others. The first molars, which are larger and have a broader surface, often produce more noticeable fussiness than the front teeth. Every baby is different, though. Some sail through certain teeth with barely a whimper and struggle with others.
Teething vs. an Ear Infection
Because teething babies pull at their ears and get fussy, parents often wonder whether they’re actually dealing with an ear infection. The two can look similar on the surface, but there are clear differences.
Ear infections tend to come on suddenly and produce more intense distress. A baby with an ear infection often has a true fever (above 100.4°F), cold symptoms like a runny nose or cough, and significant difficulty lying flat. The ear tugging is typically stronger and may involve both ears. You might also notice your baby refusing to feed because swallowing creates pressure in the ear. In some cases, fluid or pus drains from the ear canal.
Teething, by contrast, causes on-and-off irritability rather than a sharp escalation in distress. There’s no fever, no cold symptoms, and no ear drainage. The ear pulling is mild and one-sided. If your baby seems unusually sick, is running a temperature above 100.4°F, or has symptoms that don’t match the teething pattern, an illness is the more likely cause.
Symptoms That Teething Does Not Cause
For years, parents attributed a long list of symptoms to teething: diarrhea, vomiting, high fever, severe rashes, and prolonged loss of appetite. Research has not supported these connections. Teething may cause a slight increase in temperature, mild gum discomfort, and extra drool, but it does not make babies genuinely sick.
The timing confusion is understandable. Babies begin teething around 6 months, which is the same age they lose the protective antibodies passed from their mother during pregnancy. They also start putting everything in their mouths, exposing themselves to new germs. So teething and the first round of common illnesses often overlap, but one doesn’t cause the other.
Safe Ways to Ease Teething Pain
The simplest relief is pressure on the gums. A clean finger, a chilled (not frozen) washcloth, or a solid teething ring kept in the refrigerator all work well. The gentle counter-pressure helps offset the sensation of the tooth pushing through. For babies who are eating solids, chilled foods like cold applesauce or a refrigerated teething cracker can serve double duty.
If your baby is clearly uncomfortable and having trouble sleeping, infant pain relievers appropriate for their age and weight can help. Talk to your pediatrician about the right option and dose.
Products to Avoid
The FDA has issued strong warnings against several popular teething products. Topical gels containing benzocaine (found in many over-the-counter oral pain products) can cause a rare but serious condition that reduces the blood’s ability to carry oxygen. Prescription lidocaine gels carry risks of seizures, heart problems, and severe brain injury in young children. Neither type offers meaningful relief for teething, and both can be dangerous.
Homeopathic teething tablets have also drawn FDA warnings after reports of serious injury and death in children. And amber teething necklaces, which are marketed as natural pain relief, pose real strangulation and choking hazards. The FDA has received reports of infant deaths linked to teething jewelry. None of these products are worth the risk.
Teething and Sleep Disruption
Night waking is one of the most frustrating parts of teething for parents. Gum soreness, extra drooling, and general discomfort can wake babies who were previously sleeping through the night. This is normal and temporary. The disruption usually tracks with the 3-to-8-day window of each teething episode.
Keeping your baby’s usual bedtime routine consistent helps signal that it’s still time to sleep, even when they’re uncomfortable. A teething ring before bed or a dose of age-appropriate pain relief (if needed) can take the edge off enough for your baby to settle. Once the tooth breaks through, sleep patterns typically return to normal within a few days.