For teething pain, Motrin (ibuprofen) is generally the better choice because it reduces both pain and the gum inflammation that causes much of the discomfort. But there’s an important catch: ibuprofen is not safe for babies under 6 months old. Since most babies start teething around 4 to 6 months, Tylenol (acetaminophen) is often the only option when those first teeth arrive. Once your baby hits the 6-month mark, ibuprofen becomes the stronger tool for teething relief.
Why Ibuprofen Has an Edge for Teething
The two medications work differently in the body, and that difference matters for teething specifically. Both block the chemical signals (called prostaglandins) that generate pain and fever. But acetaminophen only works in the brain, dulling how your baby perceives pain. Ibuprofen works in the brain and at the site of the problem, meaning it also reduces the swelling and inflammation happening right there in the gums.
Teething pain isn’t just about nerve sensitivity. The gums become red, puffy, and inflamed as a tooth pushes through. Because ibuprofen tackles that local inflammation directly, it tends to provide more complete relief for teething than acetaminophen alone. If your baby’s gums look visibly swollen, that’s exactly the kind of discomfort ibuprofen was designed to address.
The 6-Month Rule for Motrin
Ibuprofen is not approved by the FDA for infants younger than 6 months. It simply hasn’t been established as safe for that age group. If your baby starts teething at 4 or 5 months, Tylenol is the appropriate option. It won’t address gum swelling, but it will take the edge off pain and bring down any mild fever that sometimes accompanies teething.
Once your baby turns 6 months old, you can use either medication. Many parents find that ibuprofen works noticeably better at that point, particularly during the more painful molars that come in later.
Alternating the Two Medications
When teething pain is severe and one medication alone isn’t enough, you can alternate between Tylenol and Motrin every 3 hours. So if you give Tylenol at noon and your baby is still miserable by 3 p.m., you can follow up with Motrin. This rotation should only be used short-term, up to 24 hours, to avoid overtaxing your baby’s system. If pain persists beyond that, it’s worth checking whether something other than teething is going on.
Side Effects to Know About
Both medications are safe when used at the correct dose, but they carry different risks when something goes wrong.
Acetaminophen is processed by the liver. The danger comes from giving too much, either by exceeding the daily limit or accidentally doubling up with another product that also contains acetaminophen. Overdose can cause serious liver damage. Signs of a problem include dark urine, vomiting, loss of appetite, unusual tiredness, or yellowing of the skin or eyes.
Ibuprofen is harder on the stomach. It can cause upset stomach, diarrhea, or constipation, even at normal doses. In rare cases, it can irritate the stomach lining enough to cause bleeding. If your baby seems unusually fussy after taking ibuprofen, has bloody or black stools, or vomits anything that looks dark, stop the medication and get medical attention. Giving ibuprofen with a small amount of food or milk can help reduce stomach irritation.
Skip the Teething Gels
Numbing gels and creams that go directly on the gums might seem like the most logical solution, but the FDA specifically warns against them for teething. Products containing benzocaine can trigger a rare but potentially fatal condition where red blood cells lose much of their ability to carry oxygen. Prescription lidocaine gels are equally dangerous for young children, with risks including seizures, heart problems, and severe brain injury. Beyond the safety concerns, these topical products wash away quickly with drool and offer little measurable benefit.
Non-Medication Relief That Works
You don’t always need medication for teething. Cold pressure on the gums is one of the most effective natural remedies. A clean, damp washcloth chilled in the refrigerator (not the freezer) gives your baby something safe to gnaw on while the cold numbs the sore area. Solid rubber teething rings work the same way, especially when cooled first. Avoid any teething ring filled with liquid, since these can break or pose a choking hazard.
Gently rubbing your baby’s gums with a clean finger can also provide temporary relief. The counter-pressure seems to soothe the aching sensation of a tooth pushing through. Many parents find that a combination of cold pressure during the day and a dose of ibuprofen before bedtime is enough to get through the worst stretches of teething without heavy reliance on medication.