Most babies start teething between 4 and 7 months old, and the signs are usually a combination of swollen gums, extra drooling, and a sudden urge to chew on everything in reach. No single symptom confirms teething on its own, but when several show up together, you can be fairly confident that a tooth is on its way.
What Teething Gums Look Like
The most reliable sign is what you can see and feel inside your baby’s mouth. Run a clean finger along the gum line and check for a firm, slightly raised bump where a tooth is pushing through. The gums in that spot will typically look red and swollen compared to the surrounding tissue. Some babies develop a small bluish or dark-colored blister on the gum, called an eruption cyst, which looks alarming but is harmless and resolves on its own once the tooth breaks through.
The lower front teeth (central incisors) almost always come in first, so start by checking the center of the bottom gum. The upper front teeth usually follow within a couple of months.
Behavioral Changes to Watch For
Before you ever see a bump on the gum, your baby’s behavior will probably shift. The most common signs include:
- Increased drooling. Saliva production ramps up noticeably, sometimes weeks before a tooth appears. You may need to change bibs multiple times a day, and the constant moisture can cause a mild rash around the chin and neck.
- Chewing and gnawing. Babies press down on toys, fingers, and anything they can get into their mouths because the counter-pressure on the gums feels soothing.
- Irritability. The discomfort tends to come in waves, not a constant ache. Your baby may be fine one hour and fussy the next, especially in the days right before a tooth cuts through.
- Ear pulling or cheek rubbing. The nerves in the gums, ears, and cheeks share pathways, so babies often tug at their ears or rub the side of their face on the side where a tooth is erupting. This can look a lot like an ear infection, which is worth keeping in mind.
Sleep and Feeding Disruptions
Parents often notice a sleep regression right around teething. Babies who previously slept through the night may start waking more frequently or have trouble falling asleep. The discomfort tends to be worse at night because there are fewer distractions, and lying flat can increase pressure on the gums.
Feeding changes are common too. Some babies nurse or bottle-feed less because sucking creates uncomfortable pressure on the gums. Others actually want to nurse more for the comfort it provides. Babies who have started solids may temporarily refuse food, especially anything that requires chewing. This is usually short-lived and resolves once the tooth breaks through the surface.
Fever, Diarrhea, and What Teething Doesn’t Cause
This is where a lot of confusion happens. Teething can nudge your baby’s body temperature slightly above the normal 98.6°F, but it does not cause a true fever. A fever is defined as 100.4°F (38°C) or higher. If your baby hits that threshold, something else is going on, most likely an infection, and teething should not be the assumed explanation.
The timing is what tricks parents. Babies begin teething around the same age that maternal antibodies from pregnancy start to fade, which means they’re catching more illnesses right when teeth are also coming in. It’s easy to blame every symptom on teething when a cold or stomach bug is the actual culprit.
Diarrhea is not caused by teething. Neither is congestion, vomiting, or a high fever. The legitimate symptoms of teething are relatively minor: drooling, gum soreness, fussiness, and a slight temperature bump. If your baby has symptoms beyond that list, treat them as their own issue rather than writing them off as teething.
When Teeth Typically Appear
The first tooth usually shows up between 6 and 10 months, though some babies get one as early as 4 months and others don’t see their first until after their first birthday. Both ends of that range are normal. The general eruption pattern goes like this: lower front teeth first, then upper front teeth, then the lateral incisors on either side, followed by the first molars, canines, and second molars. By age 3, most children have all 20 primary teeth.
Molars, which come in around 12 to 16 months and again around 20 to 30 months, tend to cause the most discomfort because of their larger surface area pushing through the gum. You may notice a second round of teething symptoms that feels more intense than the first.
Safe Ways to Ease Teething Pain
A chilled (not frozen) teething ring or clean washcloth gives your baby something safe to press against their gums. The cold helps reduce inflammation, and the pressure provides natural relief. You can also gently rub the swollen area with a clean finger. For babies already eating solids, chilled foods like cold fruit in a mesh feeder can do double duty.
If your baby is clearly in pain and non-medication approaches aren’t enough, infant acetaminophen is an option for babies 8 weeks and older. Infant ibuprofen can be used starting at 6 months. Dose by your baby’s weight, not age, and follow the label limits: acetaminophen every 4 to 6 hours with no more than 5 doses in 24 hours, ibuprofen every 6 to 8 hours with no more than 4 doses in 24 hours.
Products to Avoid
Several popular teething products carry real risks. The FDA has issued specific warnings about numbing gels containing benzocaine (sold under brand names like Orajel and Anbesol). These products can cause a rare but potentially fatal condition that severely reduces the blood’s ability to carry oxygen. Prescription lidocaine gels are equally dangerous for infants and have been linked to seizures, heart problems, and death.
Amber teething necklaces and other teething jewelry also carry FDA warnings. Reports of infant strangulation and choking have been filed, and there is no evidence that amber releases any pain-relieving substance through the skin. The safest teething remedies are the simplest ones: cold, pressure, and if needed, weight-appropriate pain medication.