Babies can’t describe what teething feels like, but the best comparison is the pressure and soreness you’d feel if a hard object were slowly pushing through swollen, tender tissue. The gums become inflamed, red, and sensitive as each tooth works its way to the surface, creating a dull, persistent ache that intensifies with each millimeter of progress. For a baby experiencing this for the first time with no frame of reference, it can be genuinely distressing.
What’s Happening Inside the Gums
Teething isn’t just a tooth poking through soft tissue. Weeks before you see anything, the tooth is moving upward through bone. Specialized cells break down the bone above the tooth to create a path, and as the root lengthens, the tooth picks up speed. Once it clears the bone, it still has to push through a layer of dense connective tissue and the gum surface itself.
This process triggers a localized inflammatory response. The gum tissue swells, blood flow increases to the area, and the nerve endings in the gums become more sensitive. That’s why the gums look puffy and red right before a tooth appears. Your baby is feeling something similar to what you’d feel with a deep, slow bruise forming on sensitive tissue, one that builds gradually rather than arriving all at once.
The Sensation: Pressure, Itch, and Tenderness
Based on what we know about gum inflammation and how babies respond, teething likely produces three overlapping sensations. The first is deep pressure from the tooth pushing outward. The second is surface tenderness, where even light contact with the swollen gum feels sharp or stinging. The third is something close to itching or tingling as the tissue stretches and nerve endings fire in unfamiliar ways.
This explains why babies both want to chew on things and cry when they do. Biting down creates counterpressure that temporarily dulls the deeper ache, but it also irritates the tender surface of the gums. It’s a frustrating loop: the thing that partially relieves one sensation worsens another. Firm pressure on the gum from a teething ring or a clean finger works because it compresses the tissue enough to override some of the pain signals, similar to how pressing hard on a sore muscle can feel both painful and relieving at the same time.
How Long Each Tooth Hurts
The worst discomfort clusters around the days just before and just after a tooth breaks through the gum surface. The entire eruption process for a single tooth takes roughly a week, but sleep disruption and fussiness can stretch to about two weeks per tooth. Once the tooth has fully cut through, the inflammation subsides quickly and your baby gets a break until the next one starts moving.
The trouble is that babies get 20 primary teeth over roughly two years, and sometimes multiple teeth erupt close together. The bottom front teeth typically come first, usually around six months, followed by the top front teeth. After that come the teeth on either side of those, then the first molars, the pointed canine teeth, and finally the second molars. Molars tend to cause more discomfort simply because they’re larger and have a broader surface pushing through the gum.
Behaviors That Signal Pain
Since your baby can’t say “my gums hurt,” they communicate it through behavior changes. The most consistent signs are increased drooling, chewing or gnawing on anything within reach, and irritability that doesn’t have an obvious cause like hunger or a dirty diaper. Some babies pull at their ears or rub their cheeks on the side where a tooth is coming in, because the pain can radiate along the jaw.
Sleep disruption is one of the most noticeable effects. Babies who normally sleep through the night may start waking more frequently, and falling asleep can take longer. This makes sense: during the day, a baby has distractions and things to chew on, but at night the discomfort has their full attention. The lying-down position may also increase blood flow to the gums, intensifying the throbbing sensation.
Some babies handle teething with minimal fuss. Others are clearly miserable for days at a stretch. Pain tolerance varies in infants just as it does in adults, and there’s no reason to doubt a baby who seems to be struggling even if a sibling breezed through the same stage.
What Teething Does Not Cause
Teething has a reputation for causing fevers, diarrhea, and rashes, but the Cleveland Clinic notes that teething does not cause true fevers. It may nudge your baby’s temperature slightly above their baseline, but it won’t reach 100.4°F (38°C) or higher. A temperature at or above that threshold signals an infection, not teething. The timing is coincidental: babies start teething around the same age they lose some of their maternal antibodies and start putting everything in their mouths, which means more exposure to germs.
If your baby has a genuine fever, vomiting, diarrhea, or a rash alongside what looks like teething, those symptoms deserve their own attention rather than being dismissed as part of the process.
What Actually Helps With the Pain
The simplest and safest relief is counterpressure. A firm silicone teething ring, a clean finger, or a cold (not frozen) washcloth gives your baby something to bite against that compresses the swollen tissue and temporarily reduces pain signaling. Chilled teething rings work especially well because the cold adds a mild numbing effect on top of the pressure.
Gently rubbing the swollen area of the gum with a clean finger for a couple of minutes can also bring noticeable relief. You’re essentially doing what your baby is trying to do every time they gnaw on a table edge or your shoulder.
What you should avoid is more important than what you try. The FDA has issued explicit warnings against numbing gels and liquids containing benzocaine or lidocaine for teething pain in children. Benzocaine can cause a dangerous condition where red blood cells lose much of their ability to carry oxygen. Lidocaine solutions can cause seizures, serious brain injury, and heart problems if too much is applied or accidentally swallowed. These products offer little measurable benefit for teething and carry risks that are wildly out of proportion. Homeopathic teething tablets have also drawn FDA warnings for inconsistent ingredient levels and adverse events.
For nights when your baby is clearly in pain and nothing else is working, an age-appropriate dose of infant acetaminophen or ibuprofen (for babies over six months) can take the edge off long enough for them to fall asleep. Your pediatrician can confirm the right dose based on your baby’s weight.
Why Some Teeth Hurt More Than Others
Not every tooth produces the same level of discomfort. The first few teeth tend to be rough because your baby has never experienced the sensation before and doesn’t understand what’s happening. After a few teeth, many babies seem to adjust to the process and react less dramatically.
The molars, which typically arrive between 13 and 19 months for the first set and 23 to 33 months for the second, are a common exception. Their wide, flat tops create a larger area of gum disruption compared to the narrow front teeth. Many parents notice a second wave of significant teething distress during the molar phase, even if the earlier teeth came in without much trouble. The canine teeth, with their deeper roots, can also cause more noticeable symptoms than the incisors did.