Teething shows up as red, swollen gums where a tooth is pushing through, often with a visible white or bluish bump on the gum surface. Before you ever see a tooth, you can spot the signs on your baby’s gums if you know what to look for. The changes happen gradually, starting weeks before a tooth actually breaks through.
What Teething Looks Like on the Gums
Even before teething starts, you can see lighter areas on your baby’s gums that mark where teeth will eventually come in. As a tooth gets closer to the surface, the gum tissue over it becomes noticeably red and swollen. If you run a clean finger along the gum, you may feel a hard ridge just beneath the surface.
Small white bumps sometimes appear on the gums during this process. These are collections of gum tissue that form as the tooth pushes upward, called gingival cysts. They look a bit like tiny blisters and resolve on their own once the tooth breaks through. In some cases, the bump appears bluish or purple instead of white. This happens when small blood vessels break as the tooth moves upward, creating a fluid-filled lump on the gum. These bluish bumps, known as eruption cysts, are most common toward the back of the lower jaw and are typically harmless. They clear up once the tooth emerges.
Right before the tooth cuts through, the gum may look especially puffy and tender in that spot. Some babies also have minor gum bleeding or inflammation. Once the tooth finally pokes through, you’ll see a thin white edge of enamel visible through the gum tissue.
When Eruption Cysts Need Attention
Most eruption cysts disappear within a couple of weeks without any treatment. But if a bluish bump on your baby’s gum bleeds, oozes pus, causes obvious pain, or lasts longer than two weeks, it’s worth having a dentist take a look. Cysts that persist beyond a month may occasionally need a minor procedure to help the tooth come through, but this is rare.
Signs Beyond the Mouth
Teething doesn’t just change how your baby’s gums look. It often triggers heavy drooling, which can cause its own visible signs on the skin. A teething rash, sometimes called a drool rash, shows up as red, slightly raised patches around the mouth, chin, and sometimes the neck. The skin in those areas may look dry, chapped, or dotted with small bumps. Keeping the area clean and dry helps, but the rash tends to come and go as long as your baby is actively drooling.
Behaviorally, babies going through teething tend to chew or bite on anything they can get their hands on. They may be fussier than usual, especially during feeding or at bedtime. Some parents notice their baby pulling at their ears on the same side as an incoming tooth.
Temperature Changes During Teething
Teething can nudge your baby’s body temperature slightly above the normal range of about 98.6°F, but it does not cause a true fever. A fever is defined as 100.4°F or higher. If your baby’s temperature reaches that threshold, something else is going on. It’s a common misconception that teething causes high fevers, diarrhea, or widespread illness, but studies have not supported that connection.
What the Timeline Looks Like
The four front teeth, two on top and two on the bottom, are usually the first to appear. They can start coming in as early as six months, though the timing varies widely from baby to baby. Some infants get their first tooth at four months, while others don’t see one until closer to their first birthday. After the front teeth, the lateral incisors (the teeth on either side) follow, then the first molars, canines, and finally the second molars. Most children have a full set of 20 primary teeth by age three.
The front teeth are small and relatively thin, so they tend to cut through the gums with less visible swelling. Molars are a different story. Their broad, flat surfaces create more pressure on the gum tissue as they push through, which often means more pronounced swelling, redness, and discomfort. If your baby seemed to breeze through the front teeth but struggles later, the molars are the likely reason.
Safe Ways to Help
The American Academy of Pediatrics recommends rubbing your baby’s swollen gums with a clean finger to provide counter-pressure, which many babies find soothing. A firm rubber teething ring also works well. Avoid liquid-filled teethers, which can break, and don’t freeze teething rings because a rock-hard surface can actually bruise tender gums. A chilled ring from the refrigerator is a better option.
The FDA warns against using topical numbing gels or creams containing benzocaine or lidocaine on infants’ gums. Benzocaine can cause a dangerous condition that reduces the blood’s ability to carry oxygen, and lidocaine can lead to seizures, heart problems, and severe brain injury in young children. Homeopathic teething tablets carry similar warnings. These products offer little benefit for teething pain and pose real risks, so the safest approach is sticking with physical soothing methods like gentle pressure and something cool to chew on.