Teething can cause swollen gums, increased drooling, irritability, mild sleep disruption, and a slight rise in body temperature, but it does not cause true fevers, diarrhea, or serious illness. Most babies start teething around 6 months, and the process continues in waves until roughly age 3. Understanding what teething actually causes, and what it doesn’t, helps you tell normal discomfort apart from something that needs medical attention.
Confirmed Symptoms of Teething
The symptoms directly tied to teething are local and mild. As a tooth pushes through the gum tissue, the area becomes swollen, red, and tender. Babies respond by chewing on anything they can get their hands on, which puts pressure on the gums and provides relief. Drooling ramps up significantly, sometimes soaking through bibs and clothing. Irritability and fussiness are common, particularly in the hours right before a tooth breaks the surface.
Some babies briefly lose interest in eating because sucking or chewing creates pressure on sore gums. Others want to nurse or bottle-feed more frequently for comfort. You may also notice your baby pulling at their ears on the same side as an emerging tooth. This is referred to pain from the gums, not an ear infection, though the two can look similar from the outside.
Sleep Disruption Around Eruption
Sleep disturbance is one of the most common complaints parents have during teething, but the window is shorter than many people assume. A study tracking 231 individual tooth eruptions found a higher frequency of sleep disruption on the day the tooth broke through and the following day, compared to non-teething days. Other research has found no measurable change in sleep in the five days leading up to eruption. So if your baby has been sleeping poorly for a week or more, teething alone probably isn’t the explanation.
Slight Temperature Rise, Not Fever
Teething can cause a small uptick in body temperature, but it does not cause a true fever. Researchers have confirmed that while a baby’s temperature may rise slightly around the time a tooth comes in, the increase stays below 100.4°F. A reading at or above 100.4°F is a fever by medical definition and points to illness rather than teething.
The reason these two things so often overlap is timing. Babies typically start teething around 6 months, which is exactly when the protective antibodies they received from their mother during pregnancy fade. Maternal antibody levels decline steadily over the first six months of life, leaving babies more vulnerable to infections right as teething begins. This overlap leads many parents to blame teething for fevers and illnesses that are actually caused by the viruses and bacteria a baby’s still-developing immune system is encountering for the first time.
Drool Rash on the Face and Chest
All that extra saliva can cause a secondary problem: drool rash. When a baby’s skin stays wet with saliva for long stretches, it becomes red, irritated, and sometimes bumpy. The rash typically shows up around the mouth, chin, and neck folds but can spread to the chest if clothing stays damp.
Prevention comes down to keeping the skin dry. Gently blot saliva from your baby’s face, chin, and neck folds with a clean, soft cloth throughout the day, especially after feedings and naps. Change damp clothing promptly. If a rash develops, wash the area with warm water twice a day and pat dry. Avoid scrubbing, rough towels, or medicated soaps, all of which can make things worse. Most drool rashes clear up on their own within a week. If the rash persists, cracks, or seems painful, a pediatrician may recommend a mild hydrocortisone cream.
What Teething Does Not Cause
Teething does not cause diarrhea, vomiting, high fever, or significant congestion. These are signs of illness. Some babies do have slightly looser stools during teething, likely because sore gums encourage them to drink or nurse more often, increasing their fluid intake. But watery or frequent diarrhea is not a teething symptom and should be taken seriously on its own.
Attributing real illness symptoms to teething can delay treatment for infections, which are more common at this age precisely because maternal antibody protection is waning. If your baby has a temperature of 100.4°F or higher, persistent diarrhea, a rash that doesn’t match the drool pattern, or unusual lethargy, those warrant a call to your pediatrician regardless of whether a tooth is coming in.
When Each Tooth Typically Appears
Teeth generally arrive in a predictable order, though the exact timing varies from baby to baby. The lower central incisors (bottom front teeth) are usually first, appearing between 6 and 10 months. Upper central incisors follow at 8 to 12 months. From there, the lateral incisors fill in between roughly 9 and 16 months.
The first molars arrive between 13 and 19 months, and many parents report that molars cause more discomfort than incisors because of their larger, flatter surface area pushing through the gum. Canines come in around 16 to 23 months. The second molars are last, erupting between 23 and 33 months. By age 3, most children have all 20 primary teeth.
Safe Ways to Relieve Teething Pain
The simplest relief is pressure. Gently rubbing or massaging your baby’s gums with a clean finger works well. Solid rubber teething rings give babies something firm to chew on. Avoid liquid-filled teethers, which can break and leak. Chilling a teething ring in the refrigerator (not the freezer) adds a numbing effect.
For pain that’s clearly bothering your baby, infant acetaminophen is an option for babies 3 months and older, given every 4 to 6 hours as needed up to five times a day. Ibuprofen is an alternative for babies 6 months and older, given every 6 to 8 hours. Both are dosed by weight, so check the packaging or ask your pediatrician for the right amount.
Products to Avoid
The FDA has issued clear warnings against two categories of teething products. Topical gels and liquids containing benzocaine or lidocaine, sold under brand names like Orajel, Anbesol, and Baby Orajel, should not be used for teething. These products offer little benefit because saliva washes them away quickly, and benzocaine carries a risk of methemoglobinemia, a serious condition that reduces the blood’s ability to carry oxygen. It can be fatal.
Homeopathic teething tablets are the other major concern. The FDA warned consumers specifically about tablets containing belladonna after testing revealed that products from major brands contained inconsistent, sometimes dangerously high levels of toxic compounds including atropine and scopolamine. Some tablets had levels far exceeding what was listed on the label. The FDA recommends disposing of any homeopathic teething tablets you may have at home.
Amber teething necklaces, though still widely sold, pose a strangulation and choking hazard and have no evidence supporting their claimed pain-relieving properties.