The best things you can do for a teething baby are simple: give them something cool to chew on, gently massage their gums, and keep them comfortable while each tooth works its way through. Most babies start teething around 6 months, though it can begin as early as 4 months or as late as 12. The process continues in waves until all 20 baby teeth arrive by age 2½ to 3.
When Teeth Come In and What to Expect
The two bottom front teeth usually appear first, typically between 6 and 10 months. The top four front teeth follow between 8 and 13 months. After that, teeth fill in roughly in pairs, one on each side of the jaw. The first molars come in around 13 to 19 months, the pointy canines between 16 and 23 months, and the second molars last, between 23 and 33 months.
Each new tooth can cause a few days of fussiness before and after it breaks through the gum. Some babies sail through with barely a whimper. Others are clearly uncomfortable, especially when the larger molars arrive. Knowing the general timeline helps because you can anticipate rough patches rather than being blindsided by sudden crankiness.
Real Teething Symptoms vs. Illness
Teething commonly causes drooling, irritability, swollen gums, and a strong urge to chew on everything. Some babies lose interest in eating or have mildly disrupted sleep. About 25% of teething children run a slightly elevated temperature, but it typically stays below 100°F, which doesn’t qualify as a true fever. Around 20% experience loose stools, most often when the first front teeth come in, though this tends to decrease with later teeth.
A rectal temperature above 100.4°F, vomiting, a rash that spreads beyond the chin, or persistent diarrhea are not teething symptoms. Those point to an illness that happens to overlap with the teething timeline. Because babies are losing the immune protection they got from their mothers around the same age teething starts, infections are common in this window, and it’s easy to blame the teeth for something unrelated.
Cooling and Pressure: The Most Effective Relief
Sore gums respond best to gentle pressure and cool temperatures. You have several options that work well together.
A chilled teething ring made of solid rubber gives your baby something safe to gnaw on. Put it in the refrigerator, not the freezer. Frozen rings become rock-hard and can bruise tender gums. Avoid fluid-filled teethers, which can leak. Look for rings made of firm, nontoxic rubber, with or without textured bumps for extra gum stimulation.
A cold washcloth is another reliable option. Soak a clean washcloth in water, wring it out, and refrigerate or freeze it for 30 to 60 minutes. Your baby can chew on it freely, and the cold fabric molds to their gums better than a rigid ring. You can keep a few in rotation so a fresh one is always ready.
Your own clean finger works surprisingly well, especially at moments when you don’t have a teething toy handy. Use gentle, firm pressure on the swollen area of the gum. For extra soothing, dip your finger in cool water first. Many babies find this calming, and it lets you feel exactly where the new tooth is pressing through.
Products to Avoid
Several widely sold teething products carry real risks. The FDA warns against using any topical numbing gel or liquid containing benzocaine or lidocaine on a baby’s gums. Benzocaine (found in products like Orajel, Anbesol, and similar store-brand gels) can cause a rare but potentially fatal condition where red blood cells lose their ability to carry oxygen normally. Lidocaine solutions can cause seizures, heart problems, and severe brain injury if too much is applied or accidentally swallowed. These products also offer little measurable benefit for teething pain.
Homeopathic teething tablets are another category to skip entirely. The FDA found that tablets marketed by major brands contained inconsistent and sometimes dangerously high levels of belladonna compounds. The amount of these toxic substances varied from tablet to tablet within the same package, making safe dosing impossible.
Teething jewelry, including amber necklaces, silicone beads, and wooden bead bracelets, poses choking and strangulation hazards. The FDA has received reports of beads breaking off and being swallowed, and at least one 18-month-old died from strangulation by an amber necklace during a nap. The American Academy of Pediatrics recommends against all forms of teething jewelry.
When Pain Relief Medication Helps
For nights when nothing else is working, infant acetaminophen (Tylenol) can take the edge off. It’s dosed by weight, not age, and can be given every 4 to 6 hours, up to 5 times in 24 hours. Don’t use it in babies under 8 weeks old. Giving it about 30 minutes before bedtime can help a miserable baby settle enough to fall asleep.
Ibuprofen (Motrin, Advil) is another option, but only for babies 6 months and older. It’s given every 6 to 8 hours, up to 4 times a day, and works best when given with food or milk to prevent stomach upset. Like acetaminophen, the correct dose is based on your baby’s weight. Your pediatrician can confirm the right amount at your baby’s next visit or over the phone.
Neither medication should become a daily habit. Teething discomfort typically flares for a few days around each eruption and then fades. If your baby seems to need pain relief for more than a few consecutive days, something else may be going on.
Getting Through Teething Nights
Teething disrupts sleep, sometimes yours more than your baby’s. The key is keeping your existing bedtime routine intact while adding a few comfort measures. Offer a chilled teething ring or washcloth before bed. Wipe away drool from your baby’s chin and neck so they’re not lying in dampness, which can cause an irritating rash that makes sleep even harder.
A white noise machine can help your baby settle back down after waking. If they wake crying, try gum pressure with your finger before reaching for medication. Some nights you’ll need acetaminophen, and that’s fine. The goal is to avoid creating new sleep habits (like bringing your baby into your bed for the first time, or introducing a bottle they didn’t previously need) that will be harder to undo once the tooth is through.
Caring for New Teeth
Start brushing as soon as the first tooth appears. Use a soft-bristled infant toothbrush with just water, or with a rice-grain-sized smear of fluoride toothpaste if your child’s dentist or pediatrician recommends it for babies under 2. The CDC recommends introducing fluoride toothpaste at age 2, with a rice-grain amount until age 3 and a pea-sized amount from ages 3 to 6.
Your baby’s first dental visit should happen by their first birthday or within six months of the first tooth appearing, whichever comes first. This visit is mostly about establishing a baseline, checking for early problems, and getting guidance on oral care specific to your child. It’s typically quick and low-key.