Baby teething: when it happens, the signs and how to help
Updated
Teething is a natural stage, not an illness. The timing differs for every baby: one gets a first tooth at 4 months, another closer to a year, and both are normal. Teething itself causes discomfort, but it should not make a baby genuinely ill.
Below: when and in what order teeth come through, which signs are real, what helps ease things, what not to do, and why a high fever must not be blamed on teeth.
When and in what order teeth come through
Most often the first tooth appears around 6 months, but the normal range is wide — from 4 to 12 months. The lower central incisors usually come first, then the upper ones. By 2.5–3 years all 20 baby teeth are typically in place. If there are no teeth at all by a year, that is a reason to see a doctor calmly, not to panic.
| Teeth | Age |
|---|---|
| Lower central incisors | 6–10 mo |
| Upper central incisors | 8–12 mo |
| Lateral incisors | 9–16 mo |
| First molars | 13–19 mo |
| Canines | 16–23 mo |
| Second molars | 23–33 mo |
Signs of teething
A few days before a tooth appears you usually notice:
- Heavy drooling and a wish to put everything in the mouth and chew.
- Swollen, red, tender gums; sometimes a white bump is visible.
- Fussiness, irritability, worse sleep.
- A slight drop in appetite, refusing the breast or bottle because the gums hurt.
But a high fever, diarrhoea, vomiting, a rash and a bad cough are NOT signs of teething. The most it causes is a slight rise in temperature. Everything else is a coincidence with an infection, which is easy to catch at this age (the baby puts everything in the mouth). Blaming such symptoms on teeth is dangerous — you could miss an illness.
What helps ease it
- Cold and pressure. Offer a chilled (from the fridge, not the freezer) teething ring or a clean cool damp cloth. Cold and something to chew ease the discomfort.
- Gum massage. With a clean finger gently massage the gum — light pressure reduces the pain.
- Keep the drool off. Gently pat the chin dry with a soft cloth and apply a barrier cream around the mouth to prevent a rash from constant saliva.
- Attention and cuddles. At this time a baby especially needs calm and closeness — sometimes that works better than any teething ring.
- Pain relief only with a doctor's advice. Infant paracetamol or ibuprofen at a dose for the baby's age and weight is used only when the baby is clearly suffering, and only after checking with the paediatrician.
What not to do
- Amber or any necklaces — dangerous: a risk of strangulation and of a bead getting into the airway. Their pain-relieving effect is unproven.
- Numbing gels with lidocaine or benzocaine — do not use them: they are dangerous for infants and banned for this age in many countries.
- Frozen hard objects or food — hard ice can injure the gums; chill a teether but do not freeze it.
- Blaming a high fever, diarrhoea or lethargy on teeth — these are separate symptoms that must be judged on their own.
When to see a doctor
See a doctor if there is a fever of 38 °C or higher, diarrhoea or vomiting starts, a rash appears, the baby refuses food and drink, or is unusually lethargic or inconsolable. This is not "teething" — another cause is looked for, most often an infection. In a baby under 3 months, any fever is a reason to seek help immediately.
It is worth seeing a dentist after the first tooth appears and no later than age one — for a check-up and advice on care.
Caring for the first teeth
Brush from the very first tooth — with a soft baby brush twice a day, using a "grain of rice" amount of fluoride toothpaste (agree the amount and strength with your doctor or dentist). Do not give sweet drinks or juice in a bottle, especially at night: prolonged contact of sugar with the teeth quickly leads to decay. Noting when each tooth came through and how the baby coped makes it easy to keep track of the timing and to answer the dentist's questions specifically.
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Open in TelegramFrequently asked questions
At what age do the first teeth come through?
Most often around 6 months, but the normal range is 4 to 12 months. The lower central incisors usually appear first. If there are no teeth by a year, it is worth seeing a doctor calmly.
Can teething cause a high fever?
Teething itself may cause only a slight rise in temperature. A high fever (38 °C or higher), diarrhoea or vomiting are not teething but a sign of another cause, usually an infection. They must be judged separately, and the baby seen by a doctor.
What helps with teething pain?
A chilled (not frozen) teething ring, a cool damp cloth, a gentle gum massage with a clean finger, and a parent's attention. Pain relief (infant paracetamol or ibuprofen by age) only on a doctor's advice and when the baby is clearly suffering.
Can I use amber necklaces or numbing gels?
No. A necklace is dangerous because of the risk of strangulation, and its effect is unproven. Gels with lidocaine and benzocaine are dangerous for infants and banned for this age in many countries. Use safe methods: cold, massage, attention.
When should I start brushing teeth?
From the first tooth — with a soft baby brush twice a day, using a "grain of rice" amount of fluoride toothpaste. Check the amount and strength with your dentist. Do not give sweet drinks in a bottle at night.
Sources
- Baby teething symptoms — NHS
This article is for general information and does not replace medical advice. Give any pain relief only as directed by a paediatrician, at a dose for the baby's age and weight. Do not blame a high fever, diarrhoea or other clear symptoms on teeth — have your baby seen by a doctor.