Teething causes drooling and gum soreness — but not true fever. Here's the eruption timeline, what actually helps, and three products with FDA safety warnings.
Teething begins when the first tooth pushes through the gum — for most babies, somewhere between 4 and 12 months, with around 6 months as the most common starting point.1 The full set of 20 primary teeth usually completes by age 3. Some babies sail through it; others are clearly uncomfortable for a few days around each eruption.
Understanding exactly what teething causes — and what it doesn't — lets you respond to the real symptoms and recognise when something else is happening.
When teeth arrive: the typical eruption order
Teeth follow a fairly consistent sequence, though individual variation is wide:12
| Teeth | Typical age of eruption |
|---|---|
| Lower central incisors (bottom front 2) | 6–10 months |
| Upper central incisors (top front 2) | 8–12 months |
| Upper lateral incisors | 9–13 months |
| Lower lateral incisors | 10–16 months |
| First molars (upper and lower) | 13–19 months |
| Canines / cuspids (upper and lower) | 16–22 months |
| Second molars | 23–33 months |
A baby with no teeth at 12 months is within normal range. If no teeth have appeared by 18 months, mention it to your health visitor or dentist — it rarely indicates a problem, but it's worth a check.
What teething actually causes
The evidence on teething symptoms is narrower than most parents expect. Both the NHS and AAP agree on what can reasonably be attributed to teething:12
- Increased drooling — often starting a few weeks before the first tooth appears
- Gum swelling and redness in the area where the tooth is emerging
- Increased chewing and mouthing of objects
- Mild irritability in the 3–5 days around eruption (typically the day before and a few days after the tooth breaks through)
- A very slight temperature elevation — sometimes reported in the 24 hours around eruption, but this does not reach the threshold of true fever
Teething does not cause true fever. A temperature of 38°C (100.4°F) or above is not a teething symptom.12 If your baby has a fever during teething, the fever is coincidental — the teething is not the cause. Assess and respond to the fever independently using the age-based thresholds in baby fever: when to worry.
What is not caused by teething
These symptoms are commonly — and incorrectly — attributed to teething:
High fever (≥38°C): Not a teething symptom. The NHS and AAP are both explicit on this point.12 Attributing fever to teething can delay identification of an illness that needs treatment.
Diarrhoea: Not caused by teething. Increased saliva swallowing is not enough to cause loose stools. Diarrhoea during the teething period is coincidental — often a viral infection — and should be evaluated as such, especially if it is accompanied by signs of dehydration.
Runny nose and cold symptoms: Not a teething symptom. Your baby probably has a virus.
Ear pulling: Sometimes attributed to pain "radiating" from the gum. There is no consistent evidence for this. Ear pulling combined with fever or significant distress can indicate an ear infection — see your GP.
Safe relief options
Chilled teething rings: Safe and effective. Refrigerate, do not freeze — a frozen ring can damage sensitive gum tissue.1 Many babies find the combination of counterpressure and mild cold soothing. Look for rings labelled "for the fridge," not "for the freezer."
Gentle gum massage: A clean finger pressed and rubbed gently over the sore area provides counterpressure that many babies find calming.
Distraction: Engagement and play can interrupt the discomfort cycle more effectively than many products. Time spent on something interesting often provides more relief.
Paracetamol or ibuprofen: Appropriate if your baby is clearly distressed around tooth eruption and other measures aren't working. Paracetamol from 2 months (over 4 kg), ibuprofen from 3 months (over 5 kg). Always follow weight-based dosing from the package or NHS guidance — never estimate.1
What to avoid — FDA and AAP safety warnings
Amber teething necklaces and bracelets: The FDA warns against these products. They present a documented strangulation risk and a choking hazard from broken beads. There is no clinical evidence that amber releases active compounds through the skin that reduce teething pain.3 The AAP also advises against them. Do not use them — not even for short periods during the day.
Benzocaine teething gels: The FDA warns that benzocaine oral health products should not be used in children under 2 years.4 Benzocaine is associated with methemoglobinaemia — a condition in which the blood's ability to carry oxygen is reduced — which can be serious and in rare cases life-threatening. This warning applies to all products containing benzocaine, including those marketed specifically as "baby teething gels."
Lidocaine-containing remedies: Not safe for infants. High doses of lidocaine have caused serious heart problems and deaths in infants. The FDA specifically recommends against using lidocaine to treat teething pain.4
Homeopathic teething tablets and gels: Several products have been recalled following adverse event reports in infants. The FDA found inconsistent amounts of belladonna in recalled products. The AAP advises against homeopathic teething remedies.3
Starting dental care
As soon as the first tooth appears, start dental hygiene. Wipe the tooth daily with a clean, damp cloth or a soft infant toothbrush. A rice-grain-sized amount of fluoride toothpaste is appropriate from the first tooth — fluoride helps protect enamel from the moment teeth arrive.1 Aim for a first dental visit by 12 months, or within 6 months of the first tooth appearing.
← Back to the complete guide: Baby health basics
Also in this cluster: Fever: when to worry · When to call the doctor
Sources
- NHS. "Teething." NHS, 2023. https://www.nhs.uk/conditions/teething/
- American Academy of Pediatrics. "Baby Teething Pain." HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Teething-4-to-7-Months.aspx
- U.S. Food and Drug Administration. "Teething Necklaces and Beads: A Caution for Parents." FDA Consumer Update. https://www.fda.gov/consumers/consumer-updates/teething-necklaces-and-beads-unsafe-baby-jewelry
- U.S. Food and Drug Administration. "FDA Drug Safety Communication: Reports of a Rare, but Serious and Potentially Fatal Adverse Effect with the Use of Over-the-Counter (OTC) Benzocaine Gels and Liquids Applied to the Gums or Mouth." https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-benzocaine-over-counter-teething-gels-and-liquids-not-safe-babies
Footnotes
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NHS. "Teething." NHS, 2023. https://www.nhs.uk/conditions/teething/ ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8
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American Academy of Pediatrics. "Baby Teething Pain." HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Teething-4-to-7-Months.aspx ↩ ↩2 ↩3 ↩4
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U.S. Food and Drug Administration. "Teething Necklaces and Beads: A Caution for Parents." FDA Consumer Update. https://www.fda.gov/consumers/consumer-updates/teething-necklaces-and-beads-unsafe-baby-jewelry ↩ ↩2
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U.S. Food and Drug Administration. "FDA Drug Safety Communication: Reports of a Rare, but Serious and Potentially Fatal Adverse Effect with the Use of Over-the-Counter (OTC) Benzocaine Gels and Liquids Applied to the Gums or Mouth." https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-benzocaine-over-counter-teething-gels-and-liquids-not-safe-babies ↩ ↩2