Teething: what is normal, what is not, and what actually soothes
Last updated September 3, 2026.
Teething is the slow eruption of twenty baby teeth through the gums between about six months and three years of age, and most of it is more annoying than dramatic. Parents blame teething for almost everything in that window; the evidence supports a much shorter list, and knowing the difference keeps real illness from being waved away.
What does teething actually cause?
The supported list: sore, red gums where a tooth is coming; one flushed cheek; more dribbling than usual; gnawing and chewing on anything available; rubbing an ear on the affected side; mild fussiness and disturbed sleep; and a slight rise in temperature. A tooth typically causes a few days of symptoms around its eruption, not weeks. The first teeth (the bottom front pair) and the big molars tend to be the worst offenders.
What teething does not cause?
This is the safety-critical part. Teething does not cause a true fever (38C or above), diarrhoea, vomiting, a rash, reduced feeding, congestion and cough, or a baby who is genuinely unwell. Those symptoms mean illness, and attributing them to teething is the classic way babies end up reviewed late. If your baby has a fever, is off their feeds, or is not themselves, treat it as illness first and teething never.
What actually soothes?
- Cold and pressure: a chilled (never frozen) teething ring, or clean fingers rubbing the gum; firm pressure is what babies are seeking with all that chewing.
- Something safe to chew: solid silicone or rubber teething toys, and for babies on solids, chilled cucumber sticks or crusts under supervision.
- Dribble management: constant wiping and a barrier cream on the chin prevent the sore dribble rash that adds to the misery.
- Pain relief when needed: weight-appropriate paracetamol or ibuprofen (ibuprofen from three months) for genuinely unsettled nights, used occasionally rather than nightly.
- What to avoid: teething gels with lidocaine, amber necklaces (choking and strangulation risk), and anything frozen solid, which can burn the gum.
When is it an emergency?
Teething never is. A fever of 38C or more in a baby under three months is always urgent regardless of suspected teething. At any age, seek same-day advice for a fever with a non-blanching rash, breathing difficulty, unusual drowsiness or floppiness, refusing fluids, fewer wet nappies, or a baby you simply feel is seriously unwell. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Can teething cause a fever?
Teething can nudge the temperature up slightly, but it does not cause a true fever of 38C or above, and large studies confirm this. A real fever means infection, and blaming teeth is how illnesses get missed, including serious ones. The same applies to diarrhoea, vomiting, rashes, and poor feeding: none of them are teething. If your baby has a fever, manage it as illness; and any fever in a baby under three months needs same-day medical assessment whatever the gums look like.
Are amber teething necklaces safe?
No, and regulators warn against them explicitly. They carry two risks that have caused real harm: strangulation (especially during sleep, which is when parents most want them on) and choking if the string breaks and releases beads. There is also no plausible mechanism or evidence for the claimed effect; the supposed active ingredient cannot meaningfully absorb through intact skin. The same warning covers teething bracelets and anklets. A chilled teething ring does the soothing job with none of the risk.
Which teething gels are safe?
The ones to avoid are gels containing lidocaine (a local anaesthetic): they numb for minutes at most before being swallowed, and lidocaine overdose in babies has caused seizures and deaths. Sugar-free gels without lidocaine are harmless but offer little beyond the rubbing. In practice, mechanical soothing (cold, pressure, chewing) plus occasional weight-appropriate paracetamol or ibuprofen for bad nights outperforms any gel. Check the label, and if it says lidocaine, leave it on the shelf.
My baby is 3 months and seems to be teething. Is that too early?
Not necessarily. The average first tooth arrives around six months, but the normal range runs from about three months to past the first birthday, and some babies are born with a tooth. Early dribbling and chewing at three months is often just developmental (babies discover their hands and drool glands switch on), but early teeth happen and are fine. Late teeth are equally fine: a baby with no teeth at twelve months usually needs nothing more than patience, though your dentist or doctor can confirm at the one-year check.
Does teething cause nappy rash and loose stools?
The extra dribble means babies swallow more saliva, which can make stools slightly looser, and that can aggravate a nappy rash; that much is plausible. But diarrhoea proper (frequent watery stools) is an illness, usually a tummy bug, and it brings a dehydration risk that teething never does. Manage nappy rash with frequent changes and barrier cream, and treat true diarrhoea as an illness: fluids, watching wet nappies, and medical advice if it persists or your baby seems unwell.
How long does each tooth take to come through?
The fussy, symptomatic window for one tooth is typically a few days: the gum swells, the baby grumbles for two to five days, the tooth tip breaks through, and it settles. The tooth then continues moving into place over weeks without symptoms. With twenty teeth arriving over roughly two and a half years, the gaps between teeth mean most weeks are symptom-free; a baby who has been miserable for weeks on end without a tooth appearing deserves a look for another cause rather than a teething diagnosis.