Teething: Symptoms, Timeline & What Actually Helps

Teething is one of the most frequently discussed — and most frequently misunderstood — aspects of baby development. Blame for a huge range of symptoms, from fever to diarrhea to sleep disruption, gets attributed to teething when research consistently shows teething causes a much narrower range of effects. This guide covers what teething actually does, what the timeline looks like, and which remedies are backed by evidence (and which ones aren't).

When Teething Starts

The average age for the first tooth to erupt is 6 months, but the normal range is wide: anywhere from 3 to 12 months for a first tooth is considered within the range of typical development. Babies who are born early may teethe later. Family history plays a role — if parents were late teethers, their children often are too.

Teething itself — the process of a tooth working its way through the gum tissue — typically begins weeks before the tooth actually erupts. This means symptoms (drooling, gum sensitivity, wanting to chew on things) can appear 6–8 weeks before a tooth becomes visible. By the time you see the tooth, the worst is often already over.

By age 3, most children have all 20 primary (baby) teeth. If your baby has no teeth at all by 18 months, it's worth mentioning to your pediatrician — while likely normal, it's worth ruling out nutritional deficiencies or other causes.

Order Teeth Come In

While there is natural variation, teeth typically erupt in a predictable sequence:

Tooth	Typical Age of Eruption	Notes
Lower central incisors (front bottom)	6–10 months	Usually the first teeth
Upper central incisors (front top)	8–12 months	Often closely follow lower
Upper lateral incisors	9–13 months	Beside the central incisors
Lower lateral incisors	10–16 months
First molars (top and bottom)	13–19 months	Often most uncomfortable eruption
Canines (eye teeth)	16–23 months
Second molars	23–33 months	Last primary teeth; can be uncomfortable

Symptoms That Are Teething

Research supports teething as a cause of the following symptoms, typically in the days immediately before and after a tooth erupts:

• Drooling: Often significantly increased — the inflammation of teething stimulates saliva production
• Drool rash: A mild chin or cheek rash from constant drool contact with the skin
• Gum rubbing and chewing: Babies chew on everything because counter-pressure on the gum provides temporary relief
• Mild fussiness: More than baseline but not inconsolable; typically in the days immediately surrounding tooth eruption
• Slightly disrupted sleep: Usually short-term (1–2 nights around a tooth eruption) — not weeks of disruption
• Mild temperature elevation: Up to 38°C (100.4°F) — at the very threshold of fever. Research in the journal Pediatrics confirmed this mild elevation, but not true fever above 38°C.
• Pulling ears: If no signs of ear infection — sometimes from referred gum pain. But persistent ear pulling with fever warrants a pediatrician visit.

Myths: What Teething Doesn't Cause

The following are commonly attributed to teething but are not caused by teething according to current research:

• True fever (above 38°C / 100.4°F) — if your baby has a real fever, look for another cause
• Diarrhea — a persistent myth with no research support. The increased drooling and the coincidence of teething age with the age when babies begin putting things in their mouths may explain why illness (often causing diarrhea) coincides with teething, but the teething itself is not the cause
• Runny nose — again, coincidence of age range with increased viral exposure, not teething itself
• Prolonged sleep disruption — teething may disrupt sleep for 1–2 nights around a tooth eruption, but weeks of broken sleep is not teething
• Refusing all food for days — mild gum sensitivity may reduce appetite briefly, but extended food refusal needs evaluation

What Actually Helps

1. Chilled (Not Frozen) Teething Rings

A teething ring cooled in the refrigerator (not the freezer — frozen rings are too hard and can damage gum tissue) provides cooling relief and counter-pressure. Silicone teething rings are safe and easy to clean. Look for rings large enough that they cannot be fully inserted into the mouth and have no liquid filling that could leak.

2. Chilled Washcloth

A clean damp washcloth chilled in the refrigerator works on the same principle as a teething ring. Babies can gnaw on it safely. Simple and effective.

3. Gum Massage

Using a clean finger to apply firm, gentle counter-pressure to the gum over the erupting tooth can provide temporary relief. The pressure counteracts the pressure sensation of the tooth pushing through, which is the source of the discomfort.

4. Acetaminophen or Ibuprofen (When Needed)

When teething discomfort is clearly significant — not manageable with other methods, affecting sleep or feeding — age-appropriate pain relief is appropriate. Acetaminophen (Tylenol) is safe for babies 2+ months. Ibuprofen (Advil/Motrin) can be used from 6 months. Always use the correct dose for your baby's weight and consult your pediatrician for guidance. Pain relief should be used for genuine discomfort, not routinely throughout the teething period.

What Doesn't Help — and What's Unsafe

Topical Benzocaine Gels (Orajel, Anbesol)

The FDA warns against using benzocaine products in children under 2. Benzocaine can cause methemoglobinemia — a serious, potentially fatal condition where hemoglobin cannot carry oxygen effectively. The AAP recommends against their use. The numbing effect also wears off in minutes, making the risk-benefit ratio clearly unfavorable.

Homeopathic Teething Tablets

The FDA has warned against and issued recalls for homeopathic teething tablets (including Hyland's Teething Tablets) containing belladonna. Testing found inconsistent and potentially dangerous levels of belladonna alkaloids. Avoid these products.

Whiskey or Alcohol

Rubbing alcohol on a baby's gums is dangerous — even small amounts of alcohol can cause hypoglycemia and CNS depression in infants. This folk remedy has no place in modern infant care.