Written by Dr James Tran, principal dentist at Lumi Dental.
Few things unsettle new parents like a grizzly, dribbling baby who will not settle. Teething gets blamed for a lot, and while it genuinely causes discomfort, it is also credited with symptoms it does not actually cause. Knowing the difference matters, because it helps you soothe your baby safely and spot when something else is going on. This guide covers when teething starts, the symptoms that are real, the safe ways to help, and the popular remedies that are best left on the shelf.
Key takeaways
- The first tooth usually appears between about 4 and 12 months, most often around 6 months.
- Real teething signs are mild: drooling, gum rubbing, chewing, and irritability.
- High fever, vomiting, and diarrhoea are not caused by teething and should be checked by a doctor.
- Safe relief is simple: a clean finger, a chilled (not frozen) teething ring, and comfort.
- Avoid teething necklaces, benzocaine gels, and homeopathic teething tablets, which carry real safety risks.
The one rule: teething causes local discomfort, not illness
The most useful thing to hold onto is that teething affects the mouth, not the whole body. It can make gums sore and a baby unsettled, but it does not cause high fevers, vomiting, or diarrhoea. If your baby is genuinely unwell, it is safer to assume that something other than teething is responsible and to have them checked, rather than putting worrying symptoms down to a new tooth.
When teething starts
Most babies get their first tooth around 6 months, though anywhere from about 4 to 12 months is normal. The bottom front teeth usually come through first, followed by the top front teeth, with the full set of baby teeth generally in place by around two and a half to three years. Timing runs in families, so an early or late start is often simply inherited. For the bigger picture of tooth development, see our guide to when adult teeth come in.
The symptoms that are actually teething
Real teething signs are local and mild:
- Increased drooling
- Rubbing or gnawing at the gums, and putting hands or objects in the mouth
- A slightly red or swollen patch of gum where a tooth is coming through
- Irritability or being harder to settle
- Some disrupted sleep or reduced appetite for a day or two
A slightly raised temperature can occur, but a genuine fever is not a teething symptom.
Symptoms that are not teething
These need a doctor rather than a teething ring:
- A fever over 38 degrees Celsius
- Vomiting or diarrhoea
- A rash, cough, or runny nose beyond mild drool-related skin irritation
- Being difficult to rouse, unusually floppy, or clearly unwell
Attributing these to teething can delay care for an actual illness, so it is worth being cautious.
Safe ways to soothe a teething baby
Simple, low-tech comfort works best and is the approach paediatric and dental bodies recommend:
- Gum massage. Rub the sore gum gently with a clean finger. The pressure is soothing.
- A firm rubber teething ring, chilled in the fridge but not frozen. A frozen ring is hard enough to bruise the gums.
- A cool, clean washcloth to chew on.
- Wiping the drool from the chin to prevent skin irritation.
- Extra cuddles and distraction, which often do more than any product.
If your baby is truly miserable, infant paracetamol dosed for their age and weight can help, but it is worth checking with your pharmacist or doctor first, especially for younger babies.
Remedies to avoid
Several popular products carry genuine safety concerns:
- Amber teething necklaces. There is no reliable evidence they relieve pain, and they carry real choking and strangulation risks. They should never be worn during sleep or unsupervised.
- Benzocaine gels (numbing teething gels). Regulators have warned against using benzocaine products in young children because of a rare but serious blood condition called methemoglobinemia. They are not recommended for babies.
- Homeopathic teething tablets and gels. These have been the subject of safety warnings after inconsistent ingredients and serious adverse events were reported. They are best avoided.
When a remedy promises to fix something teething does not actually cause, that is a good sign to be sceptical.
Caring for those first teeth
New teeth need looking after from day one. Wipe the gums with a clean damp cloth before teeth arrive, and once the first tooth is through, brush twice a day with a smear of fluoride toothpaste on a soft baby brush. Avoid putting your baby to bed with a bottle of milk or juice, which is a leading cause of early decay, as explained in our article on baby bottle tooth decay. Plan a first dental visit around the first birthday, covered in our guide to a child's first dental visit. If feeding has been difficult, our article on tongue-tie in babies may also help.
Frequently asked questions
Can teething cause a fever?
Teething may cause a slight rise in temperature, but not a true fever above 38 degrees Celsius. A genuine fever, or a baby who seems unwell, should be assessed by a doctor rather than assumed to be teething.
How long does teething pain last?
Discomfort around each tooth usually lasts a few days, flaring as the tooth pushes through the gum and settling once it appears. It comes and goes as different teeth arrive over the first couple of years.
Are teething gels safe?
Numbing gels containing benzocaine are not recommended for babies because of a rare but serious blood condition. Simple measures like a chilled teething ring and gum massage are safer, with infant paracetamol only if advised by your pharmacist or doctor.
When should I take my baby to the dentist?
A first dental visit is recommended around the first birthday, or within six months of the first tooth appearing. Early visits are short and gentle, and they help catch any concerns while everything is easy to manage.
The takeaway
Teething is a normal, if trying, phase that causes local discomfort rather than illness. Safe relief is refreshingly simple: a clean finger, a chilled teething ring, and plenty of comfort. Skip the necklaces, numbing gels, and homeopathic tablets, and treat any real illness as exactly that. If you have questions about your baby's teeth or want to book that first visit, the team at Lumi Dental in Melrose Park is happy to help. See our general dental care or current offers on the deals page. This article is general information and not a substitute for personal medical or dental advice.
