Your Infant is Teething: Know the Signs and Symptoms

Advice From Our Experts

July 10, 2020

Teething can be a time of great frustration for caregivers, in this post I will list some of the most common symptoms, explain how they relate to teething and share some insight on how to help soothe your little one during this potentially uncomfortable time.

When Does Teething Begin for Infants?

Teething usually starts around four to eight months with the lower front teeth and continues until 30-36 months of age when the last set of molars appear. During the teething period there are symptoms that include irritability, disrupted sleep, swelling or inflammation of the gums, drooling, loss of appetite, rash around the mouth, mild temperature, diarrhea, increased biting and gum-rubbing and even ear-rubbing. These symptoms were reported by 70-80 percent of parents according to an article from the British Dental Journal. So, why don’t all infants experience teething symptoms? Keep reading to find out.

Why Teething Symptoms May Be Confused with Cold Symptoms

Research has pointed out that teething begins around six months of age. This is the same time when an infant’s immunities they received from their mother, via the placenta, are diminishing. This means that the infant’s own immune system is becoming established. During this time, infants become vulnerable to minor infections. Because these two changes are taking place, the symptoms of teething can be confused with a minor illness or cold and visa versa. This explains why only 70-80 percent of parents reported teething symptoms of their infant; it’s very likely that parents of the remaining 20-30 percent associated the symptoms to a minor illness or cold.

Below is a list of commonly reported teething symptoms, with ways to help your infant at home and when to call the doctor:

• Irritability
• Drooling/Skin Rashes
• Coughing
• Biting and Gnawing
• Low Grade Fever
• Cheek rubbing and ear pulling
• Diarrhea

Irritability

This is caused by the discomfort of the teeth erupting through the gums. Often the first teeth and molars are the most uncomfortable.

How to help your infant’s irritability: Cuddle, cuddle, cuddle! Every baby can use some good cuddle time when they are having a hard time with teething. The extra time spent with your baby can help alleviate their pain, by providing feelings of being comforted and reassured.

Drooling/Skin Rashes

Teething can stimulate drooling and many babies drool a lot!

How to help your infant’s drooling: Excessive drooling can cause a rash around the mouth, cheeks, chin and neck area due to the extra bacteria on the skin from the saliva. Try to keep the area as clean and as dry as possible by periodically wiping the area. Applying a simple barrier cream can help with the dry, chapped and sore skin.

Coughing

The extra saliva produced during teething can cause an occasional cough or gag.

How to help your infant’s coughing: If your infant’s cough continues or is accompanied by a high fever and cold or flu symptoms, contact your infant’s pediatrician. The high fever with cold and flu symptoms is not related to teething, but is actually a sign that your infant is sick.

Biting and Gnawing

The counter pressure from biting on practically anything can alleviate the pressure from under the gums.

How to help your infant’s biting and gnawing: Anything cold works great! My best friend mixes water with the pouches of baby food and freezes them to make fruit and veggie popsicles. There are teething rings, chew beads and any commercially bought teething toys can help, especially when chilled or frozen.

Low Grade Fever

A low grade fever is defined and caused by the following:

• A temperature ranging from 98-100 degrees.
• It can be caused by an infant putting their unclean hands in their mouth.

If the fever reaches above 101 degrees or continues, contact your infant’s pediatrician because it may not be the teething but a more serious illness.

How to help your infant’s low grade fever: Use an age-appropriate pain medication and please consult your infant’s pediatrician and the medication label for correct dosage.

Cheek rubbing and ear pulling

This is caused by pain in the gums, which can travel to the cheek and ear, especially when the molars are erupting. Infants will rub those areas. Keep in mind that ear pulling or rubbing can also be a sign of an ear infection, please contact your infant’s pediatrician if this symptom continues or is accompanied with a high fever.

How to help your infant’s cheek rubbing and ear pulling: Try rubbing and massaging the gums with a clean finger for one to two minutes to help with the discomfort.

Teething and Diarrhea

Many believe that the increased saliva produced during teething can cause stool to become slightly loose.Keep in mind, diarrhea can be a sign of a more serious infection so contact your infant’s pediatrician if the stool becomes watery, because your infant could be at risk for dehydration. Contacting your infant’s pediatrician is especially important if the diarrhea is accompanied by vomiting or a high fever.

I hope the list of symptoms and ways you can help your infant will guide you through your infant’s teething phase. I also hope this helps ease the potential stress experienced by many parents. Just remember, that many symptoms we think are teething can be associated with illness, may be completely unrelated to teething and may need to be addressed by a physician.

Teething in Babies: Symptoms and Remedies

Written by WebMD Editorial Contributors

Reviewed by Amita Shroff, MD

on November 30, 2022.

Reading time: 4 minutes

In this Article

• What Is Teething?
• When Do Babies Start Teething?
• Signs and Symptoms of Teething
• Order of Tooth Eruption
• Soothe a Teething Baby
• Treatments to Avoid
• Teething Necklaces
• Teething Medicine
• How to Care for Baby’s New Teeth

Teething is when your baby’s teeth start to come through their gum line. Another word for it is odontiasis.

Most babies begin to teethe between 4 and 7 months old, but some start much later. There’s no need to worry if your baby’s teeth come in on another timetable — it can be different for every baby.

The symptoms aren’t the same for every baby, but they may include:

• Swollen, tender gums
• Fussiness and crying
• A slightly raised temperature (less than 101 F)
• Gnawing or wanting to chew on hard things
• Lots of drool, which can cause a rash on their face
• Coughing
• Rubbing their cheek or pulling their ear
• Bringing their hands to their mouth
• Changes in eating or sleeping patterns

Teething can be painful, but it doesn’t usually make babies sick. Call your doctor if your baby has diarrhea, vomiting, rashes on the body, a higher fever, or cough and congestion. These aren’t normal signs of teething.

You also should call the pediatrician if your baby’s gums are bleeding or you see any pus or swelling of their face.

When and how teeth come in can be different for every baby and may be based on family history. But most of the time, the lower front two teeth come in first between 6 and 10 months, followed by the opposite top two teeth and the two on either side of those between 8 and 13 months. Next come the two on either side of the bottom front teeth, then the first molars appear between 10 and 16 months. The teeth in front of the first molars are next, and the back molars are the last ones to come in.

In all, 20 “baby teeth” will eventually be in place, usually by age 3.

What works to soothe a friend’s baby might not work for yours. You may need to try different things to help your little one feel better:

• Something cold in your baby’s mouth, like a cold pacifier, spoon, clean wet washcloth, or a solid (not liquid) refrigerated teething toy or ring. Some experts say frozen teething toys are too cold and may hurt your baby’s mouth. Make sure to clean teething toys, washcloths, and other items after the baby uses them.
• Try offering a hard, unsweetened teething cracker.
• If your baby is older than 6-9 months, you can offer cool water from a sippy cup, too.
• Massage the gums by gently rubbing them with your clean finger. If the teeth haven’t come in yet, you can let your baby gnaw on your finger. If you’re nursing your baby, try dipping your fingers in cool water and massaging their gums before each feeding. That may keep them from biting your nipple while nursing.

Never put anything in your baby’s mouth that isn’t specifically approved to help soothe teething. Even some products described as teethers or teething aids aren’t safe choices, including ones:

• Filled with liquid that can tear and spill
• Made of breakable material, like plastic, that can possibly lead to choking
• That are frozen solid — these can be too hard on a baby’s mouth

Another reason to be aware of the material used to make the teethers: Some can be made from harmful substances, like lead. Look for ones made of rubber.

Child health experts don’t recommend teething necklaces. They’re dangerous: They can strangle the baby. They also can choke if the necklace breaks and they swallow the beads.

If you do choose to use one, make sure to:

• Put it on a wrist or ankle, not around the baby’s neck.
• Always watch your baby when they wear it.
• Take it away when you aren’t watching your baby, even for a very short time.

You may have heard that amber teething necklaces release a pain reliever when heated. That’s not proven, and doctors say using one is not a good idea.

Medicine that you rub on your baby’s gums to stop the pain of teething may not help. It quickly washes away in the mouth and may numb the back of their throat and make it hard for them to swallow.

Stay away from over-the-counter teething gels and liquids that have the ingredient benzocaine. The FDA says this ingredient shouldn’t be given to children under 2. It can cause rare but serious side effects.

A small dose of a children’s pain reliever, such as acetaminophen, may help your baby. Don’t use ibuprofen for an infant under 6 months old, and ask your doctor before giving your baby any medication. Use it exactly as the doctor says.

Teething can be rough for you and your baby at first. But it’ll get easier as you both learn how to soothe each new tooth that pops out.

Good oral hygiene is important, even before your baby has teeth:

• Until teeth start to come in, clean your baby’s gums with a wet washcloth or piece of gauze at least once a day.
• Once they have teeth, clean your baby’s mouth the same way at least twice a day. After feedings is a good time for this.
• After their first birthday, you can start to use a soft-bristled baby toothbrush with water and a small amount of toothpaste that doesn’t have fluoride in it. You can also start flossing between their teeth.

Your child should see a pediatric dentist when the first tooth appears, or no later than their first birthday.

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Teething at 2 months: normal or abnormal

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The baby is naughty, his sleep is disturbed, he takes the breast and immediately lets go? Perhaps the process of teething has begun. “Teeth cutting at 2 months?” – you ask. When your baby is very young, you can associate the baby’s anxiety with some kind of illness, but not with the process of the appearance of the first incisors. Let’s understand the possible timing of teething. We cannot regulate them, but we can alleviate the condition of children in the event of unpleasant symptoms.

Is it possible for a baby to cut teeth at such an early age? The two lower central incisors grow first and usually erupt one after the other. But you should understand that the time frame is not limited. Sometimes the process can take a while. There are times when the first incisors appear earlier. Therefore, when asked whether teeth can be cut at two months, experts give an affirmative answer. Deviation of the time frame for several months in both directions is considered the norm. Only in the event that a one-year-old child does not have a single tooth, you should consult a doctor.

Every body is different, so some babies have their first tooth at 2-3 months. The process is determined not only by genetics, but also by a number of other factors:

• climatic conditions;
• maternal nutrition;
• peculiarities of the course of pregnancy;
• disorders of the endocrine system – sometimes the early appearance of teeth may indicate its anomalies.

If a mother during pregnancy drank multivitamins or additional mineral complexes containing vitamins D and C, then teething may accelerate. Contributes to this and the use by a woman of fermented milk products in large quantities.

What are the symptoms of teething

Only some parents do not experience difficulties with teething in a child and notice the incisor by chance, not understanding when it appeared. In most cases, the process is accompanied by unpleasant symptoms:

1. Puffiness, “looseness” of the gums. Redness, bumps may form. Sometimes the teeth are visible through the gums. In some cases, there are bluish hematomas.
2. Increased salivation. Because of this, rashes around the mouth may appear. But salivation at 2 months of age does not always indicate teething. During this period, such a process is physiological. If the rash occurs elsewhere, it has nothing to do with teething.
3. Restless state. The child cries a lot, is naughty, the quality of his sleep worsens. Often the baby cannot be soothed. Conventional methods (swinging, nipples, etc.) do not help.
4. Increased body temperature. More often these are indicators up to 37.5 ˚C. This can happen due to local inflammation (gums). A higher temperature indicates the activity of viruses.
5. Loss of appetite. During the period of the appearance of teeth, children do not eat well or refuse to eat at all. Sometimes the baby cannot be attached to the breast. Some babies kick their feet while feeding.
6. Runny nose and cough. Due to increased salivation, mucus flows down the back of the throat. It enters the nasal passages, since the baby at the age of two months is more in a supine position. When mucus enters the throat, it provokes a cough. More often it occurs during sleep.

These symptoms do not occur all at once and can be combined in different ways. Often for parents, they become a serious cause for concern. Even the fact that a child is teething at such an early age is already shocking.

It is important not to confuse signs of infectious or neurological diseases that have similar symptoms with the process of teething. Therefore, it is better to show the baby to the doctor. The following symptoms also serve as a reason to seek help: the child is very lethargic, he has a high temperature (above +38 ˚С), vomiting or sores in the mouth have appeared. A child can also vomit due to excessive salivation when mucus enters the stomach. Liquid and frequent stools also indicate the attachment of an infection. Diarrhea can cause dehydration.

How to help a baby

If a baby starts teething at 2 months, besides fatigue due to sleepless nights, parents are worried about their baby. Since he is tormented by pain, discomfort, he eats little and sleeps poorly, it is necessary to help relieve unpleasant symptoms. To do this, use the following methods:

1. Massage the gums. Wash your hands thoroughly first. Massage is done with a fingertip. It is worth trimming your nails so as not to damage the gums. Massaging relieves pain. The degree of effectiveness of the method can be determined by the reaction of the child.
2. Apply cold. Ordinary teethers, which are sold in pharmacies and are offered to older children, a baby at the age of two months will not gnaw. In this case, he can cool the nipple or apply a gauze pad to the problem area. It is pre-moistened with cold water or chamomile infusion, which helps relieve inflammation.
3. Lubricate gums with anesthetic gels. For example, “Kamistad” or “Kalgel” are the means that can be used even at an early age.
4. Provide antipyretic and analgesic drugs based on ibuprofen and paracetamol. 2-month-old babies put candles. It can be, for example, “Efferalgan”.

During teething, it is important to provide your baby with the right care. It is necessary to monitor the cleanliness of the pacifier. Saliva needs to be wiped only with clean napkins. The skin around the mouth should be lubricated with a special baby cream. You also need to walk more – fresh air will only benefit. But it is better to avoid crowded places so that the baby does not pick up an additional virus.

If your child has early teething, if he is breastfeeding, it is worth visiting a dentist. The fact is that the risk of developing bottle caries in this case is quite high.

Date: May 4, 2021

When does a baby’s first teeth erupt?

All babies teething according to their own individual program: for some, this process begins earlier, for others later. As practice shows, the first tooth in most children appears at the age of 6 to 8.5 months, and by the year every healthy child has at least one milk tooth in his mouth.

At the age of three or four months, teeth preparing for eruption begin to announce themselves quite actively: the baby becomes capricious, cries, tries to bite everything that gets into his hands.

The first to appear are usually the two lower, centrally located teeth (lower central incisors or “ones”). Then – the central upper incisors, after which, by about ten months, the upper “twos”, or lateral upper incisors, erupt. By eleven to twelve months, the lateral incisors can also be seen on the lower jaw. Thus, ideally, a one-year-old child is the proud owner of eight milk teeth.

By about sixteen months, many babies already have first molars on the bottom and top. Fangs (“threes”) appear at the top and bottom later, in the eighteenth – twenty-second month of a child’s life. The second upper and lower molars erupt at the age of 24-33 months. But again, it should be remembered that this process is individual and the order of teething may also be different.

Teeth often grow in pairs: two, and sometimes four at the same time. In girls, for the most part, teeth erupt earlier than in boys. By the age of 2.5-3 years, a complete set of twenty fully erupted teeth can be found in a baby.

Alertness must be shown if a child who is almost a year old does not have a single tooth. In principle, some children may have a congenital feature in the form of late teething, but you should not draw any conclusions on your own, you should definitely consult with a qualified specialist who, if necessary, will prescribe additional examinations.

Causes of late teething in children:

• hereditary predisposition, which is a variant of the norm and can be traced in other blood relatives;
• decreased thyroid function;
• rickets;
• diseases of the digestive system;
• enzymatic (fermentative) metabolism disorders;
• pituitary insufficiency;
• lack of calcium in the child’s body;
• genetically determined diseases.

For the baby himself, the process of teething can proceed in different ways. Some children practically do not experience discomfort, others suffer from pain, their sleep is disturbed, their appetite worsens, their temperature rises (up to 38-39 ° C), salivation increases, nasal congestion, wet cough (due to profuse salivation), constipation or, conversely, , increased stool.