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.

Top Picks

Mom asks: “Can a 2-month-old baby cut teeth?”

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supersizer / E+ / Getty Images

. In recent days, I notice that she seems to be cutting her teeth. The child began to cry more, began to gnaw on his fist, even if he had eaten quite recently. Drooling constantly. Can teeth be cut so early? Whether is it a pathology? And how to relieve the child’s pain?

Pediatric dentist at PerfectSmile Aesthetic Dentistry and Bone Regeneration Center

— Teething at 2 months is possible. It is not considered a pathology. Cases have been recorded when babies were born already with teeth. Mostly they need to be removed because they interfere with breastfeeding and make it difficult to take formula from a bottle. But there are times when they are left behind. Everything is individual.

At 2 months, eruption is considered early. This is due to genetics. The mother’s past illnesses, the intake or lack of intake of any vitamins by the mother does not affect the timing of teething. But it can affect the quality of the teeth.

The timing of eruption may be affected by vitamin and microelement deficiencies in the child himself, but in this case, on the contrary, we assume a later eruption.

Teething – how to relieve pain

Gels with lidocaine, benzocaine and other local anesthetics should not be used under the age of 4 years! Homeopathic preparations containing belladonna are also prohibited. Preparations in which choline salicylate is present are questionable. The risks and side effects outweigh the potential benefits.

What to do:

1. Massage your baby’s gums with your finger or silicone brush.

2. Use a cold teether. Just freeze in the refrigerator, not the freezer.

3. Give the nibbler a chilled product that is familiar to the baby.

4. Give me a pacifier. Personally, I am against the nipple, it is better to once again give the baby a breast. But for formula-fed babies, this may be the way out.

5. If all else fails, as a last resort, use pain relievers approved for children.

Whether to brush a baby’s teeth

We start brushing teeth with toothpaste and a brush (not a fingertip and not a silicone brush) as soon as the first tooth erupted. It is very important!

There is a myth that the earlier milk teeth erupt, the more they are subject to caries. This is wrong. It’s just that most pediatricians still advise starting brushing your teeth with toothpaste not earlier than a year, or even a year and a half.

If you start brushing and flossing your baby’s teeth right away, and use xylitol wipes to brush your teeth after nightly feedings, you can avoid cavities.

Ksenia Voronezhtseva, Expert

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Teething in children , or more correctly, teething is quite often accompanied by various changes in the behavior and well-being of the baby, which is very frightening for parents who are not ready for such a development of events. What dental symptoms in children should alert adults what to do.

Helping your baby when teething

If your baby is just worried about teething, constantly salivating, sucking on his fingers or trying to scratch his gums with something, it is quite easy to help your baby:

1. Get some very soft wipes and constantly wipe off saliva. This will protect the baby from irritation of the skin of the face. When sleeping, put a napkin under your baby’s head to absorb involuntary saliva.
2. Be sure to buy quality special silicone toys for developing gums – teethers, or special rings with liquid so that the baby can chew on them. The liquid makes the rings softer and pleasantly cools the gums (the rings can be stored in the refrigerator). Do not save – take only branded, certified products. After all, this is the health of your beloved child.
3. Periodically massage the gums with a special nozzle, or just with your finger (wash your hands thoroughly, nails are short, with neatly finished edges), it is possible with a moistened gauze pad. This procedure will also prevent the occurrence of stomatitis (“Stomatitis in infants – types, causes, symptoms”).
4. Breastfeeding your baby often is a great way to soothe your baby and relieve itchy gums.
5. Some babies enjoy sucking and nibbling bagels, a crust of bread, an apple without a peel – offer it, it’s a good distraction.
6. It is strictly forbidden to lubricate the gums with various medications without a doctor’s prescription, to give the baby pills and medicines on his own. Only a specialist – a pediatrician or pediatric dentist can prescribe an ointment or gel to relieve pain, while a preliminary test for allergic reactions is mandatory. Although ointments and gels with lidocaine (Kamistad, Kalgel) are sold without a prescription, it is impossible to lubricate the baby’s gums without checking, because if the baby is allergic to lidocaine, the baby may experience anaphylactic shock. For allergy sufferers, the doctor prescribes a special Baby Doctor ointment or others.
7. Try to distract the child, take more time to play with him, walk.

When should I see a doctor?

It is imperative to consult a pediatrician if the following signs of teething are observed in a child:

• high fever;
• vomiting;
• diarrhea;
• runny nose;
• cough;
• skin rashes;
• convulsions;
• persistent drowsiness;
• prolonged irritability, capriciousness.

Such symptoms should in any case be a reason to see a doctor. Often, parents, on the advice of grandmothers, attribute everything to the fact that the child is teething, the temperature, they say, , happens in all children. And here it is not. Most children tolerate tooth growth without fever. And fever is a sign of most diseases. Therefore, it is possible to miss the onset of some disease or pathological process that coincides with the period of teething.

Why does the temperature appear? The fact is that at the site of the eruption of the tooth, the gum swells, which is associated with raising the tooth and an increased influx of biologically active substances. The body reacts to this with a protective increase in temperature – to prevent infection of the gums cut with sharp edges. Tooth temperature lasts one or two days. If the child tolerates it easily, is not prone to convulsions, and the doctor does not find other reasons for the increase in temperature, then it is not necessary to bring it down to 38 degrees. In the case of a longer increase in temperature, an examination of the baby and a doctor’s consultation are necessary.

Should alert vomiting in a child during teething, in case of exclusion of other causes of this condition. All changes in the gastrointestinal tract have a fairly simple explanation: during this period, it secretes a lot of saliva and the child constantly swallows it often, which causes increased secretion of gastric juice and vomiting (rare), as well as increased intestinal motility, which means that appears diarrhea in a child during teething. Diarrhea is rare (2-3 times a day), discharge is watery, lasts no longer than 2 days.