Teething Symptoms: Timeline and What to Do

When Do Babies Start Teething?

A baby’s first tooth typically emerges around 6 months old. However, they may come in as early as 3 months or as late as 1 year.

Even before these teeth begin to show, you may already notice your baby showing symptoms of teething.

Baby teeth, also called milk teeth, primary teeth, or deciduous teeth, generally show up in pairs. They tend to come in the following order:¹

• Lower central incisors (the very front bottom teeth) at about 6 months
• Upper central incisors around 8 months
• Upper lateral incisors (on either side of the central ones) around 10 months
• Lower lateral incisors around 10 months
• First molars between about a year and 18 months
• Canine teeth around 16 to 20 months
• Second molars around 2 to 3 years

The exact order baby teeth come in is usually due to genetics.² In rare cases, one or more central incisors might already be present when a baby is born. A neonatal tooth is a tooth that is present at birth. 

Signs Your Baby is Teething

Some common symptoms suggest your baby is starting to teethe. Many of these symptoms develop because teething can be painful and uncomfortable. But keep in mind that every child is different, so they will handle discomfort in different ways.

In addition, no one symptom or cluster of symptoms can predict exactly when a tooth is about to come in.³

Normal Symptoms

Symptoms commonly associated with teething include:⁴

• Drooling or dribbling more than usual — The irritation of the gums during teething can stimulate saliva production.
• Increased chewing or biting — The pressure from biting on their fingers or objects can help alleviate your baby’s discomfort.
• Mood changes — Teething may make your baby irritable or cranky. This isn’t universal, and some babies aren’t fussy at all while teething.
• Difficulty sleeping — Like crankiness during the day, teething can also cause restlessness at night.
• A slight rise in body temperature — This minor elevation in temperature might be labeled a fever, but it should not go above 102 degrees Fahrenheit (high-grade fever).
• Swollen gums — Your baby’s gums are under pressure when new teeth come in.

The pain of teething might lead your baby to refuse to eat, drink, or suckle. Your baby may also pull on their ears in an effort to relieve pain or pressure.

Excessive drooling might cause a rash to form on your baby’s chin or the edges of their mouth. Wiping your baby’s mouth periodically can help prevent this.

Concerning Symptoms 

Around the time babies start teething, they lose the protection of their mother’s antibodies against bacterial and viral infections.⁵

Human herpesvirus 6 (HHV-6), for example, infects the vast majority of people before the age of 2.⁶ This and other viruses can cause symptoms that overlap with signs of teething. You’ll want to pay close attention to rule out other possible causes if your baby is uncomfortable.

Symptoms that may suggest an infection and not just teething include:

• A high-grade fever or a fever lasting multiple days
• Persistent diarrhea
• Sores or blisters in or around the mouth or elsewhere

Signs and symptoms of infection are sometimes easy to mistake for teething symptoms. Poor appetite, irritability, and sleep disturbances can be caused by herpes and teething pain.⁷

Diarrhea can be a sign of illness, but it may be a result of contamination from your baby biting their fingers or contaminated objects. Swallowing excess saliva may also cause looser stools than usual.⁴

3 Ways to Soothe a Teething Baby

There are several ways you can give your teething baby relief:

1. Give them something to bite

Your baby may have a strong desire to bite or chew to relieve teething pain. There are teething toys and teething biscuits or crackers made just for this purpose.

You can even offer your clean finger for your baby to nibble on if their teeth haven’t emerged yet. Massaging your baby’s gums can also help relieve pressure.

2. Use cold teething toys

Cold temperatures can have a soothing effect for teething babies. You can put teething toys in the fridge to cool them down. Or, place a small cold spoon over your baby’s gums.

Avoid giving your baby anything frozen solid. This might be too hard on their mouth.

Yogurt, fruit or vegetable puree, and other cold foods can also provide relief. Teething meshes or feeders allow babies to safely gnaw on solid food.

3. Provide gentle care and reassurance

Holding and comforting your baby will go a long way in helping them through teething. You can wipe their mouth to prevent a rash from forming due to excessive drooling.

However, if your baby has trouble sleeping through the night, you’ll want to avoid encouraging a habit of early waking. After providing comfort, try to encourage self-soothing.

If your baby’s pain seems especially persistent, talk to your pediatrician about providing baby doses of pain relievers. Follow their instructions carefully.

Teething Remedies to Avoid 

Avoid the following remedies:

• Teething rings or other toys that contain fluid, which can easily break and leak.
• Numbing agents such as alcohol, lidocaine, or benzocaine. These can be harmful to children under 2 years old. 
• Over-the-counter (OTC) teething gels or homeopathic remedies. These can contain ingredients (such as belladonna) that have unhelpful, dangerous, or unpredictable effects.
• Teething necklaces or bracelets that may cause strangulation or provide a choking hazard.
• Sugary foods or drinks. These will encourage oral bacteria to proliferate, which can cause infection or cavities in your baby’s new teeth.³

If you’re unsure about a product meant to provide relief for your baby, consult your dentist or pediatrician.

When to See a Dentist or Doctor

The American Dental Association (ADA) recommends a baby’s first dental appointment shortly after their first tooth appears, but no later than their first birthday.

The time when your baby begins to teethe is also a time that they are vulnerable to infections such as first-time herpes (HSV-1 or HHV-6) infection. Sometimes these infections cause symptoms that are mild and easy to confuse with teething.

You should notify a doctor if your baby shows any of the following:

• A high-grade fever (above 102 degrees Fahrenheit)
• Loose, watery stools that persist for more than one bowel movement
• Refusal to eat food or nurse for multiple days
• Sores, blisters, or widespread rashes

Summary

Baby teeth generally start coming in between 3 and 12 months of age. Teething can be painful and uncomfortable, but special care and reassurance will help your baby get through it.

Sometimes infections can cause symptoms that are easy to mistake for normal teething. Pay close attention to rule out other causes. Talk to a doctor if your baby shows any concerning symptoms like a high-grade fever, a rash, diarrhea, or refusing to eat.