Most babies get their first tooth during the second half of the first year, although the timing varies widely. HealthyChildren.org notes that many first teeth appear between about 6 and 12 months, and some babies still have no visible teeth by their first birthday.
The lower front teeth are commonly among the first to appear. Drooling and chewing may begin earlier, but those behaviors alone do not prove that a tooth is about to erupt.
Common signs that can fit teething
According to current AAP/HealthyChildren guidance, teething may be associated with:
- drooling;
- chewing more than usual;
- swollen or tender gums;
- mild fussiness; and
- a rash around the mouth caused by saliva irritation.
Not every baby has obvious symptoms.
Teething does not cause a true fever
This is an important distinction. HealthyChildren.org’s updated guidance says teething can cause a slight rise in body temperature within the normal range, but a true fever—100.4°F (38°C) or higher—is not caused by teething.
Do not assume fever, diarrhea, repeated vomiting, severe crying, or a child who appears genuinely ill is “just teething.” Those symptoms deserve another explanation and may need medical assessment.
See HealthyChildren’s current teething pain guidance.
Safe ways to soothe sore gums
Gently massage the gum
Wash your hands, then use a clean finger to rub the tender gum gently.
Offer a chilled teether
Use a firm teething ring or other product intended for your baby’s age. Chill it in the refrigerator rather than freezing it solid; frozen teethers can become too hard for tender gums.
Try a clean chilled washcloth
A clean damp washcloth chilled in the refrigerator can provide a safe texture to chew while you supervise.
Manage drool gently
Pat saliva away instead of rubbing irritated skin. If your baby’s skin becomes sore, ask your pediatrician what barrier product is appropriate.
What to avoid
The FDA and AAP advise against common teething products that can cause harm.
- Benzocaine teething gels: the FDA warns against using benzocaine to treat teething pain in infants and young children.
- Teething necklaces or beads: they can create choking and strangulation hazards and have no proven teething benefit.
- Frozen-solid teethers: they can become too hard for sore gums.
- Small or breakable foods and objects: anything that can become a choking hazard should not be used as a teether.
- Honey for babies under 12 months: do not use honey as a teething remedy.
See the FDA’s teething safety guidance.
What about pain medicine?
Most teething discomfort can be managed without medicine. If your baby is very uncomfortable, ask your pediatrician about an appropriate pain reliever and the correct dose for your child’s age and weight. Do not guess a dose from an adult product or an older child’s medication.
When to call the pediatrician
Contact your child’s healthcare provider if your baby has a fever, appears unusually ill, has repeated vomiting or diarrhea, is feeding poorly, has fewer wet diapers, is difficult to wake, is crying in a way that seems unusual, or has another symptom that worries you.
For very young infants, fever can require prompt evaluation. Follow the medical advice you have been given for your child’s age and health history.
Caring for the first tooth
Once the first tooth appears, begin brushing gently with a small soft-bristled toothbrush. Current pediatric dental guidance recommends a first dental visit within six months of the first tooth appearing and no later than the first birthday.
Bottom line
Teething timing varies, but the first tooth commonly appears around the middle of the first year. Drooling, chewing, tender gums, and mild fussiness can fit teething. A true fever, significant illness, or severe distress should not be blamed on teeth. Use simple drug-free comfort first, avoid unsafe gels and jewelry, and ask your pediatrician when symptoms do not fit ordinary teething.
