The most important thing on this page: teething does not cause a real fever. A temperature of 38°C / 100.4°F or higher, diarrhoea, or vomiting need to be assessed as illness, not written off as teething. This page summarises published research and regulator guidance; it is not medical advice and is not a substitute for your doctor.
Teething gets blamed for almost everything that happens between 4 months and 3 years. Some of that is fair. A lot of it is not, and the mismatch has a real cost: when a genuinely unwell baby is assumed to be teething, treatment gets delayed.
Symptoms genuinely associated with teething
Two large prospective studies — Macknin and colleagues, and Wake and colleagues, both published in Pediatrics in 2000 — tracked infants daily through tooth eruptions. A later systematic review pooled the evidence. They broadly agree on the following:
- Drooling, often with a rash on the chin from the constant wet
- Gum irritation — swollen, tender gum over the emerging tooth
- Biting and chewing on anything within reach
- Increased irritability and being harder to settle
- Reduced appetite for solids, and sometimes for the bottle or breast
- Ear pulling or cheek rubbing on the same side as the erupting tooth — referred discomfort
- A slight rise in temperature, but below the fever threshold
Two findings are worth holding on to. First, symptoms cluster tightly around eruption — roughly the day before through a couple of days after the tooth cuts through, not for weeks. Second, no combination of symptoms reliably predicted an eruption. Teething is a real but mild and brief phenomenon.
What teething does not cause
See a doctor rather than assuming teething if your baby has any of these:
- Fever of 38°C / 100.4°F or above. The studies found no association between eruption and true fever. In an infant under 3 months, any fever is an urgent assessment.
- Diarrhoea or vomiting. Repeatedly attributed to teething, repeatedly not supported by the evidence.
- Rash anywhere other than the drool-contact area on chin, neck and chest.
- Cough, congestion, or ear discharge.
- Lethargy, floppiness, or unusual drowsiness.
- Refusing fluids, or fewer wet nappies.
- Symptoms dragging on for more than a few days. A tooth cuts through and the discomfort passes; illness persists.
A useful reframing: teething is common and so are viral infections, so they frequently coincide. Coinciding is not causing.
“Is this worse than last week, or does it just feel worse at 3am?” NapNap keeps the record so you can look back at whether the wakings really did spike — and for how long. A few rough nights that resolve look very different from a pattern that keeps going.
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Safe ways to relieve teething
Pressure and cold are the two things that reliably help:
- A clean finger rubbed firmly on the gum. Simple, free, and often the most effective thing available.
- A chilled — not frozen — teething ring. Solid silicone or rubber, cooled in the fridge. Rock-hard frozen objects can bruise the gum.
- A cold, damp washcloth to gnaw on, supervised.
- Chilled soft food for babies already on solids — a cold spoon works too.
- Extra comfort. Teething is uncomfortable; being held more for a few days is not a habit you will regret.
- Infant paracetamol or ibuprofen, at the correct dose for weight and age, if your baby is genuinely distressed. Check with your pharmacist or doctor, particularly under 3 months.
- A barrier cream on the chin for drool rash, and dabbing rather than wiping.
What to avoid
Regulators have issued specific warnings about several popular teething products:
- Benzocaine gels. The US FDA warned in 2018 that over-the-counter oral anaesthetics containing benzocaine should not be used for teething in children under 2, because of the risk of methemoglobinemia — a rare but serious condition that reduces the blood's oxygen-carrying capacity.
- Viscous lidocaine. Carries an FDA boxed warning and is not for teething.
- Amber teething necklaces and bracelets. The FDA has warned against them and the AAP advises against: they present a strangulation risk worn, and a choking risk if beads come loose. There is no good evidence they work.
- Homeopathic teething tablets and gels. The FDA warned about products containing belladonna after inconsistent amounts were found; several were recalled.
- Frozen solid objects pressed hard against the gum, which can bruise.
- Anything small enough to be a choking hazard, or that can break into pieces.
If it is the nights that have collapsed rather than the days, teething and sleep covers how to separate teething from the other common causes. For when each tooth is due, see the teething chart by age.
Sources
- Macknin ML, Piedmonte M, Jacobs J, Skibinski C, Symptoms associated with infant teething: a prospective study, Pediatrics (2000).
- Wake M, Hesketh K, Lucas J, Teething and tooth eruption in infants: a cohort study, Pediatrics (2000).
- Massignan C et al., Signs and symptoms of primary tooth eruption: a meta-analysis, Pediatrics (2016).
- US Food and Drug Administration, safety communications on benzocaine teething products (2018), homeopathic teething tablets (2017), and amber teething jewellery (2018).
- NHS, Baby teething symptoms. American Academy of Pediatrics, teething guidance.
Common questions
Does teething cause a fever?
No. Large prospective studies found no association between tooth eruption and true fever. A slight rise in temperature can occur, but anything reaching 38°C or 100.4°F should be treated as possible illness and assessed, not attributed to teething.
Does teething cause diarrhoea?
The evidence does not support it. Teething and viral infections are both very common in the same age range, so they often coincide, but coinciding is not causing. Diarrhoea in a baby warrants the usual assessment for illness and dehydration.
How long do teething symptoms last?
Symptoms cluster tightly around the eruption itself — roughly from the day before the tooth cuts through to a couple of days after. Discomfort lasting more than a few days is more likely to be something else.
What helps a teething baby the most?
Pressure and cold. Firm gum rubbing with a clean finger, a chilled (not frozen) teething ring, and a cold damp washcloth are the most reliable options. Infant paracetamol or ibuprofen at the correct dose can help genuine distress — check with your pharmacist or doctor.
Are amber teething necklaces safe?
No. The FDA has warned against them and the AAP advises against their use: they pose a strangulation risk when worn and a choking risk if beads come loose, and there is no good evidence that they relieve teething.