What are the signs of teething?

Teething usually begins between 4 and 7 months, though some babies cut a first tooth at 3 months and others not until after their first birthday. The lower front incisors tend to erupt first, then the upper front pair. Signs include heavy drooling, gnawing on anything within reach, puffy red gums and short-lived crankiness. Fever above 100.4°F, vomiting or diarrhea point to illness, not teeth.

Key takeaways

• Bottom incisors usually appear first, around 6 months.
• Drool, gnawing and tender gums are the classic clues.
• Cold, firm objects help most; frozen rings can bruise gums.
• Avoid benzocaine gels, teething tablets and amber necklaces.

Typical eruption order

• 6 to 10 months: lower central incisors.
• 8 to 12 months: upper central incisors.
• 9 to 16 months: lateral incisors.
• 13 to 19 months: first molars.
• 16 to 23 months: canines.
• 23 to 33 months: second molars.

All 20 primary teeth are usually in by about age 3.

What teething looks like

• Drooling that soaks bibs and can cause a chin rash.
• Rubbing the jaw or pulling at an ear on the same side.
• Biting fingers, crib rails or spoons.
• Waking more at night for a few days.
• Swollen spot on the gum where the tooth is coming through.

Soothing ideas

1. Rub the gums with a washed finger for a minute or two.
2. Offer a solid rubber ring chilled in the fridge, not the freezer.
3. Let your baby chew a cold, damp washcloth.
4. Wipe drool often and use a barrier ointment on the chin.
5. Ask your pediatrician about acetaminophen dosing; ibuprofen only after 6 months.

What to skip

• Benzocaine or lidocaine gels: risk of a rare blood disorder.
• Homeopathic tablets: inconsistent ingredients.
• Amber or wooden necklaces: strangling and choking hazard.
• Liquid-filled rings that can leak or split.

Care for new teeth

Once the first tooth shows, brush twice a day with a smear of fluoride toothpaste the size of a grain of rice, and book a dental visit by the first birthday.

When to call the doctor

Call for a fever over 100.4°F, refusing to drink, unusual sleepiness, or no teeth by 18 months.

A teething day, hour by hour

Discomfort often comes and goes. Many parents notice the worst stretch in the evening and overnight, when there's less to distract a baby from a sore spot. A few patterns that help:

• Morning: offer a chilled ring before breakfast, when gums may feel puffy after a night of gnawing.
• Feeds: some babies pull off the breast or bottle because sucking presses on tender gums. Try a cool spoon on the gums first, or offer a slightly firmer nipple if bottle-feeding.
• Naps: a minute of gum massage can make settling easier.
• Bedtime: keep the usual routine. Teething is a short phase, and new sleep habits started during it can outlast it.

Teething and feeding

Older babies who already eat solids may prefer cool, soft foods for a few days: chilled applesauce, yogurt, or mashed banana from the fridge. Mesh or silicone feeders filled with cold fruit can give something firm to chew on. Avoid hard pieces such as raw carrot or teething biscuits that break into chunks, which can cause choking. Stay with your baby whenever they're chewing.

Myths worth dropping

• "Teething causes a high fever." Studies find at most a slight rise in temperature. A true fever means look for another cause.
• "Teething causes diarrhea or a runny nose." Babies this age catch many colds, which happen to overlap with teething. Treat these symptoms as separate.
• "A chilled carrot is a safe teether." Pieces can snap off.
• "Rubbing whiskey on the gums helps." Alcohol is unsafe for infants in any amount.

Drool rash and skin care

Constant drool can irritate the chin, neck and chest. Change damp bibs often, pat (don't rub) the skin dry, and use a thin layer of petroleum jelly or a fragrance-free ointment before naps and at night. If the rash cracks, oozes or spreads, show it to your pediatrician.

Teeth that come in out of order

Sometimes the upper teeth appear before the lower ones, or a side tooth shows up first. Variation in order is usually normal. A baby born with a tooth (a natal tooth) or one who has none by 18 months should be checked by a dentist or pediatrician.

Questions parents ask

Can teething cause ear pulling? Yes, pain can travel along nerves to the ear. But ear pulling with fever, crankiness lying down or a recent cold may be an ear infection, so call your doctor.

How long does each tooth hurt? Usually a few days before and after it breaks through the gum.

Should I wipe the gums before teeth appear? A soft, damp cloth after feeds gets babies used to mouth care and keeps gums clean.

Later on, when the binky retires, the pacifier book tells an illustrated goodbye story built from one photo.

Books for babies: a board-book shelf for this age

Look through a sample pacifier book, then start from a photo.

Sources

1. Teething: 4 to 7 Months, HealthyChildren.org (American Academy of Pediatrics), accessed November 4, 2026
2. Teething Tots, KidsHealth (Nemours), accessed November 4, 2026