Does teething cause fever?

Research has found that teething can cause a very slight rise in temperature, but not a true fever of 38°C or above. A baby with a genuine fever is likely to have an infection, such as an ear infection or viral illness, which happens to coincide with teething. Do not assume teething is the cause; have your baby checked if the fever is high or they seem unwell.

Are teething gels safe?

Gels containing benzocaine or lidocaine are not recommended for babies because of rare but serious side effects, and regulators in several countries have restricted them. Homeopathic teething tablets have also been subject to safety warnings. Chilled teething toys and, if needed, infant paracetamol or ibuprofen are safer and more effective options.

In what order do baby teeth come through?

The usual order is the two bottom front teeth first, then the top front teeth, followed by the teeth either side of them, the first molars, the canines, and finally the second molars at around two to three years. The sequence varies a lot between children and a different order is rarely a cause for concern.

PediatricICD-10: K00.7Universal; every child goes through teething, with symptoms ranging from barely noticeable to a few uncomfortable days per tooth

Teething

Also known as: Tooth eruption, Cutting teeth

Teething is the process of a baby's first teeth pushing through the gums. It usually begins between four and seven months, although some babies get their first tooth earlier or not until after their first birthday, and all 20 milk teeth have normally arrived by about two and a half to three years. As each tooth moves through the gum it can cause soreness, dribbling, chewing, and fussiness for a few days. Teething is a normal part of development, not an illness. It does not cause high fever, diarrhoea, or rashes on the body, and attributing those symptoms to teething can delay the diagnosis of a real infection. Simple comfort measures are usually all that is needed.

At a Glance

Common symptoms: Red, swollen, or tender gums where a tooth is about to appear, Increased dribbling, sometimes with a rash around the mouth and chin, Chewing or gnawing on fingers, toys, and anything within reach
Main treatments: Gently rubbing the gums with a clean finger, Chilled (not frozen) teething rings, a cold clean flannel, or chilled soft foods for babies already on solids, Paracetamol or ibuprofen in age-appropriate doses if the baby is clearly uncomfortable, especially at night
Category: Pediatric · Universal; every child goes through teething, with symptoms ranging from barely noticeable to a few uncomfortable days per tooth
See a doctor if: A temperature of 38°C or higher, which is not caused by teething and needs assessment

Symptoms

Red, swollen, or tender gums where a tooth is about to appear

Increased dribbling, sometimes with a rash around the mouth and chin

Chewing or gnawing on fingers, toys, and anything within reach

Irritability, fussiness, or clinginess

Flushed cheeks, often on one side

Mild disruption to sleep or feeding for a few days

A very slight rise in temperature (not a true fever)

Causes

Pressure and inflammation as the tooth crown moves through the gum tissue
Normal developmental timing, largely determined by genetics
Local irritation from the dribbling and chewing that accompany eruption
Mild inflammation of the gum as the tooth breaks through the surface

Risk Factors

Teething is universal; family history mainly influences timing
Premature babies may teethe later, counted from their due date
Some genetic and developmental conditions are associated with early, late, or absent eruption
Low birth weight and certain nutritional deficiencies can delay eruption

Diagnosis

Observation of the gums and the baby's behaviour, usually by parents
Assessment by a doctor or health visitor if symptoms are more than mild, to rule out infection or other causes
A dental check if no teeth have appeared by 12 to 18 months

Treatment

Gently rubbing the gums with a clean finger
Chilled (not frozen) teething rings, a cold clean flannel, or chilled soft foods for babies already on solids
Paracetamol or ibuprofen in age-appropriate doses if the baby is clearly uncomfortable, especially at night
Wiping away dribble regularly and applying a barrier cream to prevent a chin rash
Avoiding teething gels containing benzocaine or lidocaine for babies, and homeopathic teething products, which health authorities have warned against
Supportive: extra cuddles, distraction, and keeping to a normal routine

Prevention

Teething cannot be prevented, but you can prepare: have chilled teething toys ready from around 4 months
Start brushing as soon as the first tooth appears, with a smear of fluoride toothpaste
Avoid teething necklaces made of amber or beads, which pose choking and strangulation risks
Do not dip dummies in sugar, honey, or juice, which causes tooth decay
Book a first dental visit by the child's first birthday

When to See a Doctor

A temperature of 38°C or higher, which is not caused by teething and needs assessment
Diarrhoea, vomiting, a body rash, or a cough: look for another cause
A baby who is inconsolable, refusing all feeds, or unusually drowsy
Swelling, pus, or a bluish lump on the gum that does not settle
No teeth by 18 months of age

Frequently Asked Questions

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