Teething

Is this your child's symptom?

  • The normal process of new teeth working their way through the gums
  • Questions about teething
  • Baby teeth come in between 6 and 24 months of age
  • Caution: At least one tooth should be seen before using this care guide

Proven Symptoms of Teething

Teething has been researched in-depth. Kids who are teething are little different from kids who are not teething. Here are the main symptoms that have been proven:

  • Drooling. Increased spit and drooling.
  • Rash. Face rash from drooling. The drool contains little bits of food that are irritating to the skin.
  • Chewing. Increased need to chew on things.
  • Gum Pain. Gum pain is mild and not always present. May be due to mouth germs getting into the new break in the gum. Most often, your baby just acts a little more fussy. There's not enough discomfort to cause crying. It also doesn't hurt enough to cause sleep problems.

False Symptoms of Teething

  • Teething does not cause fever, diarrhea, diaper rash or runny nose.
  • It does not cause a lot of crying.
  • It does not cause your baby to be more prone to getting sick.
  • Caution about Fevers. Blaming teething for fevers can lead to a delay in seeking care for infections. Examples are ear and urinary tract infections. Another example is meningitis.
  • There are 2 reasons why infections start between 6 and 12 months of age. One is the loss of antibodies transferred to baby from the mother at birth. The other is the developmental milestone of chewing on everything.
  • Caution about Crying. Blaming teething for crying can lead to a delay of care for other illnesses. Examples are ear infections or other causes of pain.

When to Call for Teething

Call Doctor or Seek Care Now

  • Your child looks or acts very sick

Contact Doctor During Office Hours

  • You think your child needs to be seen
  • You have other questions or concerns

Self Care at Home

  • Normal teething

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Teething

  1. What You Should Know About Teething:
    • Teething is a natural process.
    • It's harmless and it may cause a little gum pain.
    • The main symptoms of teething are drooling and rubbing the gums.
    • It does not cause fever or crying. If these are present, look for another cause.
    • Here is some care advice that should help.
  2. Gum Massage:
    • Find the irritated or swollen gum.
    • Rub it with your clean finger for 2 minutes.
    • Do this as often as needed.
    • Putting pressure on the sore gum can decrease pain.
    • Age over 12 months. You can use a piece of ice wrapped in a wet cloth to rub the gum.
  3. Teething Rings (Teethers):
    • Babies rub their own sore gums by chewing on smooth, hard objects.
    • Offer a teething ring, pacifier or wet washcloth that has been chilled. Chill these items in the fridge. Do not use items frozen in the freezer.
    • Age over 12 months. A piece of chilled banana may help.
    • Do not use hard foods that could cause choking. An example is a raw carrot.
    • Do not use ice or popsicles that could cause frostbite of the gums.
    • Avoid "teething necklaces." They are not approved by the FDA and are not helpful. They also have harmful risks including choking and death.
  4. Cup Feeding:
    • If your baby refuses nipple feedings, try a cup.
    • A spoon or syringe can also be used for a short time as needed.
  5. Pain Medicine:
    • Pain medicines usually are not needed for the mild discomfort of teething.
    • Fussiness often gets better with gum massage. If not, you can give an acetaminophen product (such as Tylenol). If age over 6 months, another choice is an ibuprofen product (such as Advil). Just do this for one or two days. (Reason: Frequent use can cause liver or kidney damage).
  6. Teething Gels: Do Not Use
    • You can get special teething gels without a prescription.
    • Most have benzocaine in them. They are not approved by the FDA at any age.
    • Reason: Benzocaine can cause choking, bluish skin and allergic reactions. It can be very harmful if used during the first 2 years of life.
    • Also, teething gels only give brief pain relief.
    • Gum massage works much better.
  7. What to Expect:
    • Most often, teething does not cause any symptoms.
    • If your child is having some discomfort, it should pass in 2 or 3 days.
  8. Call Your Doctor If:
    • Crying occurs
    • Fever occurs
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.