Infant (2–12 months) · Toddler (1–3 years) · Growth & development, Illness & symptoms
Teething: what is normal, what is not, and safe ways to soothe
First teeth arrive between 4 and 12 months, usually the bottom front two. Teething causes drooling, gum rubbing and fussiness, not fever, diarrhea or rashes. Chilled teethers help; numbing gels and amber necklaces do not and can harm.
Key takeaways
- Teething does not cause fever over 100.4°F, diarrhea or a runny nose; look for another cause
- A chilled (not frozen) teether or a cold washcloth is the safest relief
- Do not use benzocaine gels (Orajel and similar) or homeopathic teething tablets
- No amber or other teething necklaces: choking and strangulation risk
- Brush from the first tooth with a smear of fluoride toothpaste; first dental visit by age 1
When do teeth come in?
The first tooth usually appears between 4 and 12 months; a few babies are earlier or later, and both are normal. Bottom front teeth come first, then top front, then the sides, with the first molars around a year and the full set of 20 by about 3 years.
What does teething really cause?
Drooling, chewing on everything, sore gums, mild fussiness and a slightly raised temperature. Studies have not found that teething causes fever over 100.4°F, diarrhea, vomiting or rashes beyond a drool rash around the mouth. If your baby has those, something else is going on and we want to hear about it.
Safe soothing
- A solid rubber teether chilled in the refrigerator, or a clean cold washcloth to gnaw
- Gentle gum massage with a clean finger
- For a baby on solids, cold soft foods like chilled applesauce
- Weight-based acetaminophen for a bad day, after 3 months and with our okay; ibuprofen from 6 months
What to avoid
- Benzocaine gels and sprays: the FDA warns against them under age 2 because of methemoglobinemia, a dangerous blood condition
- Homeopathic teething tablets and gels: inconsistent belladonna content led to FDA warnings
- Amber, wood or silicone bead necklaces and bracelets: strangulation and choking deaths have occurred
- Frozen teethers: too hard, and they can injure gums
- Teething biscuits and cookies: choking risk and sugar on new teeth
Caring for new teeth
Wipe gums daily before teeth arrive. From the first tooth, brush twice a day with a rice-grain smear of fluoride toothpaste; from age 3, a pea-sized amount. No bottles in bed, and only water in a bottle or cup between meals. We apply fluoride varnish at well visits, and every child should see a dentist by their first birthday.
When to call us
- Fever over 100.4°F, diarrhea, vomiting or a rash: teething is not the cause
- No teeth by 15 months
- Gums that are swollen, bleeding or have a bluish lump that does not go away
Go to the emergency room or call 911 if…
- Choking, or blue or gray lips after using a gel or necklace
- A fever in a baby under 3 months
Questions parents ask
Can I give ibuprofen for teething?
From 6 months, weight-based ibuprofen is fine for a rough day. Before that, use acetaminophen with our guidance. Most days a chilled teether is enough.
My baby is 13 months with no teeth. Is that a problem?
Usually not; some healthy babies get their first tooth after a year. We check at the 15-month visit if none have appeared.
Not sure? Ask us
Call or text the office during hours, or send a portal message. For emergencies call 911.
(770) 615-7000Trusted further reading
- HealthyChildren.org (opens in new tab)American Academy of Pediatrics