Baby Teething: Signs, Timeline, and Comfort Tips

Few milestones get as much attention as teething. Parents often wonder when it will start, how to recognize it, and what to do when their baby is uncomfortable.

The truth is, teething varies a lot from baby to baby. Some barely seem to notice new teeth coming in. Others have a harder time. Here's what you should know.

Important: The information below is general guidance based on AAP recommendations. Every baby is different. Always discuss teething concerns, especially regarding pain relief, with your pediatrician.

When Does Teething Start?

Most babies get their first tooth between 4 and 7 months old. However, some babies start earlier, and others don't get teeth until after their first birthday. Both ends of this spectrum are typically normal.

The AAP notes that there's wide variation in when teeth appear, and late teething alone usually isn't a concern.

What Order Do Teeth Come In?

Teeth generally appear in a predictable pattern, though timing varies:

6 to 10 months: Lower central incisors (bottom front teeth) usually come first.

8 to 12 months: Upper central incisors (top front teeth).

9 to 13 months: Upper lateral incisors (teeth next to the top front teeth).

10 to 16 months: Lower lateral incisors.

13 to 19 months: First molars.

16 to 23 months: Canines (the pointed teeth).

23 to 33 months: Second molars.

By age 3, most children have all 20 primary teeth. But again, your baby might follow a different timeline, and that's usually fine.

Signs of Teething

Common signs that a tooth might be coming include:

Drooling: Often increases significantly during teething.

Chewing: Babies may chew on fingers, toys, or anything they can get in their mouth.

Gum changes: The gum where a tooth is coming might look swollen or red.

Irritability: Some babies are fussier during teething.

Sleep disruption: Teething discomfort can affect sleep for some babies.

Decreased appetite: Some babies eat less when teething.

Rubbing ears or cheeks: The discomfort can radiate, causing babies to rub nearby areas.

What's Not Caused by Teething

For a long time, many symptoms were blamed on teething that probably aren't related. The AAP notes that teething doesn't cause:

High fever (over 101°F / 38.3°C), diarrhea, significant rash, or extended illness.

If your baby has these symptoms, contact your pediatrician. Something else is likely going on that needs attention.

Comfort Measures

Here are AAP-recommended ways to help a teething baby:

Something to chew: Teething rings, a cold (not frozen) washcloth, or a clean finger for baby to gnaw on can help. The pressure feels good on sore gums.

Cold items: A chilled teething ring or cold washcloth can provide relief. Avoid frozen items, which can be too cold and hurt sensitive gums.

Gum massage: Gently rubbing your baby's gums with a clean finger can help.

Comfort and distraction: Sometimes just extra cuddles and attention help baby feel better.

What to Avoid

The AAP and FDA recommend avoiding:

Teething gels with benzocaine: These numbing gels can cause serious side effects in young children.

Homeopathic teething tablets: The FDA has warned about potential dangers with some products.

Teething jewelry: Amber necklaces and other teething jewelry pose choking and strangulation risks.

Frozen teething rings: Too-cold items can hurt gums. Chilled is better than frozen.

Always check with your pediatrician before using any teething remedy.

Pain Relief

If your baby seems very uncomfortable, talk to your pediatrician about whether pain relief medication is appropriate. They can advise on whether infant acetaminophen or ibuprofen (for babies over 6 months) might help, and what dose is safe for your baby's weight.

Never give medication without consulting your pediatrician first, and always follow dosing instructions exactly.

Teething and Sleep

Teething can disrupt sleep, but it's usually temporary. If your baby is having trouble sleeping during teething:

Offer extra comfort at bedtime. Stick to your normal sleep routines as much as possible. Consider talking to your pediatrician about pain relief if discomfort is significant.

Try not to make major changes to sleep habits just because of teething. The phase will pass, and you don't want to create new sleep associations that are hard to undo.

Tracking Teething

Noting when teeth appear can be fun to look back on later. It's also useful information for pediatric dental visits.

Tracking feeding and sleep during teething helps you see whether and how teething affects your baby's patterns. This can help you plan and also gives you data to share with your pediatrician if you have concerns.

When to Call the Doctor

Contact your pediatrician if:

Your baby has a fever over 101°F (38.3°C). Symptoms seem severe or prolonged. Your baby refuses to eat for an extended period. You notice signs of infection in the gums. You're concerned about anything.

Most teething is just an uncomfortable phase that passes. But your pediatrician is there to help if something doesn't seem right.

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BabyZone helps you track your baby's milestones, including those first teeth, and monitor how teething affects feeding and sleep patterns.

This article is for informational purposes only and does not constitute medical advice. Always consult your pediatrician with questions about teething and pain relief.