Teething signs can be confusing and you’ll hear so many myths out there. Here we explore what teething is exactly, the sure signs to look out for, and the signs something more serious is at play.
The dreaded teething. A journey every baby experiences in those first precious months and years. Yes your baby too (there’s no escaping it we’re afraid).
Unfortunately, teething happens at the same time as they are vulnerable to a number of other illnesses and ailments (Lyttle, 2015). This has led to confusion around what’s a sign of teething, and what’s not. Not just among parents but also some healthcare professionals (Macknin et al, 2000; Wake, 2002; Sarrell et al, 2005; Plutzer et al, 2012; Eisenstadt et al, 2017). In the words of all those babies out there...uh oh.
This article sets out the signs and symptoms those pesky pearls are widely agreed to cause as they emerge. It also flags up signs and symptoms not caused by teething that you’ll need to go and see your doctor about.
But first, the basics: What exactly is teething?
Teething is where your baby’s teeth start to emerge through their gums (Lyttle et al, 2015).
"The first milk teeth are already lurking under the gums when your baby is born, and they usually appear on the surface between six and nine months (Lyttle et al, 2015)."
Your baby’s complete set of pearly whites is usually on show by the time they’re three years old (Lyttle et al, 2015). For a full guide to which teeth appear and when, see our month-by-month teething article.
Teething: What are the signs?
A baby’s teeth sometimes appear with no pain or discomfort at all, phew (NHS Choices, 2016). But others experience a constant, dull pain that gets increasingly intense in the four days before a tooth pops through, before rapidly improving (Lyttle et al, 2015).
Your baby can’t tell you they are in pain (sad face), but you might see some pretty obvious signs there is a tooth on its way. The signs widely agreed to be sure indicators of teething include:
- Drool, and lots of it. Babies can dribble way more than usual.
- Them biting and gumming down on anything and everything – that’s because the gnawing and chewing provides them with relief.
- Them being more grumpy, distressed and irritable than usual
- Sore and red gums.
- A loss of appetite. (Macknin et al, 2000; Sarrell et al, 2005; Ramos-Jorge et al, 2011; Lyttle et al, 2015; NHS Choices, 2016; Eisenstadt et al, 2017)
Other symptoms that might be signs of teething (although there is some debate over these) include: gum-rubbing; sucking; wakefulness; ear-rubbing; facial rash; and a runny nose. A mildly-raised temperature might also be a sign but it should not be over 38°C (Macknin et al, 2000; Ramos-Jorge et al, 2011; NICE, 2014; Eisenstadt et al, 2017).
Your baby might be showing one of these signs or symptoms, or all of them. As with everything baby related, no two little ones are the same (Lyttle et al, 2015). In fact, teething signs can be so wide ranging, and vary so much from baby to baby that only one third of teething infants would experience any one of the signs above (Macknin et al, 2000).
Some studies go as far as to say none of these symptoms can be proven to be a sign of teething. They suggest the only way to know if your baby is teething is to examine their mouth – looking and feeling for an emerging tooth (Tighe and Roe, 2007).
Try laying your baby on your lap and sneaking a peek inside their mouth by moving their top or bottom lip or gently coaxing open their jaw. Use a clean finger to gently feel around their upper and lower gums systematically, one potential tooth spot at a time.
And what’s not teething?
Other signs and symptoms people often associate with teething but that studies have found are generally NOT linked with teething include:
- congestion and coughs
- sleep disturbance
- runny poos, increased number of poops and nappy rash associated with them
- less interest or appetite for liquids
- rashes other than facial rashes
- fever over 38°C
- vomiting. (Macknin et al, 2000; Wake, 2002; Sarrell et al, 2005; NICE, 2014; Eisenstadt et al, 2017)
"It’s really important you don’t assume one of these is a sign of teething. It could be more serious and require medical attention."
A fever and other clinically important symptoms, like diarrhoea, rashes, and vomiting are very unlikely to be caused by teething, so make sure you talk to your GP or call NHS 111 (Tighe and Roe, 2007).
Don’t just brush off illness as teething
One study looked at 50 babies admitted to hospital suffering from teething. In 48 of these children, a medical condition other than teething was identified, including a case of bacterial meningitis (Tighe and Roe, 2007).
Right, I’ve established my baby is teething. Now what?
It is also important to look after yourself, as your baby’s upset is likely to be stressful. You might feel exhausted too, as they’ll require even more of your attention. Our keeping calm with a crying baby article has some useful techniques you can try to keep your stress levels down.
This page was last reviewed in September 2018.
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You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
Read more about fever in children from the NHS.
For more information on what other illnesses may be causing their fever, this article from NICE is very useful.
If you are concerned, contact your GP or call NHS 111 where you can access urgent medical help fast.
NCT has partnered with the British Red Cross to offer courses in baby first aid.
Eisenstadt M, Malkiel S, Pollak U (2017) It’s alright, ma (I’m only teething...) dispelling the myth from the teeth. Acad J Ped Neonatol. 3(4):555618. Available at: https://juniperpublishers.com/ajpn/pdf/AJPN.MS.ID.555618.pdf [accessed 17th September 2018].
Lyttle C, Stoops F, Welbury R, Wilson N (2015) Tooth eruption and teething in children. The Pharmaceutical Journal. 295:7883. Available at: DOI: 10.1211/PJ.2015.20069598 [accessed 17th September 2018].
Macknin ML, Piedmonte M, Jacobs J, Skibinski C (2000) Symptoms associated with infant teething: a prospective study. Pediatrics. 105:747-52. Available at: https://www.researchgate.net/publication/12574630_Symptoms_Associated_W… [accessed 24th September 2018].
Memarpour M, Soltanimehr E, Eskandarian T (2015) Signs and symptoms associated with primary tooth eruption: a clinical trial of nonpharmacological remedies. BMC Oral Health [online]. 15:88. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517507/ doi: 10.1186/s12903-015-0070-2 [accessed 18th September 2018].
NICE (2014) Clinical Knowledge Summaries: Teething. Available at: https://cks.nice.org.uk/teething#!diagnosissub:1 [Accessed on 28th September 2018].
NHS Choices (2016a). Tips for helping your teething baby. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/teething-tips/ [accessed 1st April 2018].
Plutzer K, Spencer AJ, Keirse MJ (2012) How first-time mothers perceive and deal with teething symptoms: a randomized controlled trial. Child: Care, Health and Development. 38(2):292-299.
Ramos-Jorge J, Pordeus IA, Ramos-Jorge ML, Paiva SM (2011) Prospective longitudinal study of signs and symptoms associated with primary tooth eruption. Pediatrics. 128(3):471-476.
Sarrell EM, Horev Z, Cohen Z, Cohen HA (2005) Parents' and medical personnel's beliefs about infant teething. Patient Education and Counseling. 57(1):122-125.
Tighe M, Roe MFE (2007) Does a teething child need serious illness excluding? Archives of Disease in Childhood 92(3):266-268.
Wake M (2002) Teething symptoms: cross sectional survey of five groups of child health professionals. BMJ 2002 [online]. 325:814. Available at: https://doi.org/10.1136/bmj.325.7368.814 [Accessed on 17th September 2018].