Baby Health · Teething
Baby Teething — Order, Soothing, Safety
First teeth typically 6-10 months. Teething does NOT cause real fever (Massignan 2016). Safe soothing: cold ring, breastfeeding, paracetamol. AVOID amber necklaces (choking) + lidocaine gels (deaths). NHS / FDA.
Last reviewed 2 June 2026
Baby teething check
Is my baby teething — and what helps?
Teething-pattern signs
⚠️ These are NOT teething — call your GP
When do babies usually get teeth?
- 6–10 mo: lower central incisors (first 2 bottom teeth)
- 8–12 mo: upper central incisors
- 9–13 mo: upper lateral incisors
- 10–16 mo: lower lateral incisors
- 13–19 mo: first molars
- 16–22 mo: canines
- 23–31 mo: second molars (often the toughest)
- All 20 primary teeth by age 3
Huge variation is normal. Some babies are born with a tooth (natal tooth, ~1 in 2,000). Others don’t get their first until 12+ months. Late teething alone doesn’t signal a problem unless still no teeth by 15–18 months.
What helps with teething discomfort
- Cold, NOT frozen. Chilled teething ring from the fridge (NOT freezer). Cold sterile silicone teether. Frozen items can cause cold burns to delicate gums.
- Gentle gum massage. Clean finger, light pressure on the sore area.
- Cold food in a feeder net (for weaning-age babies). Cucumber, banana, slightly chilled. Always with adult present (choking risk).
- Damp washcloth chilled in fridge. Cheap, works well.
- Paracetamol 15 mg/kg if very distressed and other comfort hasn’t worked. Ibuprofen for ≥ 3 months, > 5 kg.
- Lidocaine teething gels (e.g. Bonjela Junior in UK) — for ≥ 4 months, brief use only, not a primary strategy.
- Plenty of cuddles + skin-to-skin. Distress is real; comfort matters.
AVOID:
- Amber teething necklaces / bracelets — strangulation + choking risk; no proven benefit. AAP, FDA, and consumer safety bodies have warned against.
- Homeopathic teething tablets / gels — FDA recalled multiple products containing belladonna (highly variable dosing).
- Powdered teething remedies — variable safety, may contain harmful ingredients.
- Aspirin — never under 16 (Reye’s syndrome).
- Topical lidocaine in < 4 months — can numb the gag reflex and cause aspiration.
- Rubbing alcohol on gums — toxic and dangerous, never.
Common teething questions
- "Does teething cause fever?" No. The Massignan 2016 meta-analysis was definitive: teething can cause a MILD warming (up to about 37.9 °C / 100.2 °F) but NOT a true fever ≥ 38 °C / 100.4 °F. Higher temperatures during teething are coincidental viral illness (likely picked up at the same time the toothing is happening).
- "Does teething cause diarrhoea?" No. Diarrhoea + teething = probably gastroenteritis happening at the same time. Excess drool can soften stools slightly but not cause true diarrhoea.
- "My baby has a red bottom — is it teething?" Red bottom + diarrhoea is usually nappy rash from frequent loose stools (gastroenteritis or food sensitivity), not teething. Red around the mouth from constant drooling is normal and resolves with barrier cream.
- "Why is my baby refusing to feed during teething?" Sucking can intensify pain when gums are sore. Try slower-flow bottle teats, paced bottle feeding, or breastfeeding in different positions. Solid food may be easier than feeds during a tooth flare.
- "When should I take my baby to the dentist?" AAP / British Dental Association: by age 1 OR within 6 months of the first tooth appearing. Brush teeth twice daily with fluoride toothpaste (smear under 3, pea-size 3-6) as soon as the first tooth comes through.
- "My baby has no teeth at 12 months — should I worry?" Wide variation is normal. By 15–18 months with no teeth, see your GP or dentist to look for ectodermal dysplasia or other rare causes. Late teething alone (with everything else developing normally) usually just means the timeline is yours.
- "Why are second molars the worst?" Large surface area, two cusps, often the last to come through (~2 years), at an age when language and tantrum complexity peak. The combination is rough on everyone.
- "My baby was born with a tooth." Natal teeth occur in ~1 in 2,000. Usually a normal primary incisor that erupted early. If loose, dentist review (aspiration risk). Otherwise leave alone — it counts as your first tooth.
- "Should I use teething gels?" Lidocaine-based gels (e.g. UK Bonjela Junior) are licensed for ≥ 4 months for brief use. AAP and FDA advise caution with prolonged use. Sugar-based gels are not actually treating pain. Many parents find a cold teether more effective.
- "What about Calpol / Tylenol every few hours?" Use paracetamol or ibuprofen for genuine distress, not as routine prevention. Treat the discomfort, not the fact of teething. Most teething is manageable without medication.
- "Is teething affecting my baby’s sleep?" Probably for 24–48 hours around an active tooth coming through, then settles. Sleep disturbance lasting more than a few days is more likely a sleep regression or another upset. See /calculators/sleep-regression.
- "My toddler bites me / others during teething." Common at 12–30 months. Stay calm, brief “no biting — biting hurts,” remove from the situation, offer something acceptable to bite (cold teether). Doesn’t mean they’re aggressive — it means their gums hurt and they don’t yet have words.
- "How do I look after my baby’s first teeth?" Brush twice daily with fluoride toothpaste as soon as the first tooth erupts. Smear of toothpaste < 3 years; pea-size 3–6 years. Stop bottle-to-bed (decay risk). Limit sugary drinks. First dental visit by age 1.
Educational tool only — not medical advice. Symptoms ≥ 38 °C fever, diarrhoea, vomiting, significant cough, or unwell-looking child are NOT teething. See your GP same-day.
What does this mean?
The single most important teething fact is what teething doesn’t cause. The definitive Massignan 2016 meta-analysis in Pediatrics looked at all the symptoms parents attribute to teething and found that the consistently-associated ones are gum irritation, drooling, decreased appetite, mild irritability, sleep disturbance, biting/mouthing, and a mild temperature rise (up to about 37.9 °C / 100.2 °F) but NOT a true fever ≥ 38 °C. Diarrhoea, true fever, significant cough, vomiting, and rash are NOT caused by teething. Calling these symptoms “just teething” is a documented cause of delayed diagnosis of real illness — ear infections, UTIs, viral illnesses — in babies who happen to be teething at the same time. The typical teething timeline runs from 6–10 months (lower central incisors) to 23–31 months (second molars, often the worst), with wide normal variation. Late teething alone (with everything else developing normally) generally just means your baby’s timeline. By 15–18 months with no teeth, see your dentist or GP. All 20 primary teeth usually in by age 3. Comfort measures that help: cold but not frozen teething ring (frozen items can cause cold burns), gentle gum massage with a clean finger, cold food in a feeder net for weaning-age babies, chilled damp washcloth, paracetamol for genuine distress. Lidocaine teething gels for ≥ 4 months for brief use only. Specifically AVOID: amber teething necklaces and bracelets (strangulation + choking risk; AAP / FDA both warn against), homeopathic teething tablets (FDA recalled multiple products containing variable belladonna), powdered teething remedies, aspirin (never under 16), topical lidocaine in babies < 4 months (can numb the gag reflex), and rubbing alcohol on gums (toxic). Look after the new teeth: brush twice daily with fluoride toothpaste as soon as the first tooth erupts (smear under 3, pea-size 3–6); stop bottle-to-bed; limit sugary drinks; first dental visit by age 1 or within 6 months of the first tooth.
When do babies teethe?
Typically 6-10 months; lower central incisors first. Range 4-15 months normal. All 20 baby teeth by age 3.
Teething does NOT cause fever
Massignan 2016 Pediatrics meta-analysis: teething can cause mild warming (up to 37.9°C) but NOT real fever (≥38°C). Higher temp during teething = coincidental viral illness.
True teething symptoms
- Drooling (lots).
- Wanting to chew everything.
- Irritability / fussiness.
- Disrupted sleep.
- Mild gum swelling.
- Slight warming (up to 37.9°C).
- Cheek rubbing / ear pulling.
- Drool rash on chin.
Order of teeth
- Lower central incisors 6-10 mo.
- Upper central incisors 8-12 mo.
- Upper lateral incisors 9-13 mo.
- Lower lateral incisors 10-16 mo.
- First molars 13-19 mo.
- Canines 16-22 mo.
- Second molars 23-33 mo.
Safe soothing
- Chilled (not frozen) teething ring — silicone.
- Clean finger for gum rubbing.
- Cold flannel to chew.
- Breastfeeding for comfort.
- Paracetamol (15 mg/kg every 4-6h from 2 months).
- Ibuprofen (5-10 mg/kg every 6-8h from 3 months).
- Drool bibs + barrier cream.
Avoid
- Amber necklaces: choking + strangulation risk; no evidence; deaths recorded.
- Lidocaine / benzocaine gels: FDA / MHRA advise against; methemoglobinaemia risk.
- Choline salicylate gels (Bonjela classic): avoid <16; Reye’s risk.
Brushing
- From first tooth.
- Small soft brush.
- Smear (0-3 yr) or pea-sized (3-6 yr) fluoride toothpaste.
- Twice daily — last thing at night + one other time.
- Spit, don’t rinse.
- Parent brushes / supervises until 7+.
First dentist visit
By 1 year, or when first tooth appears. NHS dentistry free for children. 6-monthly check-ups.
Could it not be teething?
Fever ≥38°C, persistent diarrhoea, vomiting, pulling ears repeatedly = NOT just teething. Consider viral illness, ear infection, UTI, gastroenteritis. GP / 111 if uncertain.
Different scenarios
Scenario 1: 8-mo, drooling + chewing + irritable
Teething. Cold ring + paracetamol if needed.
Scenario 2: 6-mo with 38.5°C + fussy
NOT teething alone. Assess for cause — UTI, viral, ear infection.
Scenario 3: 12-mo with no teeth
Normal range. Recheck at 18 mo if still none.
Scenario 4: 4-mo chewing fingers, no teeth yet
Mouthing development (oral exploration) — not necessarily teething.
Scenario 5: Drool rash on chin
Barrier cream (Sudocrem); change bibs frequently; dry.
Care guidance
- Teething doesn’t cause real fever.
- Don’t dismiss fever as teething.
- Avoid amber necklaces + lidocaine gels.
- Paracetamol / ibuprofen safe if uncomfortable.
- Brush from first tooth.
- First dentist by 1 year.
Sources
- Massignan C, et al. Signs and symptoms of primary tooth eruption: meta-analysis. Pediatrics 2016.
- NHS. Teething.
- FDA. Benzocaine + infant teething warning.
- British Society of Paediatric Dentistry.
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Frequently asked questions
When do babies start teething?
Typically 6-10 MONTHS, with LOWER CENTRAL INCISORS coming first. Some start as early as 4 months; others not until 12+ months. ALL ranges normal. Whole set of 20 PRIMARY TEETH usually arrives by AGE 3. Late teething alone with normal growth + development usually just reflects baby's own timeline.
Does teething cause fever?
NO — not a true fever (≥38°C / 100.4°F). MASSIGNAN 2016 Pediatrics meta-analysis was definitive: teething can cause MILD warming (up to ~37.9°C / 100.2°F) but NOT real fever. Higher temperatures during teething = COINCIDENTAL VIRAL ILLNESS happening at the same time. Calling something 'teething fever' has been linked to delays in spotting real illness. ANY temp ≥38°C: assess for cause.
Does teething cause diarrhoea?
NO. Diarrhoea during teething = GASTROENTERITIS happening at the same time. Excess drool can soften stools slightly but doesn't cause true diarrhoea. Diarrhoea + teething = treat the diarrhoea separately; don't dismiss as teething. /calculators/muac-cds for dehydration check.
What ARE teething symptoms?
(1) DROOLING (a lot); (2) Wanting to chew everything; (3) IRRITABILITY / fussiness; (4) Disrupted sleep; (5) Mild gum swelling / redness; (6) Slight increase in body temperature (up to 37.9°C); (7) Cheek rubbing / ear pulling (referred pain); (8) Refusing some feeds; (9) Drool rash on chin / chest. SYMPTOMS settle within days once tooth through.
What's the order of teeth?
(1) LOWER CENTRAL INCISORS 6-10 months; (2) UPPER CENTRAL INCISORS 8-12 months; (3) UPPER LATERAL INCISORS 9-13 months; (4) LOWER LATERAL INCISORS 10-16 months; (5) FIRST MOLARS 13-19 months; (6) CANINES 16-22 months; (7) SECOND MOLARS 23-33 months. WHOLE SET 20 baby teeth by age 3. Individual variation common.
Best teething remedies?
(1) CHILLED (not frozen) teething ring — silicone preferred; (2) CLEAN FINGER for gum rubbing; (3) COLD FLANNEL to chew on; (4) BREASTFEEDING for comfort; (5) PARACETAMOL (15 mg/kg every 4-6h from 2 months) or IBUPROFEN (5-10 mg/kg every 6-8h from 3 months) if uncomfortable; (6) DROOL BIBS + barrier cream for chin rash. AVOID: amber necklaces (choking + strangulation risk; no evidence; some deaths recorded); teething gels (mostly withdrawn UK after baby deaths from lidocaine / benzocaine).
Amber teething necklaces — safe?
NO. NHS / RoSPA / paediatric dental association ADVISE AGAINST. (1) CHOKING risk if breaks; (2) STRANGULATION risk; (3) NO evidence amber relieves teething. SEVERAL infant deaths recorded internationally. AVOID. Use other strategies.
Teething gels — are they safe?
BONJELA / similar: most gels containing CHOLINE SALICYLATE — AVOID UNDER 16 (aspirin-related; Reye's risk). LIDOCAINE / BENZOCAINE gels: FDA + MHRA advised AGAINST in babies (methemoglobinaemia risk; serious; some deaths). UK NHS: paracetamol / ibuprofen safer for teething pain. PURE chamomile or homeopathic gels: limited evidence; generally low harm.
When to brush teeth?
AS SOON AS first tooth appears. Use SMALL soft brush. TOOTHPASTE: smear (0-3 yrs) or pea-sized (3-6 yrs) of fluoride toothpaste (≥1000 ppm fluoride). BRUSH twice daily — last thing at night + one other time. SPIT, DON'T RINSE (preserves fluoride). PARENT brushes / supervises until 7+. NO sugary drinks at bedtime. WATER from cup from 6 months.
When should baby see the dentist?
FIRST APPOINTMENT by 1 YEAR (or when first tooth appears, whichever first). NHS DENTISTRY FREE for children. CHECK-UP 6-monthly. ADVICE on brushing, fluoride, diet. EARLY visits build positive associations. SCHOOL fluoride varnish programmes in some UK areas. TOOTH DECAY in young children rising — preventable with brushing + diet.
Could it not be teething?
FEVER ≥38°C, persistent diarrhoea, vomiting, pulling ears repeatedly with no other teething signs = NOT just teething. CONSIDER: viral illness, ear infection, UTI, gastroenteritis. ASSESS holistically. WHEN UNCERTAIN: GP / NHS 111.
My baby still has no teeth at 12 months
WIDE NORMAL — some babies don't get first tooth until 12-15 months. RARELY: hypodontia (congenitally missing teeth — ~5% have one or more missing) or systemic causes (hypothyroidism, vitamin deficiencies, syndromes). DENTAL X-RAY if no teeth by 18 months. USUALLY just baby's timeline.
What about natal teeth (born with teeth)?
1 in 2,000-3,500 babies born with teeth (or develop in first month). USUALLY LOOSE central incisors. CONSIDER REMOVAL if: very loose (aspiration risk); interfering with breastfeeding (tongue trauma); poorly formed. OTHERWISE leave alone — early eruption of normal primary teeth (don't permanently affect). DISCUSS with paediatric dentist.
How does this relate to other calculators on BumpBites?
Companion: /calculators/baby-fever; /calculators/pediatric-dose; /calculators/baby-cough; /calculators/baby-colic; /calculators/oral-thrush; /calculators/breastfeeding-latch; /calculators/sleep-regression.