Teething: What Helps Your Baby and What to Skip

Few things test a new parent like a teething baby at 2 a.m. The fussing, the drool on every shirt, the little fists jammed in the mouth. Parents across Jefferson County ask us the same questions every week: Is this really teething? What can I give them? When should we come in?

The good news is that teething is a normal stage, and most babies get through it with simple comfort measures. The less good news is that some of the most popular teething products are ones pediatric and dental experts recommend avoiding. Here is a practical guide.

When Teething Starts

Most babies get their first tooth around 6 months old, but anywhere from 4 to 12 months is normal. A few babies are even born with a tooth, and some do not get one until after their first birthday. Late teeth are rarely a cause for concern on their own.

The bottom front teeth usually come in first, followed by the top front teeth. Molars arrive later, often between 13 and 19 months, and they tend to be the most uncomfortable because they are larger. By about age 3, most children have all 20 baby teeth.

Normal Teething Signs

Teething symptoms usually show up a few days before a tooth breaks through and settle down once it does. Common signs include:

Extra drooling, sometimes with a mild rash on the chin or cheeks from the constant moisture.

Chewing and gnawing on hands, toys, crib rails, or anything else within reach.

Swollen or tender gums where the tooth is coming in. You may see a small bump or a bluish spot.

Fussiness and lighter sleep for a few days at a time.

A slightly lower appetite, especially for solid foods that press on sore gums.

What Teething Does Not Cause

This is where many parents get caught off guard. Teething is often blamed for symptoms that actually point to a separate illness. Research has not shown that teething causes:

A real fever. A very slight rise in temperature can happen, but a fever of 100.4°F or higher is not from teething.

Diarrhea or vomiting.

Runny nose, cough, or a rash on the body.

Days of refusing to eat or drink.

If your baby has any of these, call your pediatrician. Babies between 6 and 24 months are also picking up plenty of common colds and ear infections, and it is easy to write those off as teeth.

What Actually Helps

The most effective teething remedies are also the simplest and cheapest:

Gentle pressure. Wash your hands and rub your baby's gums with a clean finger for a minute or two. Counter-pressure is soothing.

A chilled teething ring. Choose a solid rubber ring and cool it in the refrigerator, not the freezer. Frozen rings can be hard enough to hurt gums.

A cold, damp washcloth. Twist a clean washcloth, wet it, and chill it. Many babies love chewing on it.

Keep the chin dry. Wipe away drool often and use a little barrier cream if the skin gets irritated.

Pain reliever, if needed. For a rough night, ask your pediatrician whether acetaminophen, or ibuprofen for babies 6 months and older, is appropriate, and get the right dose for your child's weight.

What to Skip

Some products sold specifically for teething carry real risks. The U.S. Food and Drug Administration and the American Academy of Pediatrics advise against:

Numbing gels and liquids with benzocaine or lidocaine. These can cause a rare but dangerous blood condition in young children, and they wash away within minutes anyway. They should not be used for children under 2 unless a doctor specifically directs it.

Amber teething necklaces, bracelets, and anklets. There is no evidence they relieve pain, and they are a choking and strangulation hazard. Babies have died from them.

Homeopathic teething tablets and gels. Some have been found to contain inconsistent amounts of belladonna, which can be toxic to infants.

Hard foods as teethers. Frozen bagels, carrots, and similar foods can break off into choking-size pieces.

Sweetened anything. Do not dip a pacifier or teether in honey, juice, or sugar. Honey is unsafe for babies under 12 months, and sugar on new teeth starts the cavity process early.

Start Brushing With the First Tooth

As soon as the first tooth appears, it can get a cavity. Brush twice a day with a soft infant toothbrush and a smear of fluoride toothpaste about the size of a grain of rice. That tiny amount is safe even if your baby swallows it, and it makes a big difference in preventing decay.

Try not to put your baby to bed with a bottle of milk, formula, or juice. Liquid pooling around the teeth overnight is one of the most common causes of early childhood cavities we see.

When to Schedule the First Dental Visit

The American Academy of Pediatric Dentistry recommends a first dental visit within six months of the first tooth, and no later than the first birthday. That first visit is short and gentle. We check how the teeth are coming in, look for early signs of decay, and answer your questions about brushing, fluoride, pacifiers, and bottles.

Starting early also means your child gets comfortable with the dental office long before they ever need treatment. Our team sees children at both our Dandridge and Jefferson City offices and loves meeting families at this stage.

Common Questions

How long does teething pain last for each tooth?

Most babies are uncomfortable for a few days before a tooth breaks through and feel better once it does. Molars can take a bit longer.

Can teething cause a fever?

Teething may cause a very slight rise in temperature, but not a true fever. A temperature of 100.4°F or higher points to an illness, so call your pediatrician.

Are teething gels safe for babies?

Gels with benzocaine or lidocaine are not recommended for children under 2 because of rare but serious side effects. A chilled teething ring or gentle gum massage works well and is safer.