Short answer: Teething in babies most often starts around 6 months, but anywhere between 4 and 12 months is considered normal. Increased drooling, the urge to bite, swollen gums and fussiness are common symptoms. Gum massage and chilled teethers are safe soothing methods. High fever and diarrhea are not caused by teething; in this case, you should see your pediatrician.
A baby's first tooth marks the start of a period that is both exciting and sometimes exhausting for the family. The teething process happens at different times and with different intensity in each child; some babies cut their teeth almost without anyone noticing, while others may have restless nights. In this article, we explain when teething starts, which symptoms are expected and which may signal a different cause, soothing methods that can be safely used at home and when the first dental visit should take place.
When does teething start in babies?
A baby's first tooth most often appears around 6 months; however, any timing between 4 and 12 months is considered normal. Rarely, babies may be born with a tooth, or the first teeth may appear after the first birthday. Teething timing is largely hereditary; the mother's or father's teething history can give an idea.
Baby teeth usually come in in a certain order:
- The two lower front incisors (about 6–10 months)
- The two upper front incisors (about 8–12 months)
- The lateral incisors (about 9–16 months)
- The first baby molars (about 13–19 months)
- The canines (about 16–23 months)
- The second baby molars (about 23–33 months)
In most children, all 20 baby teeth are in place between two and a half and three years of age. Small differences in the order are usually not a cause for concern. However, it is helpful for a child who is 18 months old and has no teeth yet to be evaluated by a dentist.
What are the symptoms of teething?
The most common teething symptoms are increased drooling, the urge to put everything in the mouth, swollen and red gums, and fussiness. Symptoms usually start a few days before the tooth breaks through the gum and decrease shortly after the tooth appears.
- Increased drooling: Mild redness due to drool may form around the mouth, on the chin and on the neck.
- Urge to bite and chew: The baby tries to bite their fingers, toys or anything they can get hold of.
- Changes in the gums: In the area where the tooth will erupt, the gum may look swollen, red and tender. Sometimes a small bluish, fluid-filled bubble forms; this usually disappears on its own as the tooth comes through.
- Fussiness and disrupted sleep: The baby may be crankier and may wake up often at night.
- Rubbing the ears and cheeks: Discomfort in the gums can radiate to the cheek and ear area.
- Changes in appetite: Some babies may temporarily refuse to nurse or eat.
A very slight rise in body temperature may be seen, but a marked fever is not a typical symptom of teething. This distinction is covered separately below.
What are the ways to soothe a teething baby?
The safest ways to soothe a teething baby are to gently massage the gums with a clean finger and to use teethers chilled in the refrigerator (not frozen). These simple but effective methods provide enough relief for most babies.
- Gum massage: After washing your hands thoroughly, you can massage the gums by pressing gently with your clean finger or a damp, clean gauze pad.
- Chilled teether: Sturdy, one-piece teethers that contain no liquid can be chilled in the refrigerator and given to the baby. Very hard, icy teethers kept in the freezer can damage the gums.
- Cold, clean cloth: Wetting a clean cotton cloth and chilling it in the refrigerator also works; the baby can chew on it under supervision.
- Wiping away drool: Frequently drying the area around the mouth with a soft cloth reduces skin irritation.
- For babies who have started solid foods: Foods such as cold yogurt or purée can be soothing. Hard foods such as carrots or bread crusts, however, should only be given under close supervision and in an age-appropriate way because of the choking risk.
What to avoid
- Amber and similar teething necklaces: They are not recommended because they carry a risk of strangulation and of beads being swallowed.
- Numbing gels: Because some local anesthetic gels are known to cause serious side effects in young children, they should not be used unless a doctor recommends them.
- Pacifiers coated with honey or sugary substances: Honey poses a health risk for babies under one year of age; sugary substances set the stage for cavities.
- Liquid-filled teethers: There is a chance they can be punctured and the liquid inside can get into the mouth.
If the baby is very fussy and you are considering a pain reliever, always consult your pediatrician to determine the medication and the appropriate dose.
Common misconceptions: does teething cause fever and diarrhea?
Teething does not cause high fever or diarrhea; such symptoms are usually a sign of another illness that happens to coincide with the same period. A slight rise in body temperature may be seen during teething, but a fever of 38 degrees Celsius (100.4°F) or higher should not be explained by teething.
There is a reason this misconception is so widespread. Teething coincides with the period when the immunity passed on from the mother decreases and the baby explores their surroundings with their mouth. This leads to more frequent infections, and the symptoms are easily blamed on the teeth. You should see your pediatrician in the following situations:
- A fever of 38 degrees Celsius (100.4°F) or higher
- Diarrhea, vomiting or marked loss of appetite
- Accompanying symptoms such as a rash, cough or runny nose
- The baby being unusually lethargic or hard to console
- Spreading swelling, inflammation or bleeding in the gums
Not brushing off symptoms with "it's just teething" ensures that an infection that might otherwise be missed is noticed in time.
How should a baby's first teeth be cleaned?
A baby's teeth should be cleaned twice a day from the moment the first tooth erupts. Even before the first teeth, wiping the gums with a damp, clean cloth after feeding is a good start to the habit. After teeth erupt, an age-appropriate baby toothbrush with a small head and soft bristles can be used. In children under three, fluoride toothpaste is used in a thin smear the size of a grain of rice. Not putting the baby to sleep with a bottle and wiping the mouth after night-time breastfeeding help prevent early childhood cavities.
When should the first dental visit take place?
The first dental visit should take place when the first tooth erupts or at the latest by the baby's first birthday. This visit is usually a short get-to-know-you and information session that does not require treatment.
At the first examination, typically:
- The condition of the teeth and gums and the order of tooth eruption are evaluated.
- Toothbrushing technique and the amount of toothpaste are demonstrated in practice.
- Recommendations are given on eating habits and bottle and pacifier use.
- Factors that increase the risk of cavities are discussed, and preventive treatments are planned if necessary.
Regular check-ups starting at an early age make it easier for the child to get used to the dental setting and allow problems that may arise later to be noticed early. We have compiled other common questions about children's oral health on our frequently asked questions page.
When should you bring your child for a dental check-up in Ankara?
If your baby's first tooth has appeared or their first birthday is approaching, it is a good time to plan a get-to-know-you dental check-up. In situations such as spreading swelling in the gums, a tooth showing a color change, or no teeth having erupted despite being over 18 months old, an evaluation should be done without waiting. At our polyclinic in Oran, Çankaya, we inform families about children's oral health and make sure the first visit is comfortable and calm for the child.
Frequently asked questions
Does teething disrupt a baby's sleep?
In some babies, night-time waking may increase during teething. This usually becomes noticeable in the few days before the tooth breaks through the gum and decreases after the tooth appears. For long-lasting sleep problems, other causes should also be considered.
Is it okay to keep a teether in the freezer?
Frozen, very hard teethers can damage the baby's delicate gums. Chilling teethers in the refrigerator is enough. Sturdy, one-piece products that contain no liquid should be preferred.
When should I start brushing my baby's teeth?
Teeth should be cleaned twice a day from the moment the first tooth erupts. A soft baby toothbrush with a small head and a rice-grain-sized amount of fluoride toothpaste can be used. Wiping the gums with a damp cloth before teeth erupt is also a good habit.
Is late teething a sign of a problem?
Teething timing varies from child to child, and the first tooth erupting after the first birthday is also often normal. However, it is recommended that children who are 18 months old and have no teeth yet be evaluated by a dentist.
