Teething gets blamed for a lot. Sleepless nights, nappy rashes, runny noses, high temperatures — parents are often told it's "just teething." Sometimes it is. But understanding what teething genuinely causes, when to expect it, and what actually helps will make you a more confident parent and ensure you don't dismiss symptoms that need attention.
When does teething start?
Most babies cut their first tooth somewhere between 4 and 7 months, but the range is wide. Some babies are born with a tooth already visible (natal teeth). Others don't see their first tooth until after their first birthday — and that's completely normal.
Typical teething timeline:
| Teeth | Usual age |
|---|---|
| Lower central incisors (bottom front) | 6–10 months |
| Upper central incisors (top front) | 8–12 months |
| Upper lateral incisors | 9–13 months |
| Lower lateral incisors | 10–16 months |
| First molars | 13–19 months |
| Canines | 16–23 months |
| Second molars | 23–33 months |
Most children have a full set of 20 primary (milk) teeth by around age 3.
If your baby has no teeth by 18 months, mention it to your health visitor or GP. It's rarely a cause for concern but worth a check.
How to spot teething
Teething symptoms typically begin a few days before a tooth breaks through the gum. Once the tooth is through, symptoms usually settle quickly.
Common signs:
- Increased drooling — often noticeable from around 3–4 months, which is before most teeth arrive (the salivary glands are maturing at this stage too)
- Red, swollen, or bulging gum where the tooth is coming through
- Chewing, gnawing, or biting on anything within reach
- Rubbing their gum, ear, or cheek on the side the tooth is coming through
- Increased fussiness or irritability, especially in the days just before the tooth appears
- Slightly disrupted sleep
- A mild increase in temperature — up to around 37.5°C
What teething does NOT cause
This is important. Teething is frequently over-blamed, which can lead to parents missing genuine illness.
Teething does not cause:
- Fever above 38°C — this is not teething, it is illness. Investigate it.
- Diarrhoea — while many parents report loose stools around teething, there is no robust evidence that teething directly causes diarrhoea. If your baby has frequent watery stools, treat it as a gastrointestinal illness.
- Vomiting
- Rashes on the body (a dribble rash around the mouth and chin is common and is caused by saliva, not teething itself)
- Significant cold or respiratory symptoms
- Prolonged high-pitched crying or inconsolable distress
If your baby has a temperature above 38°C, contact your GP or call NHS 111. Do not attribute it to teething.
How to help your baby through teething
Cold and pressure
The most effective relief is a combination of cold and counter-pressure on the gum.
- Chilled (not frozen) teething rings — put them in the fridge, not the freezer. Frozen items can damage delicate gum tissue.
- Cold, clean flannel — wet, wring out, and refrigerate. Let your baby chew on it under supervision.
- Chilled cucumber or carrot sticks — for babies who are already on solids and old enough to manage them safely. Always supervise.
- Your clean finger — gentle but firm pressure on the gum can provide real relief.
Teething gels
The NHS advises caution with teething gels for babies under 4 months. For older babies:
- Sugar-free gels containing a mild local anaesthetic (e.g. lidocaine) can offer short-term relief
- Apply sparingly — numbing the back of the throat can interfere with the gag reflex
- Avoid gels containing salicylate salicylates (related to aspirin) in babies under 16 years
- Herbal teething gels have limited evidence — check with your pharmacist if unsure
Pain relief
For babies over 3 months, infant paracetamol (Calpol) can help with pain and mild discomfort — follow the dosing guidance for your baby's weight and age on the packaging.
For babies over 6 months, ibuprofen (infant formulation) is an alternative. Do not use ibuprofen if your baby has a fever and you're unsure of the cause.
Distraction and comfort
Teething is uncomfortable, not agonising — and distraction works well for babies. Extra cuddles, a change of scenery, skin-to-skin, or a bath can all help break a fussy cycle during a difficult patch.
Natural remedies: what's supported and what to avoid
Many parents prefer to try non-pharmaceutical options first. The following are aligned with NHS and WHO guidance on infant safety.
Cold, wet muslin or flannel
The simplest and most evidence-consistent remedy. Soak a clean muslin or flannel in cold water, wring it out, and refrigerate it for 15–20 minutes. Let your baby chew and suck on it under supervision. The combination of cold and gentle pressure on the gum is what provides relief — it's the same principle as a chilled teething ring, with nothing added.
Chilled fruit and vegetable sticks
For babies who are already weaning (typically from around 6 months), chilled soft fruit or vegetable sticks can double as teething relief and exploratory food. Good options:
- Cold cucumber sticks — cool, firm, and easy to grip
- Chilled mango slices
- Lightly steamed, then chilled, broccoli florets (easy for small hands to hold by the stalk)
Always supervise closely. Use pieces large enough that they cannot be bitten off and swallowed whole.
Chilled breast milk
If you are breastfeeding, chilled expressed breast milk can be given in a sippy cup or frozen into a lolly mould to make a breastmilk ice lolly. Some babies find this very soothing, and it introduces nothing unfamiliar. This is safe from any age, though frozen lollies are better suited to babies who can hold them with some control (usually from around 6 months).
Clove oil — with caution
Clove oil has a long traditional history as a dental analgesic and contains eugenol, which has demonstrated anaesthetic properties. It is used in clinical dentistry in dilute form.
If you use it:
- It must be heavily diluted — 1 drop of clove essential oil to at least 1 teaspoon of a carrier oil such as coconut or almond oil
- Apply a very small amount to the gum with a clean fingertip — do not let your baby ingest it in quantity
- Do not use on babies under 6 months
- Do not use undiluted — neat clove oil will burn mucous membranes
This remedy is not formally recommended by the NHS but is not contraindicated when used correctly and sparingly.
Massage and gum rubbing
Clean your hands thoroughly and use one finger to apply gentle but firm circular pressure directly on the swollen gum. Many babies find this immediately soothing. It costs nothing, carries no risk, and can be done anywhere.
What to avoid
Amber teething necklaces and bracelets are widely sold but carry a genuine safety risk. The NHS, WHO, and the American Academy of Pediatrics all advise against them. They present a strangulation hazard if the cord catches on something, and individual beads are a choking hazard if the necklace breaks. There is no clinical evidence that they provide any teething relief.
Whisky, brandy, or any alcohol on the gums — a traditional remedy that is not safe. Alcohol is toxic to infants even in small amounts. Do not use it.
Aspirin or salicylate-containing products — never give aspirin to children under 16, including in gel form. It is associated with a rare but serious condition called Reye's syndrome.
The dribble rash
Heavy drooling during teething is very common and can cause a red, chapped rash around the mouth, chin, and neck folds.
Managing it:
- Gently pat (don't rub) the area dry as often as you can
- Apply a thin barrier cream (Vaseline or a nappy rash cream) to the affected area before feeds and sleep
- Use a soft muslin bib to absorb drool rather than a stiff plastic-backed one
Looking after the new teeth
As soon as the first tooth appears, start brushing.
- Use a soft-bristled baby toothbrush twice a day — morning and last thing at night
- Use a smear of fluoride toothpaste (at least 1,000ppm fluoride — standard adult toothpaste in a tiny amount is fine)
- Don't rinse after brushing — let the fluoride sit
- Register your baby with a dentist as soon as the first tooth arrives. NHS dental care is free for children.
Avoid:
- Putting sugary drinks or juice in a bottle
- Dipping dummies in anything sweet
- Letting your baby fall asleep with a bottle of milk in their mouth — this causes significant early tooth decay
When to contact a GP or health visitor
Contact your GP or health visitor if:
- Your baby has no teeth by 18 months
- A tooth appears to be coming in at an unusual angle or position
- Your baby's temperature rises above 38°C — don't attribute it to teething
- A tooth is knocked out or damaged (seek dental advice within 24 hours)
- You notice any white or brown spots on the teeth — these can be early signs of decay
Teething is uncomfortable but temporary. With the right tools and realistic expectations, most families get through it with minimal drama — and the first tooth is genuinely one of the more exciting milestones.