Teething

Teething can make an otherwise settled baby suddenly seem uncomfortable, dribbly and determined to chew everything within reach. It can also be confusing because many normal baby behaviours are blamed on teething.

Most babies begin teething at around six months, although some start earlier and others later. According to the NHS, common signs can include sore or red gums, extra dribbling, chewing, one flushed cheek, increased fretfulness and disrupted sleep.

The good news is that teething usually needs comfort rather than complicated treatment. A chilled teething ring, something suitable to chew, gentle gum rubbing and plenty of reassurance may help. More importantly, do not assume every new symptom is caused by teeth. If your baby seems genuinely unwell, seek medical advice.

When do babies start teething?

There is no exact date when a baby’s first tooth should appear.

The NHS says most babies start teething at around six months. Some begin before four months, while others do not start until after 12 months. A small number of babies are even born with a tooth.

The bottom front teeth are often among the first to appear, followed by the upper front teeth. Other teeth gradually follow over the next couple of years.

This means a baby who has no teeth at the same age as another baby is not automatically behind.

Teething timing varies naturally, so try not to use another child’s smile as a developmental deadline.

What are the common signs of teething?

Some babies seem barely bothered when a tooth appears. Others are noticeably uncomfortable for a few days.

NHS guidance lists possible teething symptoms including:

a sore, red gum where a tooth is coming through
a slightly raised temperature below 38°C
one flushed cheek
a facial rash
rubbing an ear
more dribbling than usual
chewing or gnawing on things
increased fretfulness
disrupted sleep

Your baby may have several of these signs or very few.

Extra dribbling can also irritate the skin around the mouth and chin. Gently wiping your baby’s face can help keep the area dry.

The important thing is to look at your baby’s overall condition rather than automatically labelling every difficult day as teething.

Does teething cause a fever?

The NHS says teething may be associated with a slightly raised temperature below 38°C.

A high temperature should not simply be dismissed as teething.

Babies can become unwell for many reasons, and assuming that fever or other significant symptoms are caused by a tooth could delay appropriate medical advice.

If your baby has a high temperature, seems unusually sleepy, is difficult to wake, is not feeding normally, has breathing difficulties or has other symptoms that concern you, check current NHS guidance and seek medical advice.

You know your baby’s usual behaviour. If something feels noticeably different, it is reasonable to ask for help.

Does teething cause diarrhoea?

It is common to hear that diarrhoea is part of teething, but the NHS says there is no evidence that teething causes diarrhoea.

The same principle applies to symptoms that seem more significant than ordinary teething discomfort.

Do not assume diarrhoea, vomiting or signs of illness can be explained by a new tooth.

If your baby has symptoms that concern you, contact a healthcare professional or NHS 111 for advice.

How can you help a teething baby?

There is no single remedy that works for every baby.

Often the simplest options are worth trying first.

You can comfort your baby, play with them or offer extra cuddles if they want them. Distraction can sometimes help when their gums are bothering them.

The NHS also suggests gently rubbing your baby’s gums with a clean finger.

Some babies find chewing soothing. A suitable teething ring can give them something designed for that purpose.

You may need to try a few simple approaches before discovering what your baby likes.

There is no need to keep trying something that clearly makes them more irritated.

Using teething rings safely

Teething rings can give babies something safe to chew and may help distract them from gum discomfort.

The NHS recommends cooling a teething ring in the fridge if the manufacturer’s instructions allow it.

Do not put a teething ring in the freezer. A frozen teething ring can become very hard and may damage a baby’s gums.

Never tie a teething ring around your baby’s neck because of the strangulation risk.

Always follow the instructions supplied with the product and inspect it regularly for signs of damage.

If a teething product is cracked, leaking or damaged, stop using it.

Can food help with teething?

If your baby has already started solid foods, chewing suitable foods may sometimes be soothing.

The NHS suggests foods such as pieces of soft fruit for babies over six months who are already eating solids.

Any food offered needs to be appropriate for your baby’s stage of weaning and prepared safely to reduce choking risk.

Stay with your baby whenever they are eating.

Avoid using sugary foods such as rusks or biscuits as teething aids. Frequent exposure to sugar contributes to tooth decay, including in baby teeth.

If your baby has not yet started solids, do not introduce food early simply as a teething treatment.

What about teething gels?

If simpler methods are not helping, you may wonder about teething gels.

The NHS says there is limited evidence that teething gels are effective.

If you choose to use one, make sure it is specifically designed for young children. General oral pain-relief gels are not suitable for children.

Teething gels containing a mild local anaesthetic are available from pharmacies, so ask a pharmacist which products are appropriate and how they should be used.

Follow the product instructions carefully.

Do not assume that a product described as natural or herbal is automatically suitable for a baby.

Are homeopathic teething products recommended?

The NHS does not recommend homeopathic products for teething.

Some unlicensed homeopathic products sold online have been associated with serious side effects.

If you are considering any medicine, gel, powder or alternative product for your baby, speak to a pharmacist or healthcare professional first.

Babies are small, and products that are harmless for adults or older children may not be appropriate for them.

Avoid giving a baby a remedy simply because another parent says it worked for their child.

Can babies have pain relief for teething?

Pain relief may sometimes be appropriate if your baby is distressed by teething, but the correct medicine and dose depend on factors including your baby’s age and the product being used.

The NHS provides specific guidance for paracetamol and ibuprofen in babies and children.

Because age restrictions and doses vary, follow the instructions on the medicine and current NHS advice rather than using a general dose from an article or another parent’s experience.

A pharmacist can advise you if you are unsure what is suitable.

Never exceed the recommended dose, and do not give a baby medicine intended for somebody else.

Teething and sleep

A teething baby may sleep less comfortably for a while.

NHS guidance lists disrupted sleep as one possible sign of teething.

If your baby wakes more often, comfort them in the way that normally works for your family while continuing to follow safer sleep guidance.

Try not to introduce unsafe sleep products because they are marketed as soothing or because you are exhausted.

Your baby’s sleep space should continue to follow current NHS safer sleep recommendations.

If sleep disruption is severe, lasts for a long time or comes with other symptoms of illness, consider whether something other than teething may be responsible and seek advice if you are concerned.

Caring for the first tooth

Once that tiny first tooth appears, dental care begins.

The NHS recommends brushing your baby’s teeth as soon as the first milk tooth comes through.

Use a baby toothbrush and a tiny smear of fluoride toothpaste.

For babies and toddlers up to three years old, NHS guidance recommends toothpaste containing at least 1,000 parts per million fluoride.

Brush your baby’s teeth last thing at night and on one other occasion each day.

Do not worry if brushing is awkward at first. A baby may chew the toothbrush, turn their head away or object completely.

The aim is to gradually make toothbrushing part of the normal routine while cleaning the teeth as well as you can.

When should your baby first see a dentist?

The NHS recommends taking your child to the dentist when their first milk teeth appear or before they are 12 months old.

Early visits allow your baby to become familiar with the environment and give you a chance to get advice about caring for their teeth.

NHS dental treatment for children is free.

Finding an NHS dentist accepting new patients can sometimes take time, so you do not need to wait for a dental problem before looking for one.

Once your child is registered, follow the dentist’s advice about how often they should attend.

Teething does not have to become a shopping project

Teething products are everywhere, but your baby may not need many of them.

A safe teething ring, a clean finger for gentle gum rubbing, suitable food if your baby is already eating solids and plenty of comfort may be enough.

If you buy teething toys, choose products suitable for your baby’s age and check them regularly for wear or damage.

Be cautious about jewellery marketed for teething, particularly necklaces or other products worn around a baby’s neck.

You do not need to keep buying new remedies if your baby is simply having a difficult few days.

Sometimes teething is uncomfortable, and the most useful thing you can offer is comfort while the tooth works its way through.

When to get professional advice

Contact your GP, health visitor, pharmacist or NHS 111 if you are unsure whether your baby’s symptoms are caused by teething or if something about their health is worrying you.

The NHS says there is no evidence that teething causes diarrhoea, and a high temperature should not automatically be attributed to teething.

Seek medical advice if your baby seems unwell, has symptoms that are more significant than mild teething discomfort, is not feeding normally, is unusually difficult to wake, has breathing difficulties or has another change that concerns you.

If you are considering medicine or a teething gel and are unsure whether it is suitable for your baby’s age, ask a pharmacist or another healthcare professional before using it.

For dental concerns, including problems with an emerging tooth or your baby’s gums, contact a dentist.

Call 999 in a life-threatening emergency.