Teething: Symptoms, Timeline, and the Best Remedies

Teething Timeline

Most babies get their 20 primary (baby) teeth in a predictable order, though the timing varies considerably:

| Age | Teeth |

|-----|-------|

| 6–10 months | Lower central incisors (bottom middle) |

| 8–12 months | Upper central incisors (top middle) |

| 9–13 months | Upper lateral incisors |

| 10–16 months | Lower lateral incisors |

| 13–19 months | First molars (top and bottom) |

| 16–23 months | Canines |

| 23–33 months | Second molars |

If your baby has no teeth by 18 months, mention it to your dentist or paediatrician — though it is rarely a cause for concern.

Real Teething Symptoms

Research confirms these symptoms are genuinely associated with teething:

✅ Drooling — often increased significantly 2–3 months before the first tooth appears

✅ Chewing and gnawing — on hands, toys, your fingers

✅ Gum swelling and redness in the area where the tooth is erupting

✅ Fussiness and irritability — particularly in the 4 days before and after eruption

✅ Sleep disruption — may wake more frequently at night

✅ Mild temperature rise (under 38°C) due to gum inflammation

✅ Reduced appetite — sore gums may make feeding uncomfortable

✅ Pulling at ears or cheeks — referred pain along the jaw

Symptoms NOT Caused by Teething

This is important: the following are not caused by teething and require medical assessment if they occur alongside tooth eruption:

❌ High fever (38°C or above)

❌ Diarrhoea

❌ Vomiting

❌ Rash (other than drool rash around the mouth)

❌ Severe inconsolable crying

❌ Runny nose or cough

These are signs of illness. The co-occurrence with teething is coincidental — babies of this age are frequently exposed to viruses.

Effective Remedies

Cold and Pressure

These work by numbing and distracting from gum soreness:

• Chilled (not frozen) teething ring — refrigerate for 30 minutes before use; never freeze
• Cold flannel — wet, wring out, and chill; let your baby chew on it
• Clean finger massage — gentle circular pressure on the gum can provide relief

Teething Toys

Look for silicone or natural rubber toys your baby can chew on safely. Avoid toys with small parts or liquid-filled designs that could burst.

Pain Relief Medicine

For significant discomfort that disrupts sleep or feeding:

• Infant paracetamol (Calpol) — from 2 months (4kg minimum, not premature)
• Infant ibuprofen — from 3 months (not under 5kg)

Follow the dosage instructions for your baby's weight.

What to Avoid

Teething gels containing lidocaine or benzocaine — avoid in babies under 2 years. Benzocaine has been linked to a rare but serious condition (methaemoglobinaemia). NHS and AAP guidelines advise against use. Amber teething necklaces — there is no scientific evidence they work, and they pose a genuine strangulation and choking hazard. Major paediatric organisations recommend against them. Homeopathic teething tablets — FDA and MHRA have issued warnings about some products for inconsistent ingredient levels.

Drool Rash

Heavy drooling can cause a red, chapped rash around the mouth, chin, and neck. Keep the area dry by:

• Gently patting dry frequently (don't rub)
• Applying a thin layer of barrier cream (petroleum jelly or a fragrance-free balm)
• Using a bib to protect the neck and chest

Dental Care from the First Tooth

As soon as the first tooth appears:

• Wipe it twice daily with a damp cloth or soft baby toothbrush
• Once a few teeth are in, use a tiny smear of fluoride toothpaste (1000ppm minimum) for babies under 3
• Book a first dental appointment — most dentists recommend as soon as the first tooth erupts

Starting early establishes the habit and lets your dentist spot any issues early.