Teething causes sore, swollen gums, heavy dribbling, chewing on everything, and an unsettled baby — and that is roughly the whole list. It does not cause fever, diarrhoea, vomiting or a rash. A cold teething ring and firm gum pressure are the two things that genuinely help. Amber necklaces and numbing gels are not recommended, and one of them carries real risk.
If your baby seems unwell rather than simply unsettled, it is worth having them looked at.
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What is actually happening during teething?
The tooth does not cut through the gum in the way the language suggests. The body remodels the tissue ahead of the tooth so it can pass through, and that remodelling causes localised inflammation. The gum over the tooth becomes tender, sometimes slightly swollen, occasionally with a small bluish blister of fluid over it — an eruption cyst, which is harmless and resolves on its own.
The first teeth usually arrive around six months, most often the two lower front teeth, though anywhere between three and twelve months is within normal range. The full set of twenty is generally complete by around age three.
Symptoms tend to cluster in the few days before a tooth appears and settle once it is through. They are not continuous for months, which is worth knowing, because "it's teething" is often used to explain far longer stretches of unsettledness than teething accounts for.
What does teething actually cause?
- Sore, red or swollen gum over the tooth that is coming
- Heavy dribbling, and sometimes a rash on the chin or chest from the saliva itself
- Chewing and gnawing on hands, toys, cot rails, anything within reach
- Being unsettled, particularly at night
- Reduced appetite for a day or two, especially for anything that needs chewing
- Rubbing at the cheek or ear on the same side
What it does not cause
Fever, diarrhoea, vomiting, a cough, a body rash or refusing all fluids are not teething. Studies looking at large numbers of infants have consistently failed to link teething with any of them. Babies of teething age are also the age at which the antibodies passed on from the mother are declining and infections become more common, which is why the two get confused.
The practical point is simple: if a baby has a fever or seems genuinely unwell, teething is not the explanation, and it should be assessed by a GP rather than waited out. healthdirect has general information on baby teeth, and its nurse line is available on 1800 022 222.
What genuinely helps?
Cold and pressure
These are the two mechanisms that work. Cold reduces the inflammation; firm pressure on the gum provides counter-stimulation that competes with the discomfort.
- A solid rubber or silicone teething ring, chilled in the fridge. Not the freezer — frozen solid it becomes hard enough to bruise the gum.
- A clean, cold, damp face washer to chew on, which many babies prefer to a purpose-made ring.
- Firm gum massage with a clean finger. Simple, free, and often the most effective thing available.
- Cold food for babies already on solids — chilled yoghurt or purée, or a chilled hard vegetable stick under close supervision.
- Wiping the chin regularly and using a barrier cream if a dribble rash appears.
Infant paracetamol has a place for a baby who is clearly uncomfortable, used according to the packet and the child's weight, and it is worth checking with a pharmacist or GP first. It is not something to give routinely across weeks.
Not sure whether what you are seeing is teething or something else? No question is a silly one.
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What to avoid, and why
Amber teething necklaces
There is no evidence that succinic acid is absorbed through the skin in any meaningful amount, and the necklaces present two genuine hazards: strangulation if worn during sleep, and choking if a bead comes loose. Australian consumer safety authorities have issued warnings about them. The risk is small in any single instance, but the benefit is not established at all.
Numbing gels containing benzocaine or choline salicylate
These are not recommended for infants. Benzocaine has been linked to a rare but serious blood condition in young children, and salicylate-containing gels are related to aspirin, which is not given to children. Any gel is also washed away by saliva within minutes.
Freezing things solid
A frozen teething ring is hard enough to damage inflamed gum tissue. Chilled is the aim, not frozen.
Rubbing anything alcoholic on the gums
An old remedy that still circulates. Alcohol is not safe for infants in any quantity.
Sweetened dummies, rusks or juice to settle them
The teeth arriving are vulnerable from the day they appear, and prolonged sugar contact is exactly what starts decay. See why childhood decay starts the moment a tooth appears.
When should the first dental visit be?
Around the time teething starts. The visit is an introduction rather than treatment — a look, a chance for you to ask what you should be doing, and for the child to sit in the chair when nothing is wrong.
It is also the moment cleaning should begin. The first tooth needs wiping or brushing from the day it appears.
Very occasionally a baby is born with a tooth, or one appears in the first weeks. Where it is loose enough to be a feeding or choking risk it needs assessing straight away. It is uncommon, but it is why there is no minimum age for an appointment.
Quick answers
Can teething cause a fever?
No. Teething can raise gum temperature locally and leave a baby unsettled, but it does not cause a systemic fever. A baby with a fever should be assessed by a GP rather than having it attributed to teething.
Are amber teething necklaces safe?
They are not recommended. There is no established benefit, and they carry a strangulation and choking risk. Australian consumer safety authorities have warned about them.
What is the best thing for teething pain?
Cold and firm pressure. A chilled solid teething ring, a cold damp face washer, or gum massage with a clean finger cover most of what genuinely helps.
When do babies start teething?
Most often around six months, usually with the lower front teeth, though anywhere from three to twelve months is within normal range. Teeth arriving notably early or late are worth mentioning at a check-up but are frequently just variation.
If you would like it looked at
Teething is one of the more common reasons parents get in touch, and it is a perfectly reasonable one. A first appointment is meant to be easy — a look, a conversation, and a toy.
Berala Dental has provided children's dentistry in Berala since 2002.
Call (02) 9649 6468 · Book online · WhatsApp
You can also read about children's dentistry at Berala Dental, a child's first dental visit, or whether your child is CDBS eligible.
Written and reviewed by Humzah Aly, Oral Health Therapist. This article is general information only and is not a substitute for personalised dental advice. Please see a dental practitioner to discuss what is right for your child.
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