Teething is one of the most frequently cited explanations for unsettled infant behaviour in the first two years of life — and also one of the most over-attributed. Understanding what teething genuinely causes, what it does not cause, and what actually helps is useful both for managing the real discomfort and for not missing other causes of symptoms that are being incorrectly attributed to teeth.
The teething process spans from around six months to about two and a half years, as all twenty primary teeth come through. Knowing the typical order and timing means you can recognise which teeth are likely erupting at any given point and what to expect.
If you are logging your baby's development and health in Healthbooq, noting the date when each tooth appears gives you an accurate record and a reference for whether new bouts of unsettledness are likely to be teething-related.
The Teething Timeline
The first tooth most commonly appears between four and seven months, though the range extends from three months to twelve months and all of these are within the normal range. The two lower front teeth (lower central incisors) usually arrive first, followed by the two upper front teeth (upper central incisors). After these, the pattern tends to be lateral incisors, first molars, canines, and finally second molars — with the second molars typically completing the primary set by around two to two and a half years.
Not all teeth cause the same degree of discomfort. Many teeth appear with minimal fuss — parents discover a new tooth they did not notice emerging. Others, particularly the first tooth and the molars, tend to cause more noticeable discomfort.
Genuine Teething Symptoms
The symptoms most consistently linked to teething in research are localised gum irritability and sensitivity, increased drooling, a desire to chew on objects, and sometimes a mild temperature elevation (below 38°C) associated with the inflammatory response in the gum. Some studies also find associations with irritability and sleep disruption, though these are less consistent.
What teething does not reliably cause is high fever (above 38°C), persistent diarrhoea, significant vomiting, runny nose, or significant respiratory symptoms. These symptoms are common in young children and may happen to coincide with teething — babies are teething continuously for the better part of two years, and they are also in the age range of maximum vulnerability to common viral illnesses, so the overlap is frequent. Attributing fever or illness to teething and not pursuing other causes is a common and occasionally consequential mistake.
What Helps
The most effective relief for teething discomfort is counter-pressure against the gum — a chilled (not frozen) teething ring provides this and the mild numbing of the cold adds to the effect. Frozen teething rings are too hard and too cold, and can damage gum tissue. A clean finger or wet flannel can be used for direct gum massage if a teething ring is not available.
Paracetamol (acetaminophen) or ibuprofen at the appropriate weight-based dose for your baby's age can be given for persistent distress. Ibuprofen should not be given before six months. These medications address the inflammatory component of teething pain and are appropriate for brief use during particularly difficult eruptions.
Topical teething gels that contain benzocaine or lidocaine are not recommended for infants. These local anaesthetics can cause numbing of the throat and, with benzocaine specifically, there is a small risk of methaemoglobinaemia (a condition affecting the blood's ability to carry oxygen) in infants. Sugar-free teething gels that do not contain local anaesthetics are considered safe but have limited evidence for effectiveness.
Amber teething necklaces have no demonstrated mechanism or evidence of efficacy and pose strangulation and choking hazards; they are not recommended.
Dental Care for Baby Teeth
Baby teeth matter — they hold space for the adult teeth that will eventually replace them, support speech development, and are used for chewing for many years. Dental care should begin as soon as the first tooth appears. Use a smear of fluoride toothpaste on a soft baby toothbrush, twice daily. This should continue, with an increase to a pea-sized amount from age three, until the child can manage brushing adequately independently.
Key Takeaways
Teething typically begins around six months, though the range is four to twelve months for the first tooth. Common symptoms include drooling, chewing, gum irritability, and mild sleep disruption. High fever, persistent diarrhoea, and significant illness are not symptoms of teething and should not be attributed to it without excluding other causes. Effective teething relief includes chilled (not frozen) teething rings, gum massage, and paracetamol or ibuprofen at age-appropriate doses for persistent distress. Topical teething gels containing lidocaine or benzocaine are not recommended for infants due to safety concerns.
