Executive Summary

Teething represents a normal developmental milestone that all infants experience, but it can be a challenging time for both babies and parents. This comprehensive guide provides an in-depth exploration of teething, examining the process of tooth eruption, the symptoms commonly attributed to teething, evidence-based approaches to managing teething discomfort, and guidance for supporting infants through this developmental transition. Parents and caregivers will find this guide invaluable for understanding what to expect during teething, how to distinguish teething symptoms from illness, and how to provide safe and effective relief for their teething babies.

The information presented in this guide synthesizes current scientific research, clinical guidelines, and practical experience from healthcare professionals specializing in pediatric care. While teething is a normal process that does not require medical treatment, understanding teething helps parents provide appropriate comfort while recognizing when symptoms may indicate illness requiring medical attention.

Understanding teething requires appreciation for the variability in this developmental process. Infants vary greatly in when teeth appear, how they react to teething, and what interventions provide relief. This guide helps parents navigate this variability with evidence-based information and practical strategies.

Understanding Teething - Comprehensive Overview

The Process of Tooth Eruption

Teething, or tooth eruption, is the process by which teeth emerge through the gums into the oral cavity. This process begins in infancy and continues through childhood, with the full primary dentition (20 teeth) typically complete by age 3. The permanent dentition begins around age 6 and continues into early adulthood.

The timing of tooth eruption varies significantly among infants. The average age of first tooth eruption is around 6 months, but teeth may appear as early as birth (natal teeth) or as late as 18 months or later. Most infants have their first tooth by their first birthday. Delayed eruption may run in families and is usually not a cause for concern.

The order of tooth eruption is relatively predictable, though there is variation. The lower central incisors typically erupt first (6-10 months), followed by the upper central incisors (8-12 months). Lateral incisors, first molars, canines, and second molars follow in sequence. The full primary dentition is usually complete by 20-33 months.

The process of eruption involves the tooth moving through the alveolar bone and gum tissue. This process is not instantaneous but occurs over days to weeks for each tooth. The pressure of the tooth against the gums and the inflammatory response in the surrounding tissue cause the discomfort associated with teething.

Timeline of Teething

The primary teeth erupt in a relatively predictable sequence and timeline. While individual variation is common, understanding the typical pattern helps parents know what to expect.

Lower central incisors typically erupt between 6 and 10 months. These are usually the first teeth to appear. The lower central incisors help with biting and are visible when the baby smiles.

Upper central incisors typically erupt between 8 and 12 months, shortly after the lower central incisors. These front teeth are prominent in the smile and help with biting.

Upper lateral incisors typically erupt between 9 and 13 months. These teeth fill the space between the central incisors and the canines.

Lower lateral incisors typically erupt between 10 and 16 months. These complete the front teeth of the lower jaw.

First molars typically erupt between 13 and 19 months. These are the larger teeth toward the back of the mouth used for grinding food.

Canines (cuspids) typically erupt between 16 and 23 months. These pointed teeth are located between the incisors and molars.

Second molars typically erupt between 23 and 33 months. These are the last primary teeth to erupt and complete the primary dentition.

Signs and Symptoms of Teething

Many symptoms are attributed to teething, though the evidence for some associations is limited. Common symptoms that may accompany teething include gum swelling and tenderness, increased drooling, irritability and fussiness, desire to chew on objects, changes in appetite or feeding, and sleep disruption.

Gum swelling and tenderness occur as the tooth pushes through the gum tissue. The area may appear red or swollen, and the infant may react when the area is touched. Gentle massage may provide relief.

Increased drooling (salivation) is common during teething. The extra saliva may cause a rash around the mouth or chin. Drooling may begin several weeks before the tooth appears.

Irritability and fussiness result from the discomfort of teething. Infants may be more difficult to soothe during teething episodes. The discomfort is typically mild to moderate and not severe.

Desire to chew on objects (mouthing) is common. Chewing provides counterpressure against the gums that may relieve discomfort. Infants may chew on toys, fingers, or other objects.

Changes in appetite or feeding may occur. Some infants may feed more frequently for comfort, while others may refuse feeds due to gum discomfort. This is usually temporary.

Sleep disruption may occur, with infants waking more frequently at night or having difficulty falling asleep. Discomfort may be more noticeable when the infant is tired and less distracted.

What Teething Does NOT Cause

Many symptoms are attributed to teething but are not actually caused by teething. Understanding what teething does not cause helps parents recognize when symptoms may indicate illness requiring medical attention.

Teething does not cause high fever (rectal temperature of 101°F or 38.3°C or higher). Low-grade temperature elevation may occur, but true fever is not caused by teething and should be evaluated.

Teething does not cause significant diarrhea. Loose stools may occur due to increased saliva swallowing, but significant or persistent diarrhea is not caused by teething.

Teething does not cause a rash on the body. Drool rash around the mouth is common, but body rashes are not caused by teething.

Teething does not cause vomiting. If an infant is vomiting, this is not due to teething and requires medical evaluation.

Teething does not cause seizures. Febrile seizures are not caused by teething, though they may occur coincidentally during the teething period.

Teething does not cause ear pulling specifically. Infants may pull at their ears due to general discomfort, but persistent ear pulling or ear-specific symptoms warrant evaluation for ear infection.

Managing Teething Discomfort

Safe and Effective Interventions

Many interventions are available for teething discomfort. Safe options include gum massage, teething toys, cold items, and appropriate use of pain medication.

Gum massage is a safe and effective intervention. Using a clean finger, gently massage the baby’s gums where the tooth is coming through. The counterpressure can provide relief. Massage is particularly effective before feeds and bedtime.

Teething toys made of safe materials can be given to infants to chew on. Look for toys specifically designed for teething that are free of harmful chemicals and small parts that could be choking hazards. Teethers can be refrigerated for additional relief.

Cold items can provide comfort. Cold (not frozen) washcloths, refrigerated teething toys, or cold spoons can be given to infants to chew on. The cold provides numbing relief. Never give frozen items to infants, as they can cause frostbite.

Pain medication may be used for significant discomfort. Acetaminophen (paracetamol) is safe and effective for infants when dosed appropriately. Ibuprofen may be used for infants over 6 months. Always follow dosing instructions and consult with your pediatrician.

What to Avoid

Some interventions for teething should be avoided due to safety concerns. Understanding what to avoid protects infants from harm.

Teething gels containing benzocaine should be avoided. Benzocaine can cause a serious condition called methemoglobinemia, which reduces oxygen in the blood. The FDA has warned against using benzocaine products for teething.

Amber teething necklaces are not recommended. These pose choking and strangulation hazards and have no proven benefit. The American Academy of Pediatrics recommends against their use.

Homeopathic teething tablets or gels may contain ingredients that are not regulated and could be harmful. The FDA has warned against certain homeopathic teething products.

Teething tablets containing belladonna are dangerous. Belladonna (atropine) can cause serious toxicity in infants. Avoid any teething products containing this ingredient.

Frozen teething items should be avoided. Items that are frozen can cause frostbite on the gums. Cold items are fine, but they should not be frozen.

Chewable items that are small enough to pose choking hazards should be avoided. Supervise infants with any teething toys. Avoid toys that can break into small pieces.

Natural and Complementary Approaches

Some families prefer natural approaches to teething discomfort. While evidence is limited, some options are considered safe.

Breastfeeding can be soothing for teething infants. The comfort of nursing and the warmth of the mother can provide relief. Some infants may bite during nursing due to gum discomfort; gentle removal from the breast followed by a teaching moment can help.

Coconut oil or other food-grade oils may provide comfort when massaged into the gums. The oil is safe if swallowed. Choose organic, unrefined options.

Chamomile tea (cooled) can be offered in a cup or on a washcloth for infants over 6 months. Chamomile has mild calming properties. Always use caffeine-free, pure chamomile.

Clove oil should be used with caution. Clove oil has been used traditionally for tooth pain but can cause irritation if too concentrated. Dilute heavily if used and avoid prolonged use.

Always discuss natural remedies with your pediatrician before use, especially for young infants. Some natural products may not be appropriate.

When to Use Medication

Pain medication may be appropriate for teething discomfort when other measures are not sufficient. Understanding when and how to use medication helps ensure safety and effectiveness.

Acetaminophen (paracetamol/Tylenol) can be used for infants over 2 months (or as directed by your pediatrician). Dose according to weight, not age. Do not exceed the recommended dose or frequency.

Ibuprofen can be used for infants over 6 months. It is longer-acting than acetaminophen and may provide more sustained relief for some infants. Follow dosing instructions carefully.

Avoid combining acetaminophen and ibuprofen unless directed by your pediatrician. This can increase the risk of dosing errors and side effects.

Avoid aspirin for infants and children. Aspirin use in children is associated with Reye’s syndrome, a serious condition. Never give aspirin to a teething infant.

Consult with your pediatrician before using pain medication, especially for young infants or if you have questions about dosing.

Common Concerns and Questions

Teething and Fever

One of the most common concerns about teething is the relationship between teething and fever. Many parents notice their baby feels warm during teething and wonder if this is normal.

Teething may cause a slight increase in body temperature, but true fever (rectal temperature of 100.4°F/38°C or higher) is not caused by teething. If your infant has a true fever, it is important to seek medical evaluation to rule out infection or other causes.

Low-grade temperature elevation (under 100.4°F/38°C) may occur during teething. This is typically mild and transient. Monitor your infant and provide comfort measures.

If your infant has fever along with other symptoms such as persistent crying, poor feeding, lethargy, rash, or vomiting, seek medical attention. These symptoms suggest illness rather than teething.

Keeping a record of temperatures and symptoms can help distinguish teething-related temperature changes from true fever. This information is also helpful for healthcare providers.

Teething and Sleep

Sleep disruption is common during teething. Understanding how teething affects sleep and how to manage it can help families navigate this challenging period.

Teething discomfort may cause nighttime waking. Infants who were sleeping through the night may begin waking again. This is temporary and typically resolves as the tooth completes eruption.

Consistent bedtime routines help signal sleep time and provide comfort. The routine can include teething-specific comfort measures such as gum massage before bed.

Pain medication given at bedtime may help infants sleep more comfortably. This should be done under guidance from your pediatrician regarding timing and dosing.

Avoid starting new sleep associations during teething. If you rock your baby to sleep during teething, they may come to expect this. Balance comfort with maintaining healthy sleep habits.

Teething and Feeding

Feeding may be affected during teething. Some infants may feed more frequently for comfort, while others may refuse feeds due to gum discomfort.

Breastfeeding mothers may experience biting during nursing. When the infant bites, gently remove from the breast, say “no bite,” and try again after a brief pause. Most infants learn not to bite.

Formula-fed infants may take less formula during teething. Offer smaller feeds more frequently if this helps. Ensure adequate overall intake over the day.

Solid food intake may decrease during teething. This is usually temporary. Offer preferred foods and avoid forcing feeds. Ensure adequate nutrition from breast milk or formula.

Cool foods may be more appealing during teething. Yogurt, refrigerated fruit puree, or cold applesauce may provide comfort and nutrition.

Teething and Drooling

Increased drooling is a normal part of teething. The excess saliva production begins before teeth appear and may continue throughout the teething period.

Drool rash may develop around the mouth and chin due to constant moisture. Keep the area clean and dry. Apply a barrier cream such as petroleum jelly to protect the skin.

Use bibs to absorb drool and keep clothing dry. Change wet bibs promptly to prevent skin irritation.

Saliva plays an important role in oral health and digestion. The increased drooling during teething is temporary and not harmful.

Dubai-Specific Considerations

Climate and Teething

The hot climate in Dubai may affect infants during teething. Ensuring appropriate hydration and comfort is important during warm weather.

Air conditioning can help keep infants comfortable during teething. Avoid direct airflow on the infant and ensure the room is at a comfortable temperature.

Humidity levels may affect comfort. Very dry air may increase gum discomfort, while high humidity may increase skin irritation from drooling.

Healthcare Access

Pediatric dental and medical care is available in Dubai for teething concerns. Pediatricians can provide guidance on teething management and address any concerns about symptoms.

Dental evaluation is recommended by the first birthday or within 6 months of the first tooth eruption. Early dental visits establish good oral health habits.

Lactation consultants can help with breastfeeding issues that may arise during teething, such as biting or reduced feeding.

Cultural Practices

Cultural practices around teething vary across Dubai’s diverse population. Some families use traditional remedies for teething comfort. Discuss any traditional practices with your pediatrician to ensure safety.

Some cultures may use teething powders, herbs, or other preparations. Evidence for these varies, and safety is not always established. Choose evidence-based approaches when possible.

Family support during teething varies. In some cultures, extended family provides significant support for new parents. Accepting help when offered can reduce parental stress during challenging periods.

Practical Tips for Dubai Parents

Keeping teething toys clean is important. Wash toys regularly with soap and water. Check for wear and damage that could pose choking hazards.

Access to pediatric care is readily available in Dubai. Don’t hesitate to seek medical advice if you have concerns about your infant’s symptoms or teething process.

Pharmacy access for infant medications is good in Dubai. Keep appropriate pain medication on hand and know the correct dosing for your infant’s weight.

Frequently Asked Questions

Understanding Teething

When does teething start? Teething typically begins between 4 and 7 months, though it can start earlier or later. Some infants are born with teeth (natal teeth), while others may not get their first tooth until after 18 months.

How long does teething last? Teething continues until all 20 primary teeth have erupted, typically by age 3. Each tooth takes several days to weeks to erupt. The most uncomfortable period is usually when the front teeth are coming in.

In what order do teeth erupt? The typical order is: lower central incisors, upper central incisors, upper lateral incisors, lower lateral incisors, first molars, canines, second molars. However, variation is common and not a cause for concern.

Is teething painful? Teething can cause discomfort, but the level of pain varies. Some infants sail through teething with minimal fussiness, while others are quite uncomfortable. Discomfort is typically mild to moderate.

Is my baby too young to be teething? Early teething (before 4 months) is unusual but not necessarily a problem. Late teething (after 12 months) is also usually normal. Discuss extreme early or late teething with your pediatrician.

Is my baby too old to be teething? Teething continues until the second molars erupt around 23-33 months. If your toddler is over 3 and still having symptoms attributed to teething, other causes should be considered.

Symptoms and Diagnosis

What are the first signs of teething? First signs may include increased drooling, gum swelling, desire to chew on objects, and mild irritability. These signs may appear weeks before the tooth is visible.

Does teething cause fever? Teething may cause a slight temperature increase, but true fever (100.4°F/38°C or higher) is not caused by teething and should be evaluated.

Does teething cause diarrhea? Teething does not cause significant diarrhea. Loose stools may occur due to increased saliva swallowing, but persistent or severe diarrhea requires medical evaluation.

Does teething cause ear pulling? Infants may pull at their ears due to general discomfort, but persistent ear pulling or ear-specific symptoms suggest ear infection rather than teething.

How do I know if my baby is teething? Signs include drooling, gum swelling, chewing on objects, irritability, and sleep disruption. A visible tooth or a palpable ridge in the gum confirms teething.

Could it be something else? If symptoms are severe, persistent, or include fever, vomiting, rash, or poor feeding, seek medical evaluation. These symptoms suggest illness rather than teething.

Treatment and Relief

What helps teething pain? Safe options include gum massage, cold teethers, cold washcloths, and appropriate pain medication. Different infants respond to different approaches.

What should I not use for teething? Avoid benzocaine gels, amber necklaces, homeopathic tablets with belladonna, frozen items, and teething tablets with uncertain ingredients. Avoid any product not designed for infant teething.

Is acetaminophen safe for teething? Yes, acetaminophen (paracetamol) is safe and effective for infants when dosed according to weight. Consult your pediatrician for dosing guidance.

Is ibuprofen safe for teething? Ibuprofen is safe for infants over 6 months. It provides longer-lasting relief than acetaminophen for some infants. Follow dosing instructions carefully.

Do teething toys work? Teething toys provide a safe object for infants to chew on, providing counterpressure that may relieve discomfort. Different infants prefer different textures and shapes.

Do home remedies work? Evidence for home remedies is limited. Some families find relief with natural approaches such as coconut oil massage or chamomile. Discuss with your pediatrician before use.

Daily Care and Safety

Should I brush my baby’s teeth? Start brushing when the first tooth appears. Use a soft infant toothbrush and a tiny smear of fluoride toothpaste. Establish the habit early.

When should I see a dentist? The first dental visit should occur by the first birthday or within 6 months of the first tooth eruption. Early dental visits establish good oral health habits.

How do I clean drool rash? Keep the area clean and dry. Wash with mild soap and water, pat dry, and apply a barrier cream such as petroleum jelly. Change wet bibs promptly.

How do I prevent choking on teething toys? Choose teething toys specifically designed for infants. Avoid toys with small parts that can break off. Supervise your infant with any teething toy.

Can I use frozen washcloths? Use cold (refrigerated) washcloths, not frozen. Frozen items can cause frostbite on the gums. Cold washcloths provide relief without this risk.

What if my baby bites while breastfeeding? When the baby bites, gently remove from the breast and say “no bite.” Try again after a brief pause. Most babies learn not to bite. Consult a lactation consultant if biting persists.

When to Seek Help

When should I see a doctor for teething? Seek medical attention if your infant has fever, persistent crying, poor feeding, vomiting, rash, or any concerning symptoms. Also seek help if you are overwhelmed or need support.

When should I see a dentist? Schedule the first dental visit by age 1 or within 6 months of the first tooth. See a dentist sooner if there are concerns about tooth development or oral health.

Is excessive crying normal? Mild to moderate fussiness is normal with teething. Excessive, inconsolable crying warrants medical evaluation to rule out other causes.

Is teething making my baby sick? Teething does not cause true illness. If your baby appears ill (fever, lethargy, poor feeding), seek medical evaluation.

What if teeth don’t come in? Delayed tooth eruption is usually normal and runs in families. Discuss with your pediatrician if no teeth have appeared by 18 months or if you have other concerns.

What if teeth come in crooked? Minor irregularity is common and often resolves as more teeth come in. Discuss significant concerns with your pediatric dentist.

Next Steps and Action Plan

Understanding Teething

Learn about the teething process and typical timeline. Understanding what to expect helps you respond appropriately to your infant’s needs.

Know the signs of teething and the symptoms that are NOT caused by teething. This helps you distinguish normal teething from illness requiring medical attention.

Recognize that teething is a normal developmental process that will pass. While challenging, teething is temporary and does not cause long-term problems.

Providing Comfort

Have safe teething toys available. Try different textures and temperatures to find what works for your infant.

Learn gum massage technique. This safe, effective intervention can provide immediate relief and comfort.

Use cold items appropriately. Refrigerated (not frozen) washcloths, teethers, or spoons can provide numbing relief.

Use pain medication when appropriate. Consult your pediatrician for guidance on dosing and timing.

Ensuring Safety

Avoid unsafe products. Do not use teething gels with benzocaine, amber necklaces, or homeopathic products with belladonna.

Supervise infants with teething toys. Check toys regularly for damage that could create choking hazards.

Maintain oral hygiene from the first tooth. Establish brushing habits early to promote lifelong oral health.

Seeking Support

Know when to seek medical attention. Fever, persistent symptoms, or concerning signs warrant evaluation.

Ask for help when needed. Parenting through teething is challenging. Accept support from family, friends, and healthcare providers.

Take care of yourself. Your wellbeing is important for caring for your baby. Rest when you can and seek support if you are struggling.

Monitoring Development

Track tooth eruption. This helps you know what to expect and identify any unusual patterns.

Attend well-child visits. Your pediatrician monitors growth and development and can address any concerns.

Schedule dental visits. First dental visits should occur by age 1 or within 6 months of first tooth.

Conclusion

Teething is a normal developmental process that all infants experience. While it can be challenging for babies and parents alike, understanding teething helps families navigate this period with confidence and appropriate responses. The key messages are that teething is normal, effective comfort measures are available, safety is paramount, and this phase will pass.

Effective teething management involves understanding the process, providing safe and effective comfort, recognizing when symptoms may indicate illness, and supporting both the infant and the family through this challenging period. With patience, appropriate interventions, and support, families can help their babies through teething while maintaining their own wellbeing.

At Healers Clinic Dubai, we support families through all aspects of infant care, including teething. Our pediatric and dental teams provide guidance on teething management, oral hygiene, and overall infant health. We understand the challenges families face and provide compassionate, evidence-based care.

If you have concerns about your infant’s teething or any aspect of their health and development, we invite you to schedule a consultation with our team. We are here to support your family on this journey. With understanding, support, and appropriate care, teething will pass, and your baby will continue to grow and thrive.

Remember that this challenging period is temporary. Your baby is developing normally, and the discomfort of teething will resolve. Your loving care through this time matters more than any specific intervention. Trust your instincts, seek support when needed, and enjoy watching your baby’s beautiful smile as those precious teeth appear.

Medical Disclaimer

The information provided in this guide is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Healers Clinic Dubai provides integrative medicine approaches that complement conventional treatments. This guide is not intended to diagnose, treat, cure, or prevent any disease. Results may vary between individuals.

If you are experiencing a medical emergency, please call emergency services immediately or go to the nearest emergency room.

© 2026 Healers Clinic Dubai. All rights reserved.

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