Years ago, back when our daughter was still small enough to fit in the crook of one arm, she went three nights in a row where she’d wake up around 2 a.m., jam her fist into her mouth, and scream in a way that was different from her usual cry. My wife Mei was convinced she was coming down with something. I was convinced I’d broken the baby monitor because the sound felt so much louder at that hour. Neither of us guessed “teeth” until my mother-in-law took one look at the drool-soaked collar of her onesie and said, in the calm voice of someone who has seen this movie before, “she’s teething.”

That was the start of me reading more about tooth eruption than I ever expected to as someone who writes about parenting research for BloomPath. What I found surprised me: some of what I assumed was obviously true about teething — the fever, the diarrhea — turned out to be myths that pediatric sources have been trying to correct for years. And some of what I assumed was a harmless home remedy turned out to be something the FDA has specifically warned parents to stop using.

TL;DR: Real teething symptoms are drooling, gum swelling, a strong urge to chew, and mild irritability — not high fever, not diarrhea, not vomiting. The safest remedies are also the simplest: a chilled (not frozen) silicone teether, gentle gum massage with a clean finger, and extra holding. Skip benzocaine gels (FDA warning, risk of methemoglobinemia), amber teething necklaces (choking and strangulation hazard), and homeopathic teething tablets (inconsistent, occasionally dangerous ingredient levels). If your baby has a fever over 100.4°F, call the pediatrician — that’s not teething.

Related reading: if broken sleep is the part that’s wearing you down most, see Newborn Sleep: The Spreadsheet That Saved My Sanity.

What Are the Real Signs of Teething?

The real signs are surprisingly narrow: excessive drooling, red or swollen gums, a near-constant urge to chew or gnaw on anything within reach, some fussiness, and occasionally a slightly disrupted sleep pattern in the days before a tooth breaks through (HealthyChildren.org, Mayo Clinic).

That’s it. It’s a shorter list than most parents expect, mostly because teething has become the default explanation for almost any bad night or off day in the first two years — the “it’s probably teeth” catch-all. Most babies get their first tooth somewhere between 4 and 12 months, with the full set of 20 baby teeth usually in by around age 3, and there’s wide individual variation in that timeline that doesn’t mean anything is wrong.

Does Teething Actually Cause Fever or Diarrhea?

No — and this is the myth pediatric researchers most want to correct. A widely cited study tracking infants through tooth eruption found teething was associated with a very mild, short-lived rise in temperature at most, never a true fever over 100.4°F (38°C), and no meaningful link to diarrhea, vomiting, or rash (National Center for Health Research, Blueberry Pediatrics).

Here’s the likely reason the myth persists: teething often overlaps with a stretch of months when a baby’s inherited immunity from mom is fading and they’re mouthing everything in reach — including whatever germs happen to be on it. The timing lines up. The causation doesn’t. If your baby has a real fever, diarrhea, vomiting, or a rash, something else is going on, and it’s worth a call to the pediatrician rather than waiting it out as “just teeth.”

How Can You Safely Soothe Teething Pain?

The remedies with the best evidence behind them are almost boringly simple: something cold, something to chew, and more contact than usual.

  • A chilled (not frozen) silicone teether. Cold constricts blood flow to swollen gums and takes the edge off the pain. Frozen is too hard and can bruise the gums, so the fridge, not the freezer, is the move.
  • Gentle counter-pressure. A clean finger, gently massaged along the gumline, mimics the pressure a baby is instinctively trying to create by chewing.
  • A cold, damp washcloth. Cheap, always available, and gives them something textured to gnaw on.
  • More holding than usual. Not a scientific mechanism exactly, but every pediatric source on this topic mentions it, and in my experience it’s the one thing that works when nothing else does.
  • Acetaminophen or ibuprofen, dosed by weight and age per your pediatrician, for the nights when nothing else is touching it. This isn’t a first-line teething remedy, but it’s a legitimate option when pain is disrupting sleep for days.

Which Teething Remedies Should You Avoid?

Three products still sold as “teething relief” are ones pediatric and safety sources specifically warn against.

Benzocaine gels (the numbing gels marketed for sore gums) carry an FDA warning because they’ve been linked to methemoglobinemia, a rare but serious condition that reduces the blood’s ability to carry oxygen — a risk specifically flagged for children under 2 (National Center for Health Research).

Amber teething necklaces are marketed as a natural remedy, but pediatric sources are blunt about the actual risk: broken beads are a choking hazard, and the necklace itself is a strangulation hazard if it catches on a crib rail or a curious sibling’s hand. The theoretical pain relief (succinic acid absorbed through skin) has no solid evidence behind it, while the choking and strangulation risks are well documented.

Homeopathic teething tablets were the subject of an FDA warning after inconsistent, sometimes elevated levels of belladonna were found in tested products, and reports of serious adverse events in infants who used them. “Natural” and “safe” aren’t the same claim, and this is one place where that distinction matters.

I’ll admit the amber necklace one stung a little, because a friend of mine had given us one as a baby shower gift and I’d put it in the “cute, probably fine” mental bucket without ever reading past the packaging. It went in a drawer after I actually looked into it.

When Should You Call the Pediatrician Instead of Waiting It Out?

Call if there’s a fever above 100.4°F (38°C), diarrhea, vomiting, a rash, or if your baby seems genuinely unwell rather than just fussy and drooly — because those symptoms point to something other than teething, and teething shouldn’t be the assumption that delays getting it checked.

It’s also worth a call if the fussiness and sleep disruption stretch on for more than a week without a tooth ever appearing, since that pattern is less consistent with typical teething and more worth a professional look.

What Order Do Teeth Usually Come In?

Most babies get their bottom two front teeth (central incisors) first, followed by the top two front teeth, then the lateral incisors, first molars, canines, and finally the second molars — with all 20 primary teeth typically in by around age 3 (Mayo Clinic). Molars in particular tend to be the roughest round, since they’re wider and take up more room breaking through the gum.

We noticed the molar phase, months after the first-tooth phase, was honestly worse — more chewing, more night waking, more of that particular cranky-and-clingy combination that makes you google the same questions all over again even though you’d already been through it once.

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Tracking symptoms like this — is it teething, is it something else, when did it start — is exactly the kind of thing the BloomPath app was built to make less mentally exhausting. If you want a simple way to log what’s actually happening night to night instead of trying to remember it at 2 a.m., check out the app.

Frequently Asked Questions

Does teething cause a high fever? No. Teething may cause a very mild, temporary rise in temperature, but not a true fever over 100.4°F (38°C). A real fever points to an illness, not teeth.

What is the first sign that a baby is teething? Excessive drooling combined with a strong urge to chew or gnaw on things is usually the earliest and most reliable sign, often showing up days before a tooth is visible.

Is it safe to use teething gel on my baby’s gums? Benzocaine-containing numbing gels carry an FDA warning due to a rare but serious risk called methemoglobinemia, especially in children under 2. A chilled silicone teether and gum massage are safer first options.

Are amber teething necklaces safe? No. Pediatric and safety sources warn against them because of choking risk from broken beads and strangulation risk from the necklace itself, with no solid evidence they actually relieve pain.

How long does teething pain typically last per tooth? Discomfort around a single tooth’s eruption is usually most intense for a few days before and after it breaks through the gum, though molars tend to cause a longer, rougher stretch than front teeth.

When should I call the pediatrician about teething? Call if there’s a fever above 100.4°F, diarrhea, vomiting, a rash, or if fussiness and disrupted sleep last more than a week without a tooth appearing — those point to something other than teething.

Products We Recommend

BloomPath is an Amazon Associate — we may earn a small commission from purchases made through these links, at no extra cost to you.

Sophie la Girafe Natural Rubber Teether — The classic for a reason: soft enough for tiny hands to grip, textured enough to actually satisfy the chewing urge. This was the one that stayed in the diaper bag longest at our house.

Nuby IcyBite Soother Ring Teether — Fill it, chill it in the fridge (not the freezer), and it’s ready when the 2 a.m. gnawing starts. Simple, cheap, does exactly one job well.

Baby Banana Training Toothbrush & Teether — Doubles as an early toothbrush once that first tooth actually shows up, which made the transition to “we brush now” less of a fight than I expected.

This is the kind of thing that’s easier to track than to remember at 2 a.m. — BloomPath helps you log symptoms, sleep, and milestones in one place instead of relying on your half-asleep brain three weeks from now.