Teething: when the first teeth come through, what the symptoms are and how to soothe your baby

When do a baby’s first teeth come through?

A baby’s first teeth usually appear at around 6 months of age, but the UK’s National Health Service (NHS) stresses that some babies start teething before 4 months and others only after 12. The US Food and Drug Administration (FDA) gives 4 to 7 months as the typical start of teething.

Milk teeth come through gradually over roughly two years, and the full set of 20 teeth is usually in place between the ages of 2 and 3. The first to appear are most often the lower central incisors, the two bottom teeth in the middle, and the lower teeth usually come before the upper ones.

In what order do milk teeth come through?

The order in which milk teeth erupt is similar in most children: first the incisors, then the first molars, the canines and finally the second molars. The table gives the age ranges from the American Dental Association (ADA) chart, and an individual child may differ from them by a few months.

The table also shows something practical: milk molars stay in the mouth until about the age of 10 to 12. That is why a milk tooth with decay is treated rather than left until it falls out; more on this in the article on tooth decay in children.

What are the symptoms of teething?

The most common symptoms of teething are irritated gums, irritability and dribbling. In a meta-analysis of 16 studies covering 3 506 children up to the age of 3, 70.5% of children had symptoms while their teeth were coming through, and the most frequently described were gum irritation (86.8%), irritability (68.2%) and dribbling (55.7%).

Symptoms cluster around the eruption itself. In a study of 125 infants whose temperature was measured every day, complaints appeared in a window of about 8 days: from 4 days before the tooth broke through the gum to 3 days after. No symptom occurred in more than 35% of teething children, and according to the American Academy of Pediatric Dentistry (AAPD), many children teethe without obvious difficulty.

Research and the NHS list the following among the symptoms of teething:

• Chewing on everything the baby can get hold of, and rubbing the gums.
• Dribbling, sometimes with a flushed cheek or a rash on the face.
• Irritability, waking more often and sucking.
• Rubbing the ear.
• Less appetite for solid food while the appetite for liquids stays the same.
• A slight rise in temperature, which according to the NHS stays below 38 °C.

Does teething cause fever and diarrhoea?

No, teething does not cause a fever. It can cause a slight rise in temperature, which according to the NHS stays below 38 °C, and the meta-analysis of 16 studies describes it as a rise in temperature that does not meet the definition of fever. In the study of 125 infants, a fever above 38.9 °C was not associated with teeth coming through.

A temperature of 38 °C or higher is a fever, not a symptom of teething, and another cause needs to be looked for. The authors of the 2000 study state plainly that before symptoms of a potentially serious illness are attributed to teething, other causes must be ruled out. In a baby under 3 months, a temperature of 38 °C is a reason to contact a doctor urgently.

Diarrhoea is similar. The NHS says there is no evidence linking diarrhoea to teething, and in a large study looser and more frequent stools were not associated with teeth coming through. Nor were a blocked nose, cough, vomiting or rashes other than on the face.

How can you soothe a teething baby?

A teething baby can be soothed above all without medicines: by rubbing the gums with a clean finger or by giving a firm rubber teething ring to chew on. These are the recommendations of the American Academy of Pediatrics (AAP), repeated by the FDA, with the note that the teething ring should not be frozen and the child should be supervised while chewing.

Some teething rings can be cooled in the fridge, but according to the NHS never in the freezer. If pain is clearly bothering the child, a doctor or pharmacist decides on a painkiller, its type and its dose, in line with the leaflet and the child’s age.

• Rubbing the gums with a clean finger.
• A firm rubber teething ring, cooled in the fridge, never in the freezer.
• A teething ring held in the child’s or parent’s hand, never hung around the neck.
• Cuddles and play that take the mind off the discomfort.
• A painkiller only after talking to a doctor or pharmacist.

What should you not use for teething?

Amber necklaces or other teething jewellery are not used for teething, and neither are anaesthetic gels. The FDA has received reports of deaths and serious injuries in infants, including strangulation and choking, caused by teething jewellery, and the AAPD does not recommend it.

Amber also has no confirmed mechanism of action. In a 2019 study, the beads did not release measurable amounts of succinic acid, which is credited with a soothing effect, under conditions similar to skin, and in a 2025 study they released little of it and only after 7 days.

Gels are a different matter from what some older advice suggests. The FDA warns that benzocaine should not be used in children under 2, because it can cause methaemoglobinaemia, a dangerous disorder of oxygen transport in the blood, and that lidocaine used for teething can cause heart problems, severe brain injury and even death. The UK medicines agency (MHRA) advises that people under 16 should not use gels containing salicylates, because of the risk of Reye’s syndrome.

• Necklaces and bracelets made of amber, wood or other beads.
• Gum gels and ointments containing benzocaine or lidocaine.
• Gels containing salicylates, for example choline salicylate.
• Homeopathic teething tablets, which the FDA classes as products of little benefit and serious risk.
• A teething ring or dummy tied with a cord to the child’s neck or hand.

When should you start brushing, and when is the first dental visit?

A child’s teeth are brushed with fluoride toothpaste from the moment the first milk tooth breaks through. That is the NHS recommendation, and European and Polish recommendations for this age specify a rice-grain amount of 1000 ppm toothpaste, twice a day; doses for older children are covered in the article on tooth decay in children.

The first dental visit should take place within 6 months of the first tooth coming through, and no later than 12 months of age, as recommended by the AAPD and the Polish Society of Paediatric Dentistry. The NFZ (Poland’s National Health Fund) provides preventive visits for the youngest children at 6, 9 and 12 months of age, and how to prepare a child for the first visit is described in a separate article.

How it works at DentalBlue

DentalBlue in Białystok provides paediatric dentistry and preventive care: familiarisation visits, hygiene treatment, fissure sealing and fluoride application. A young child’s first visit is about getting used to the surgery, and parents can ask about teething, brushing and choosing a toothpaste. In the clinic’s price list, a familiarisation visit costs 250 zł and a dental consultation 300 zł; the final scope is agreed at the visit, and prices may change. An appointment can be booked by phone.