Teething Symptoms and Solutions for Your Baby

“She’s so touchy!” says Melanie Aguiar, mom to 14-month-old Ana. “The slightest little thing like falling down on her bum will start her crying.” Why is this usually sunny little girl so unhappy? Teething. “She’s cut four teeth in the last week and a half, including a molar,” says her mom.

Not only has Ana been irritable, but she’s been chewing on her fingers, her cheeks are bright red, and she’s had loose bowel movements. When Ana cut her first two incisors six months ago, she had a mild fever for three days, swollen gums and crying jags.

When a baby’s teeth begin to appear, it can really hurt, says pediatric dentist Raymond Lee of the London, Ontario-based Health Sciences Centre. “Cutting teeth essentially causes an open wound in the gum,” explains Lee. “The root is still developing under the gum line as the crown pushes through the gum.”

Parents report a range of symptoms associated with teething, such as red cheeks, excessive drool, hand-chewing, diarrhea, diaper rash, runny nose, and mild fever. Ahead, you will find a detailed breakdown of these symptoms and when it is appropriate to seek medical advice.

Teething symptoms

Flushed Cheeks

Although it is normal for babies to have flushed cheeks after crying, Dr. Liel Grinbaum, DMD, a pediatric dentist and owner of Smiles + Grins, points out that flushed cheeks and chin can be a common sign of teething in babies. “This is caused by an increase in drooling, which can result in dried drool on the baby’s skin,” he tells Today’s Parent. If you notice your baby experiencing red flush cheeks along with dryness, Dr. Grinbaum suggests that parents should wipe off the drool frequently and apply a gentle moisturizer.

Drooling

Drooling is another typical sign of teething, and Dr. Grinbaum suggests that it happens because the new teeth activate the salivary reflex, causing excessive saliva production. To alleviate this, Dr. Grinbaum recommends that parents buy an ice ring or teething toy to minimize drooling and provide relief to the baby's gums.

Rush Around The Mouth

Dr. Amber Bonnaig, DDS, dental practitioner and dental director for DentaQuest, explains that excessive drooling caused by teething can result in a rash around a baby's mouth due to the presence of extra bacteria in the saliva. To prevent skin irritation, she suggests that parents should aim to keep the area around the baby's mouth as dry and clean as possible.

Gum Inflammation

During the teething stage, a baby’s gums can be affected, as Dr. Grinbaum explains that the gums tend to swell and appear inflamed due to the emerging tooth. “The area around the tooth will most likely be tender and might even be slightly discolored,” adds Dr. Grinbaum.

Ear or Cheek Rubbing

If your baby is often seen rubbing their ears or cheeks, Dr. Grinbaum suggests that this behavior could signal teething. He explains that discomfort in the gums from teething can cause pain in the ear and cheek, especially when the molars are coming through. “Babies commonly rub or grab their ears when the pain extends beyond the gums,” he says. 

Appetite Loss

According to Dr. Bonnaig, appetite loss is another one of the most common symptoms of teething. “While babies are teething, their gums swell and are tender to the touch, making food a potential cause of additional pain,” she explains to Today’s Parent. “The only control they have to mitigate that pain is to avoid eating.”

Difficulty Sleeping

Because teething can be a pretty painful experience, Dr. Bonnaig says it’s normal for your child to exhibit restlessness at night. “This is because the added symptoms of teething can result in extreme fussiness, and for certain babies, the pain from teething can cause nighttime awakenings.”

Irritability

If your infant experiences a lack of sleep due to teething symptoms at night, it is common for them to also display irritability. “Irritability is caused by the discomfort of a tooth erupting through the gums, adds Dr. Bonnaig.

Flu-Like Symptoms

While loss of appetite and difficulty sleeping are attributable to pain, Lee acknowledges that some medical professionals aren’t convinced that teething can cause flu-like symptoms. “It’s largely anecdotal evidence, but I tend to trust Dr. Mom on this one,” he says. “It makes sense when you think about.

The mouth is full of bacteria, so while I wouldn’t go so far as to call it an infection, it does make sense that the baby has a systemic reaction, which manifests as flu-like symptoms.” That said, it’s important to check with your doctor about flu-like or other respiratory symptoms to rule out an illness.

Runny Nose

While irritability, increased drooling, and mild gum pain are common teething symptoms, Dr. Grinbaum states that there is usually no direct correlation between teething and a runny nose. “Instead, a runny nose is caused by hands/fingers in the mouth and the stress of the baby teething, may lead to an increased chance of catching a virus,” he says.

To help prevent these kinds of viruses, Dr. Grainbaum says that it is important to keep your baby's hands clean and to manage the symptoms of teething that the baby experiences. “Using an ice ring to suck on or infant tylenol when you sense they are extremely uncomfortable, may help reduce the chances of catching a virus,” he adds.

Mild Fever

In the same way as a runny nose, Dr. Grinbaum explains that there is no direct link between teething and a fever. Instead, the likelihood of catching something that leads to a mild fever may increase due to picking up a virus from dirty or contaminated hands or experiencing stress from teething.

Diarrhea

Teething does not directly cause diarrhea in babies, as stated by Dr. Bonnaig. Instead, it is more likely that teething is coinciding with the time when a baby is transitioning to a more solid food diet. “This change in diet can cause an acclimation period for the baby’s digestive system, which may result in diarrhea,” she tells Today’s Parent.

Hand Chewing

Infants tend to chew or suck on their hands and fingers a lot, so chewing on hands and fingers may not always be a sign of teething. “For newborns up to four to five months old, hand-sucking can be a result of their recent discovery of their hands, explains Dr. Grinbaum. “However, from ages five months and up, an infant that chews or sucks their hands may be doing so in response to the pressure of teeth starting to break through the gums.”

Parents report a variety of symptoms associated with teething: flushed cheeks, drooling and a tendency to chew on hands, diarrhea, diaper rash, runny nose and mild fever.

While loss of appetite and difficulty sleeping are attributable to pain, Lee acknowledges that some medical professionals aren’t convinced that teething can cause flu-like symptoms. “It’s largely anecdotal evidence, but I tend to trust Dr. Mom on this one,” he says. “It makes sense when you think about it.

The mouth is full of bacteria, so while I wouldn’t go so far as to call it an infection, it does make sense that the baby has a systemic reaction, which manifests as flu-like symptoms.” That said, it’s important to check with your doctor about flu-like or other respiratory symptoms to rule out an illness.

Predictable teething patterns

While babies differ in when they start teething, how it progresses is predictable. Teeth come in groups of four. On average, babies begin teething at six months and finish by 30 months in this sequence:

6–8 months - 4 lower incisors 8–10 months - 4 upper incisors 12–15 months - first molars 20–24 months - upper and lower eye teeth 20–30 months - second molars

What helps with teething pain?

Pressure and pain relief are the keys to soothing sore gums, but figuring out what works for your baby is a matter of trial and error, says Lee. Pam Hummel’s daughter Cadence didn’t like cold things at all when she was teething, but gnawing on a hard bagel (well-supervised) helped.

Cold and hard things

Frozen wet washcloths, teething rings, an unopened Freezie — anything cold helps to numb tender gums. Be careful that any hard teething rings your baby uses are free of harmful chemicals, including phthalates and bisphenol A. There is a range of soft and hard organic cotton teething dolls and hardwood teething rings available.

Pressure

If your child is OK with having your fingers in her mouth, rubbing her gums can be soothing.

Pain meds

Both Hummel and Aguiar gave their babies over-the-counter pain medications when their babies were having trouble sleeping. “It’s surprising how many parents don’t give acetaminophen or ibuprofen to relieve pain and swollen gums,” says Lee. “But they’re much safer and more effective than an oral gel.

Gels that are rubbed on the gums contain about 20 percent benzocaine, a powerful anesthetic,” explains Lee. I don’t recommend them because while they numb the gums for about 10 minutes, the risk is that if they are used continuously, the baby ingests too much.

In extremely high amounts, benzocaine can cause problems with blood circulation. Lee says if parents are going to use the gel, it needs to be used very sparingly. One application might be enough to give your child the relief he needs to fall back to sleep at night.

Hummel and Aguiar gave their babies a homeopathic remedy for teething pain, which seemed to help. According to Lee, “caution is prudent with homeopathic remedies because sometimes we don’t know how they work exactly, especially if they are combined with other drugs. That said, if you use them as directed, and it works for your child, great.”

Cuddles Sometimes the best soother is some extra attention. “Cadence loved just being in my arms when her teeth hurt,” says Hummel.

Breastfeeding and teething

Most babies never bite or clamp down when breastfeeding, says Nanaimo, BC, lactation consultant Karyn-grace Clarke. But occasionally, while teething, they might. Here’s how to prevent it:

Ensure a good latch

A baby who is properly latched has his tongue out and over the bottom gum ridge, which means he can’t clamp down. To bite, the baby has to pull his tongue back. “Pay attention during the feed,” says Clarke. “If the baby is going to bite, he will do so when he’s stopped feeding and is nibbling or playing at the breast.”

Don’t push the baby away

If he clamps down, pushing away will make things worse. Instead, pull him in close to the breast tissue, which is uncomfortable and will cause him to let go.

Just say no!

If he does clamp down, break the latch by sticking a finger in the baby’s mouth, and say very firmly, “No! That hurts Mommy!” Lay him down in a safe place and leave the room for a minute or two. With repetition, this will break the clamping habit, says Clarke.

Soothe baby’s gums

Massaging sore gums before your baby feeds can reduce pain, so that he’s less likely to clamp down or bite. If he doesn’t like that, try giving him a clean face cloth soaked in expressed breastmilk.

Experts

• Pediatric dentist Raymond Lee of the London, Ontario-based Health Sciences Centre
• Dr. Liel Grinbaum, DMD, a pediatric dentist and owner of Smiles + Grins
• Dr. Amber Bonnaig, DDS, dental practitioner and dental director for DentaQuest
• Nanaimo, BC, lactation consultant Karyn-grace Clark