Dental Tips |6 min read

Teething Troubles: When to Be Concerned

by Dr. Greg Ayers

teething

 

Table of Contents

Key Points

  • Teething can be a trying time for babies and parents.
  • While minor discomfort is extremely common, there are some signs pointing to more serious issues that need the attention of a pediatric dentist. 
  • Knowing the difference between typical symptoms and ones that require intervention is important for parents with children going through teething. 

As parents, few milestones are as eagerly anticipated—and as anxiety-inducing—as when your baby’s first tooth makes its appearance. According to recent pediatric studies, approximately 80 percent of children across the globe will have some level of teeth problems, ranging from mild discomfort to more serious problems, like high fevers.1

Given both the prevalence of issues, along with the wide variety in severity, it is important for caregivers to understand the difference between normal teething discomfort and signs that warrant a visit to a pediatric dentist. Having this knowledge can give you the peace of mind that your child is receiving the care they need in this important developmental stage.

At iGrin Dental, our pediatric dentistry team understands that teething can be a confusing and stressful time for both babies and parents. The information below can help you navigate the trials of teething. Keep reading to find out what situations are normal and which ones warrant professional attention, along with common remedies for teething issues.

The Teething Timeline

The teething process typically begins between two and four months of age, during which time a baby will start drooling and chewing things. However, with most children, teeth do not start emerging until between six and 10 months.2 In some children, teeth do not show up until after their first birthday.

Here is a general teething timeline:

  • Four to seven months: Lower central incisors (bottom front teeth) typically appear first
  • Eight  months to a year: Upper central incisors and lateral incisors emerge
  • One year to 16 months: First molars begin breaking through
  • 16 to 20 months: Canine teeth make their appearance
  • 20 to 30 months: Second molars complete the primary set of 20 baby teeth

Common Teething Symptoms

When babies are teething, they may exhibit several predictable behaviors and symptoms. Here are some common, normal signs:

  • Increased drooling: This can begin as early as 10 weeks before the tooth appears
  • Gum sensitivity: Babies may rub their gums or want to chew on everything within reach
  • Irritability and fussiness: Discomfort can make babies cranky, especially in the evening
  • Sleep disruptions: The discomfort may cause more frequent nighttime waking 
  • Decreased appetite: Sore gums might make babies less interested in feeding
  • Mild gum inflammation: You might notice slightly red or swollen gums where the tooth is emerging
  • Cheek rubbing or ear pulling: Babies may do this due to referred pain from the gums

These symptoms are manageable at home and do not typically require immediate professional attention from a pediatric dentist office.

Why Do Babies Run a Fever When Teething?

The truth is more nuanced than many parents realize. While mild temperature elevation (under 100.4°F) can occasionally accompany teething, true fevers are not directly caused by teeth breaking through the gums.3 What is actually happening may be one of several causes:infant putting toy in mouth

  • Inflammation response: The gums experience localized inflammation as teeth push through, which can cause a very slight increase in body temperature (usually less than one degree)
  • Coincidental timing: Babies are teething during the same period when they are losing maternal antibodies and becoming more susceptible to common infections
  • Hand-to-mouth behavior: Increased drooling and the tendency to put everything in their mouths during teething can increase exposure to germs that cause fever

Important distinction: If your baby has a temperature over 100.4°F, teething is likely not the cause. This indicates an actual fever, which suggests infection or illness requiring medical attention.

Red Flags During Teething

While most teething symptoms are harmless and temporary, certain signs warrant a call to your pediatric dentist or pediatrician. Our team at iGrin Dental recommends seeking professional evaluation if you notice:

  • True fever (temperature above 100.4°F)
  • Diarrhea or vomiting lasting more than 24 hours
  • Rash that spreads beyond the chin area
  • Prolonged crying or inconsolable behavior 
  • Refusal to drink fluids for more than a few hours, risking dehydration
  • Blood or pus on the gums
  • Severe swelling of the gums or face
  • Signs of infection in the mouth, including bad odor
  • Disrupted sleep continuing for more than a few nights

Additionally, if you are dealing with what appears to be 1-month-old teething, contact your pediatrician immediately. While natal teeth (present at birth) and neonatal teeth (emerging within the first month) do occur in roughly 1 in 2,000-3,000 births, any tooth development this early requires professional assessment.

Safe Home Remedies for Teething Discomfort

Try these pediatric dentistry-approved remedies to help soothe your teething baby:

  • Cold washcloth: Wet a clean washcloth, freeze it for 30 minutes, and let your baby chew on it
  • Teething rings: Choose BPA-free options and chill (not freeze) them before use
  • Gentle gum massage: Use a clean finger to gently rub your baby’s gums
  • Cold foods: For babies eating solids, offer chilled pureed fruits or vegetables
  • Pain relief: Consult your pediatrician about appropriate doses of infant acetaminophen or ibuprofen (for babies over 6 months)

Avoid these potentially dangerous remedies:

  • Teething tablets or gels containing benzocaine, which the FDA warns against 
  • Amber teething necklaces, which pose choking and strangulation risks
  • Frozen items placed directly on gums, which can cause cold burns
  • Anything small enough to be a choking hazard

The Importance of Early Dental Care

Many parents wonder when to schedule their child’s first dental appointment. The American Academy of Pediatric Dentistry recommends that children visit a pediatric dentist by their first birthday or within six months of their first tooth erupting—whichever comes first.4

At iGrin Dental, our pediatric dentistry specialists create a welcoming, anxiety-free environment for your little ones. We are not just here for dental emergencies; we’re your partners in establishing healthy oral hygiene habits that will last a lifetime. We also offer whole-family dentistry services, making us your complete dentist office solution.

Learn More About Teething

Teething is a natural developmental milestone, and while it can be uncomfortable for babies, it rarely causes serious problems. Most symptoms can be managed effectively at home with simple remedies. However, understanding when to seek professional help is crucial for your baby’s health and well-being.

At iGrin Dental, we’re proud to be the best dentist Boiling Springs and the Upstate have to offer. Our comprehensive family dentistry services are designed with you in mind.

Ready to schedule your child’s first dental visit or concerned about teething symptoms? Contact iGrin Dental today. We are here to ensure that your child’s journey to a healthy, beautiful smile starts off on the right track.

References

1. Jhunjhunwala Garima, Vijay Prakash Mathur, Nitesh Tewari, et al, “Global prevalence of teething problems in infants and children-A systematic review and meta-analysis,” International Journal of Pediatric Dentistry, September 2024, https://pubmed.ncbi.nlm.nih.gov/39344021/.

2. Cindy Gellner, MD, “The Basics: What to Expect When Your Baby Starts Teething,” Healthy Kids Zone, University of Utah, September 2025, https://healthcare.utah.edu/the-scope/kids-zone/all/2025/09/basics-what-expect-when-your-baby-starts-teething.

3. “What is a fever?” Boston Children’s Hospital, retrieved on November 2, 2025, from: https://www.childrenshospital.org/conditions/fever.

4. Suzanne D. Baker, DDS, MPH; Jessica Y. Lee, DDS, MPH, PhD; and Robin Wright, MS, PhD, “The Importance of the Age One Dental Visit,” Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry, January 2019, https://www.aapd.org/globalassets/media/policy-center/year1visit.pdf.

 

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