What are the symptoms of teething, and when does it start?
Teething usually starts with the first tooth at around six months, although some babies start earlier or later. Typical signs are sore, red gums, extra dribbling, chewing on everything, a flushed cheek, fussiness and poorer sleep, sometimes with a slightly raised temperature below 38°C. A fever of 38°C or more, diarrhoea or a baby who seems unwell is not explained by teething and needs a doctor. At Creative Arts in Dubai we see babies from the first tooth.
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At what age does teething start?
According to the NHS, most babies get their first tooth some time during the first year, and the lower front teeth usually come first, at around six months. The rest follow in a fairly predictable order over the next two years: the upper front teeth, the side front teeth, the first back teeth around the first birthday, the pointed canines around 18 months and the second back teeth around two years. By about two and a half to three years, most children have all 20 baby teeth.
These are averages, not deadlines. Some babies start at three or four months, others have no teeth at their first birthday, and both are usually normal. A few babies are even born with a tooth, which should be checked by your doctor or dentist because a loose one can be a choking risk. If no teeth have appeared by about 18 months, mention it at your child's next check-up. Our baby teeth chart shows the typical age for each tooth.
Each tooth tends to cause trouble for a few days before and as it breaks through the gum, not for months on end. Many parents notice the first teeth and the big back molars most.
Is it teething or something else?
Teething is often blamed for symptoms it does not cause. This table separates the two. If you are unsure, ask your baby's doctor.
| What you notice | Can be teething | Not teething: speak to a doctor |
|---|---|---|
| Temperature | Slightly warm, below 38°C | 38°C or higher, or any fever in a baby under three months |
| Gums | Red, swollen or tender where a tooth is coming through; sometimes a small bluish bubble over the tooth | Spreading swelling of the face, or gums with many ulcers and a sick baby |
| Mouth and face | Extra dribbling, a flushed cheek, a dribble rash on the chin | A rash on the body, or a rash that does not fade when pressed |
| Behaviour | Chewing everything, rubbing the ear on the same side, fussing and waking more for a few days | Floppy, very sleepy, inconsolable crying or a high-pitched cry |
| Feeding and nappies | Gnawing during feeds or briefly wanting less | Refusing feeds, fewer wet nappies, diarrhoea or vomiting |
| Breathing | Not affected | Fast or difficult breathing, or a persistent cough |
Teething can make an unwell baby more miserable, but it does not explain fever, diarrhoea or a sick-looking child. Blaming teeth can delay treatment for an infection. If your baby seems seriously unwell, seek urgent medical care.
What helps a teething baby?
Simple measures work for most babies, and you may need to try a few to find what your baby likes:
- Something safe to chew. The NHS suggests a teething ring, which can be cooled in the fridge first. Never put it in the freezer, because a frozen ring can hurt the gums, and never tie one around your baby's neck.
- A clean finger. Gently rubbing the sore gum with a clean finger soothes many babies.
- Soft foods for babies already weaning. From around six months, soft fruit such as melon can soothe the gums. Stay close while your baby eats, and avoid hard pieces that could break off.
- Wipe away dribble. Gently patting the chin dry through the day helps prevent a dribble rash.
- Comfort and routine. Cuddles, distraction and keeping bedtime routines steady often help more than any product.
- Pain relief only if needed. If your baby is still very unsettled, ask a pharmacist or your doctor about a sugar-free medicine suitable for your baby's age, and follow the label exactly. Children under 16 should not be given aspirin.
Which teething products should you avoid?
Some of the most popular teething remedies carry real risks or have no evidence behind them.
Amber and teething necklaces
Necklaces, bracelets and anklets sold for teething can strangle a baby or break into beads that are choked on. The US Food and Drug Administration warned parents not to use teething jewellery in 2018. There is no evidence that amber eases teething pain.
Numbing gels with benzocaine
In 2018 the FDA warned against over-the-counter benzocaine teething products for children under two, because of a rare but serious blood reaction. The NHS notes a lack of evidence that teething gels work, and that general oral pain gels are not suitable for children.
Homeopathic teething tablets
The FDA has also warned against homeopathic teething tablets and gels. If you are considering any teething product, ask a pharmacist first.
Frozen or hard objects
Frozen rings, ice and hard rusks can hurt the gums or break into choking-sized pieces. Rusks and biscuits sold for teething often contain sugar.
Honey on a dummy or gums
Honey should never be given to babies under one year old because of the risk of infant botulism, and any sweetener on a dummy feeds decay as teeth arrive.
Teething does not cause high fever
A temperature of 38°C or more, diarrhoea, vomiting, a rash on the body, breathing difficulty, refusing feeds or a baby who is floppy or very sleepy should be checked by a doctor, whatever the gums look like. For any fever in a baby under three months, or a baby who seems seriously unwell, seek urgent medical help.
How should you care for new baby teeth?
Teething is also the moment to start cleaning teeth. As soon as the first tooth appears, brush it twice a day with a soft baby toothbrush and a smear of fluoride toothpaste, the amount the NHS recommends for children under three; a thin film about the size of a grain of rice is enough. Brushing last thing at night matters most. Our guide to kids' toothpaste and brushing explains how the amount and technique change as your child grows.
Sore gums often lead to more night feeds and a bottle or feed to fall asleep. Comfort is important, but milk or juice left on the teeth overnight is the main cause of early decay in young children. Once teeth are through, try to finish feeds before your baby falls asleep and offer only water at night. Our page on baby bottle tooth decay explains the early signs.
Plan your baby's first dental visit by the first birthday, or within six months of the first tooth. It is short and mostly for you: how to clean small teeth, feeding and dummy habits, and what to expect next. See your baby's first dental visit for what happens.
What to expect as each group of baby teeth arrives
Typical ages from the NHS; your baby may be earlier or later.
| Teeth | Usual age | What parents often notice |
|---|---|---|
| Lower then upper front teeth | Around 6 months | The first rush of dribbling, chewing and unsettled nights |
| Side front teeth | Around 8 months | Often milder, as your baby is more used to teeth arriving |
| First back teeth (first molars) | Around 12 months | Larger teeth with wider gum swelling; chewing at the back of the mouth |
| Canines (pointed teeth) | Around 18 months | Can be uncomfortable; some toddlers rub their ears or cheeks |
| Second back teeth (second molars) | Around 24 months | The last baby teeth; toddlers can now tell you where it hurts |
If your toddler has toothache that lasts, a swollen gum around one tooth, or pain that wakes them, it may not be teething; see our page on toothache in children.
When should a dentist look at teething?
Most teething never needs a dentist. A check is worthwhile if a tooth appears discoloured or chipped, a gum swelling stays for weeks, teeth come through in an unusual position, a tooth has not appeared long after its partner on the other side, or no teeth have arrived by about 18 months. Bring your questions to the first visit as well; many parents ask about dummies, thumb sucking and night feeds.
At Creative Arts in Dubai, Dr. Duaa Ameen and Dr. Julia see babies and young children for short, calm visits that focus on prevention and advice for parents. We do not treat fever or illness; those belong with your baby's doctor.
First tooth through? Book a calm first visit for your baby and get practical advice on cleaning, feeding and habits from our children's dentistry team in Dubai.
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