Quick Answer: Teething (daant aana) typically starts between 4-7 months, with the bottom front teeth appearing first. Common signs include excessive drooling, gum rubbing, irritability, and mild fever (under 100.4°F). Safe remedies include chilled teethers, gum massage, and teething toys. Avoid teething gels with benzocaine and amber necklaces. If fever exceeds 101°F or baby has diarrhea, it’s likely NOT teething - see your pediatrician!
⚠️ In a baby under 3 months, ANY fever of 100.4°F (38°C) or higher is a medical emergency — see a doctor the same day, even at night. Do not give paracetamol and wait. This applies even after a vaccine. Teething does not cause fever at this age.
When Does Teething Start?
Most babies begin teething between 4 and 7 months of age, but every baby is different! Some babies are born with teeth, while others don’t get their first tooth until after their first birthday.
Teething Timeline
| Age | Teeth | Common Names |
|---|---|---|
| 6-10 months | Bottom front 2 teeth | Lower central incisors |
| 8-12 months | Top front 2 teeth | Upper central incisors |
| 9-13 months | Top side teeth | Upper lateral incisors |
| 10-16 months | Bottom side teeth | Lower lateral incisors |
| 13-19 months | First molars | Back teeth |
| 16-23 months | Canines | Pointed teeth |
| 23-33 months | Second molars | Back molars |
Reassurance: If your baby’s teeth come in a different order or timing, that’s usually perfectly normal! By age 3, most children have all 20 baby teeth.
Signs and Symptoms of Teething
Common Teething Symptoms
| Symptom | What You’ll See |
|---|---|
| Excessive drooling | Soaking through bibs, drool rash on chin |
| Gum rubbing/biting | Baby puts everything in mouth |
| Swollen, tender gums | Red or puffy gums where tooth is coming |
| Irritability | Fussier than usual, especially evenings |
| Sleep disturbances | Waking more at night |
| Ear pulling | Referred pain from gums |
| Decreased appetite | Discomfort while feeding |
| Low-grade fever | Up to 100.4°F (38°C) - NOT high fever |
What is NOT Caused by Teething
Many parents attribute these symptoms to teething, but they’re usually caused by something else:
- ❌ High fever (above 101°F)
- ❌ Diarrhea or loose stools
- ❌ Vomiting
- ❌ Severe rash
- ❌ Cough or congestion
- ❌ Loss of appetite for more than a few days
Important: If your baby has these symptoms, see a doctor. Don’t assume it’s “just teething”!
Safe Teething Remedies
Recommended Relief Methods
| Method | How to Use | Why It Helps |
|---|---|---|
| Chilled teether | Refrigerate (not freeze), give to baby | Cold numbs gums |
| Clean, wet washcloth | Chill and let baby chew | Texture soothes gums |
| Gum massage | Rub gums with clean finger | Pressure relieves pain |
| Teething toys | BPA-free, solid toys | Chewing provides relief |
| Cold spoon | Chill a metal spoon; parent-held only, do not let baby chew it unsupervised | Cold soothes inflammation |
| Chilled fruits | In mesh feeder (6+ months) | Safe way to get cold on gums |
For Severe Discomfort
If baby is very uncomfortable:
- Infant paracetamol (Calpol) - Follow the weight-based dose your pediatrician gives you
- Infant ibuprofen - For babies 6+ months only. Do not give ibuprofen if your baby is dehydrated, vomiting, or has a suspected dengue or viral fever — use paracetamol and see a doctor.
Note: Always consult your pediatrician before giving any medication.
What to AVOID
Dangerous Teething Products
| Product | Why It’s Dangerous |
|---|---|
| OTC teething gels with benzocaine | Can cause a serious blood disorder (methemoglobinemia) |
| OTC anaesthetic teething gels (lidocaine or choline-salicylate) — sold over the counter at Indian chemists | The same FDA/WHO caution applies to all OTC anaesthetic teething gels, not only benzocaine. Lidocaine can be absorbed and cause harm; choline-salicylate is a salicylate (aspirin-family) and is not advised for babies. Do not use without a doctor’s advice |
| Homeopathic teething tablets | FDA warnings about inconsistent ingredients |
| Honey or jaggery rubbed on gums | Honey can cause infant botulism in babies under 1 year — give nothing on the gums by mouth except what your pediatrician advises |
| Amber teething necklaces | Choking and strangulation hazard |
| Frozen teethers | Too hard, can hurt gums |
| Teething biscuits | Choking risk, sugar content |
Also Avoid
- Rubbing alcohol, whiskey or any spirit on gums
- Honey or jaggery on the gums (botulism risk under 1 year)
- Traditional gum-rubbing remedies and applying kajal — widely used but with no proven benefit; discuss with your pediatrician before using anything
- Aspirin or adult pain medications
- Tying anything around baby’s neck (amber/black-thread necklaces included)
- Leaving baby unsupervised with teethers
Caring for New Teeth
Start Cleaning Early
| Age | What to Use | How Often |
|---|---|---|
| Before teeth | Damp cloth on gums | After feeds |
| First tooth (~6 months) | Soft baby toothbrush + a smear/rice-grain (about 0.125 g) of fluoride toothpaste (1000 ppm) | Twice daily |
| 3+ years | Pea-sized fluoride toothpaste | Twice daily |
Note on fluoride: Current AAP/ADA/AAPD guidance — and the Indian Society of Pedodontics/IAP — recommend starting a smear/rice-grain amount of fluoride toothpaste from the first tooth (around 6 months), not at 12 months. Starting earlier helps prevent early-childhood tooth decay. Wipe away excess and supervise brushing.
Preventing Baby Bottle Tooth Decay
- Don’t put baby to bed with bottle
- No juice in bottles
- Wean from bottle by 12-14 months
- No sharing spoons (to prevent bacteria transfer)
When to See a Doctor
Call Your Pediatrician If:
- Fever above 101°F (38.3°C)
- Diarrhea lasting more than a day
- Rash on body (not just drool rash)
- Baby refusing all feeds
- Excessive crying that won’t stop
- Bleeding gums
- No teeth by 15 months
Get Same-Day / Emergency Care If:
These are not teething and need urgent review — go to the nearest hospital or call 112 (national emergency) or 108 (ambulance) if your baby has:
- A persistent high fever, or any fever of 100.4°F (38°C) or higher in a baby under 3 months
- Unusual drowsiness, floppiness, or is difficult to wake
- Refusing all feeds with fewer wet nappies than usual (signs of dehydration)
- A fit/seizure, or becomes pale, grey or blue
- Difficulty or noisy breathing
Teething and Sleep
Teething can disrupt sleep, but there are ways to help:
Tips for Better Sleep During Teething
- Offer teether before bed - Relieves pressure before sleep
- Pain relief at bedtime - If needed, give paracetamol
- Extra comfort - More cuddles and soothing
- Cool washcloth - Let baby chew before putting down
- Maintain routine - Keep bedtime routine consistent
Reassurance: Sleep disruptions from teething are temporary. Usually just a few nights per tooth.
Teething Myths Debunked
| Myth | Truth |
|---|---|
| “Teething causes high fever” | Teething only causes low-grade fever (under 100.4°F) |
| “Teething causes diarrhea” | No scientific link - likely coincides with putting things in mouth |
| “Amber necklaces relieve teething” | No evidence, and they’re a safety hazard |
| “Rubbing whiskey on gums helps” | Dangerous! Alcohol is harmful to babies |
| “Drooling means teeth are coming immediately” | Babies drool for months before teeth appear |
Frequently Asked Questions
Q: My baby is 4 months old and drooling a lot. Is teething starting?
A: Possibly, but increased drooling around 3-4 months is also normal development as salivary glands mature. Teeth may not appear for several more months.
Q: Can teething cause ear infections?
A: No, but the pain from teething can cause ear pulling, making parents think it’s an ear infection. If baby has fever or seems very unwell, check for infection.
Q: My baby has no teeth at 10 months. Should I worry?
A: Usually not! Isolated late teething (up to 15 months) is usually benign and runs in families. If there are still no teeth by 15 months, consult your pediatrician or dentist.
Q: Is it normal for baby to get teeth out of order?
A: Yes! While there’s a typical pattern, many babies get teeth in different orders. This doesn’t indicate any problem.
Q: How can I tell if my baby is teething or sick?
A: Teething: Low fever (under 100.4°F), localized to gums, baby can still be consoled. Sick: Higher fever, other symptoms like cough/vomiting/diarrhea, generally unwell.
Key Takeaways
- Teething starts around 4-7 months - but timing varies widely
- Drooling, fussiness, and gum swelling are normal teething signs
- High fever and diarrhea are NOT from teething - see a doctor
- Use safe remedies - chilled teethers, gum massage, infant paracetamol if needed
- Avoid dangerous products - teething gels with benzocaine, amber necklaces
- Start dental care early - clean gums before teeth, brush from first tooth
- Sleep disruption is temporary - usually a few nights per tooth
This article was reviewed by Babynama Pediatricians. Last updated: January 2026
Need personalized guidance? Book a consultation with our pediatricians or explore our Care Plans for 24/7 expert support!
This article is general information for Indian parents, not a substitute for examination by your pediatrician. In an emergency, call 112 or 108.
Have a question about your little one?
Join our free community for live Q&A with MD pediatricians — no cost to join.
Join the free community