When teeth arrive

The NHS puts it simply: "Most babies start teething at around 6 months, but others start teething before they are 4 months old and some after 12 months. Some babies are even born with their first teeth." The American Academy of Pediatrics gives a similar window — "babies typically start teething by about 4- to 7-months-old".

That spread of eight months or more is the single most useful fact on this page. A ten-month-old with no teeth is not behind.

The usual order

The NHS gives a rough guide:

Central incisors (front teeth) — usually first, around 6 months
Lateral incisors (either side of the front teeth) — around 8 months
First molars (back teeth) — around 12 months
Canines (between the lateral incisors and first molars) — around 18 months
Second molars — around 24 months

Bottom teeth usually appear before the matching upper ones, and most children have all their milk teeth by two to three years old. The AAP describes the same sequence: the two front teeth first, "followed by the opposite front teeth", then first molars, then canines.

What is normal

The NHS notes that baby teeth "sometimes emerge with no pain or discomfort, or only mild symptoms that last a few days". When there are symptoms, the NHS lists:

a sore, red gum where the tooth is coming through
a temperature that is slightly raised but less than 38C
one flushed cheek
a rash on the face
rubbing an ear
dribbling more than usual
gnawing and chewing on things a lot
being more fretful than usual
not sleeping very well

The AAP's list matches: "mild irritability, a slight rise in temperature (but not over 101 degrees Fahrenheit or 38.3 degrees Celsius), excessive drooling, and a desire to chew on something hard".

What teething does not cause

This is where a great deal of folklore lives. The NHS is direct: "Some people think that teething causes symptoms such as diarrhoea, but there's no evidence to support this."

Nor does teething cause a fever. Both the NHS and the AAP cap the teething temperature just under 38C. The NHS defines a high temperature in a child as 38C or more — so a reading at or above that is an illness to assess, not a tooth. Attributing a genuine fever to teething is the main way this topic causes harm.

What actually helps

Things to try first

Teething rings. They "give your baby something to chew safely". Some can be cooled in the fridge; the NHS warns "never put a teething ring in the freezer, as it could damage your baby's gums if it gets frozen", and "never tie a teething ring around your baby's neck, as it may be a choking hazard".
Gum rubbing. The AAP suggests "gently rubbing or massaging the gums with one of your fingers". The NHS says the same, with a clean finger.
Something to chew, if they are weaning. From six months, and if already on solids, the NHS suggests healthy things to chew such as raw fruit and vegetables, with soft fruit like melon to soothe gums — and "always watch when your baby is eating in case they choke". It advises avoiding rusks, because nearly all brands contain sugar.
Comfort and distraction. Playing with your baby can pull attention away from the gums, which is a smaller intervention than it sounds.
Wipe the dribble. Gently wiping the face may prevent a teething rash.

Pain relief

The NHS says a sugar-free painkilling medicine can be used if your baby is in pain: "Paracetamol can be given to relieve teething symptoms in babies and young children aged 2 months or older. Ibuprofen can be given from 3 months." Children under 16 should not have aspirin. Always follow the instructions with the medicine, and ask a GP or pharmacist if unsure.

What to avoid

The NHS states there is "a lack of evidence that teething gels are effective", and recommends trying teething rings or simple sugar-free painkillers first. The AAP goes further: "Never use teething gels to numb the gums; in rare cases they can poison babies' blood cells and keep them from carrying oxygen." It adds that "homeopathic teething tablets also provide no benefit, and in some cases they have been made with potentially harmful toxins", and that "amber teething necklaces do not do anything at all to relieve pain, and have caused cases of choking and strangulation". The NHS also says homeopathic products are not recommended for teething.

Looking after the teeth that arrive

The NHS advises brushing "as soon as their first milk tooth breaks through", with a baby toothbrush and a tiny smear of fluoride toothpaste, at least twice a day including just before bed. Register your baby with a dentist when teeth start coming through. And if your baby uses a dummy, "do not dip it in anything sweet, such as sugar or jam".

When to speak to a health visitor or doctor

The NHS's guidance is to get medical advice for any symptom that worries you — you can call 111 or contact a GP. Specifically, treat these as not-teething until proven otherwise: a temperature of 38C or more in a baby under three months, or 39C or more between three and six months; a temperature lasting five days or more; a rash; refusing feeds; or a baby who is simply not themselves. The NHS lists a stiff neck, a rash that does not fade under a glass, unusually cold hands and feet, blue, grey or blotchy skin, drowsiness, or difficulty breathing as reasons to call 999.

Teething