Teething: What Actually Helps (and What Doesn't)

One day your baby is fine. The next day they're drooling like a faucet, gnawing on everything in reach, and crying for reasons you can't fix. Welcome to teething. It sounds minor until you're in it, and then it dominates your household for months.

The good news: it's completely normal, it's temporary, and there are things you can do to help. The bad news: there's no way to skip it.

When It Starts and What Comes When

Most babies get their first tooth between 4 and 7 months, though some start as early as 3 months and others don't see one until after their first birthday. Teething symptoms often start a few days before the tooth actually breaks through the gum.

Teeth tend to follow a pattern, though your baby may freelance:

By age 3, most kids have all 20 primary teeth. The molars (around 13 to 19 months) tend to be the worst because they're bigger and take longer to push through.

How to Tell It's Teething

The classic signs: excessive drooling (soak-the-shirt level), chewing on everything they can get into their mouth, irritability that comes and goes, swollen or red gums where the tooth is emerging, disrupted sleep, and sometimes a mild decrease in appetite for solid foods.

Sometimes a small bluish blister (eruption cyst) appears over the incoming tooth. It looks alarming but is harmless and resolves on its own.

What teething does NOT cause. A common misconception is that teething causes fever, diarrhea, and diaper rash. Research doesn't support a strong link. A very slight temperature increase (under 100.4 degrees F) is possible, but a real fever of 100.4 or above is not teething. That's something else, and you should call your pediatrician. Babies teeth for months and also get sick during that stretch. The timing overlaps, and it's easy to blame the teeth when something else is going on.

What Works

Gum massage. Wash your hands and use a clean finger to gently rub baby's sore gums. The counter-pressure feels good to them. A damp, cool washcloth works too. Low-tech and effective.

Cold (not frozen) things. Chill a teething ring, wet washcloth, or spoon in the refrigerator. Not the freezer. Frozen items are too hard and can hurt their gums. The cold numbs the area slightly and reduces swelling. If baby is eating solids, cold applesauce or yogurt works well too.

Teething toys. Solid silicone or natural rubber. Avoid liquid-filled or gel-filled rings because they can break. Let them gnaw. That's the whole point.

Pain medication when it's bad. If your baby is really struggling, ask your pediatrician about infant acetaminophen (Tylenol) or, if baby is over 6 months, infant ibuprofen (Advil/Motrin). Follow the dosing instructions carefully. These are for the rough nights, not daily use.

What Doesn't Work (or Is Dangerous)

Benzocaine gels and sprays (like Orajel). The FDA has warned against using benzocaine products for children under 2 due to the risk of methemoglobinemia, a rare but serious condition that reduces the blood's ability to carry oxygen.

Homeopathic teething tablets. The FDA has issued warnings about some of these products containing inconsistent levels of belladonna. Skip them.

Amber teething necklaces. No scientific evidence that amber releases pain-relieving succinic acid through the skin. There is evidence that they're choking and strangulation hazards. The AAP and FDA both advise against them.

Whiskey on the gums. An old-school remedy that older relatives might suggest. Alcohol is not safe for babies in any amount. Hard pass.

Getting Through the Bad Nights

Teething pain doesn't care about bedtime. Teeth often seem to bother babies more at night when there are fewer distractions.

If you've got a system with your partner for night duty, stick with it. When teething is at its worst, consider running defense: you handle the wakeups, do the gum rubbing, give the Tylenol if your pediatrician okayed it, and let your partner get a stretch of uninterrupted sleep. Swap the next night.

The worst of it usually lasts 3 to 5 days per tooth. The gum heals, things calm down, and then the next one starts. You'll get breaks between rounds.

Start Brushing Right Away

Once that first tooth appears, start cleaning it. Use a soft infant toothbrush with a rice-grain-sized smear of fluoride toothpaste. Yes, fluoride. The AAP and American Academy of Pediatric Dentistry both recommend a small amount of fluoride toothpaste starting with the first tooth. Brush twice a day.

Schedule a first dental visit by age 1 or within 6 months of the first tooth appearing, whichever comes first.

The Bottom Line

Teething starts around 4 to 7 months and continues until roughly age 3. Cold things, gum massage, and the occasional dose of infant Tylenol are your main tools. Skip the gels, necklaces, and old wives' tales. When your baby cuts a new tooth after a rough few days, that tiny white speck cost everyone a lot of sleep. But you got through it.

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