Teething babies: how to ease the distress

How will I know when my baby is teething?

Your baby may sprout her first teeth with no symptoms at all, but for most babies (and their parents), it isn’t a lot of fun at times.

If your baby’s teeth are on their way, you may notice some of these signs and symptoms of teething:

• red and swollen gums
• red, flushed cheeks or face
• heavy drooling
• gum rubbing, biting or sucking
• rubbing or pulling her ear on the same side as an erupting tooth
• disrupted sleep during naps and at night
• not feeding as well
• irritable and unsettled
  (DHSV 2010, NHS 2019, NICE 2014)

It’s possible your baby may develop a fever or diarrhoea just before a tooth breaks through (NICE 2014). But there’s no evidence that these symptoms are caused by teething (DHSV 2010, NHS 2019, NSWH 2014, VDH 2018). If you’re worried, see your doctor as it could be a virus or other illness causing the symptoms (NICE 2014, NSWH 2014).

Why does teething hurt so much?

Your baby's teeth started developing while she was in your uterus (womb), when tooth buds formed in her gums. Now her teeth are pushing through her gums. This is what's causing her gums to be painful and perhaps swollen.

Pressure on your baby's teeth from chewing may relieve her pain. Nevertheless, your baby’s gums may be particularly sensitive. This is why she may turn away from your breast or a bottle when she’s teething.

What are the best ways to soothe my baby's painful gums?

Giving your baby something cool to bite on can relieve the pressure and soothe inflamed gums. You could try these ideas:

• Rub a clean finger over your baby's sore gums to ease the pain temporarily (DHSV 2010, NICE 2014, NSWH 2014).
• Give your baby a teething ring (DHSV 2010, NHS 2016, NICE 2014, NSWH 2014). Solid, silicone-based teething rings are better than liquid-filled products, which could leak and can't be sterilised. You could try putting the teething ring in the fridge for a while before giving it to your baby so it numbs the pain. Don’t put it in the freezer, though, as this could damage your baby’s gums (ADA nd, NHS 2016, VDH 2018).
• Let your baby chew on a clean, damp face cloth that’s been chilled in the fridge (ADA nd, NSWH 2014).
• Offer her a dummy, if she uses one. Chewing on the teat may help her soothe herself (ADA nd, DHSV 2010).

Never tie or put anything around your baby's neck so she can reach them easily, because it’s a strangulation hazard. This includes teething rings, dummies, attachable teething biscuits or amber teething jewellery.

If your baby has started on solid food, you could also let her chew on a crust of bread, or chilled, soft foods, such as banana and cucumber, as long as you’re nearby (NICE 2014).

Cold fruit puree, plain yoghurt, or chilled water in a bottle or feeding cup, may also give your baby some relief from painful gums. Avoid hard foods that could break up into pieces and cause your baby to choke.

There may be times, though, when your baby will reject all of these and want nothing more than a cuddle.

Should I use teething gels or alternative remedies?

Teething gels are available at pharmacies and supermarkets, and usually contain a mild anaesthetic and an antiseptic. These work together to ease pain and prevent infection. A small amount rubbed on to the sore gum with a clean finger or cotton wool pad can numb your baby’s pain for a short time.

The effect wears off quickly, though, and often the gel is washed away immediately by your baby’s tongue and saliva anyway. There’s not much hard evidence that teething gels are effective (NICE 2014, VDH 2018), although plenty of parents say they help relieve their baby’s discomfort.

Check with your doctor or pharmacist before giving your baby teething gels or other remedies that contain an anaesthetic or aspirin (salicylic acid or salicylates) (ADA 2016). If you opt for a teething gel, buy one that’s sugar-free and specifically made for babies (NSWH 2014). Follow the instructions on the pack and don’t be tempted to apply more than the instructions advise (NHS 2016, NICE 2014).

Some parents like to use homeopathic or herbal teething granules or powders. These come in small sachets that you pour into your baby's mouth or mix with cooled, boiled water to give to your baby as a drink.

There's no evidence that these remedies work (Markman 2009, NHMRC 2015, NICE 2014), but some parents swear by them. Check that the brand you’re buying is sugar-free. Sugar causes tooth decay, so you don't want to be covering your baby's emerging teeth in sugar.

Some parents say that amber necklaces, bracelets or anklets can help soothe teething pain. The theory is that the amber releases a tiny amount of pain-relieving oil onto the skin. There’s no medical evidence to back this up, though.

Wearing any kind of jewellery is also dangerous for your baby. There’s a risk of strangling or injury if it gets caught on something (ACCC 2011), or choking if your baby swallows a bead. If she does wear an amber necklace, bracelet or anklet, don’t let her suck or chew the beads (Markman 2009).

Can I give my baby infant paracetamol or ibuprofen?

Yes, you can give your baby infant paracetamol (if she’s one month or older) or ibuprofen (if she’s three months or older) (RCHM 2018). Check the dosage information on the packet or ask your doctor or pharmacist if you’re unsure how much to give your baby.

Never give aspirin to a child under 16 years old, as it may trigger Reyes syndrome, a rare but potentially fatal illness (NHS 2016).

It's worth checking whether something else is upsetting your baby before giving her medication. Ear infections can easily be mistaken for teething (NICE 2014).

Teething can make your baby feel out of sorts and make her gums sore, but it doesn’t make her really ill. So if she’s unwell or has a fever, take her to the doctor.

My baby has a rash on her chin from dribbling. How should I treat it?

Gently dry the drool off your baby's chin as often as you can by patting with a soft cotton cloth (NHS 2016, VDH 2018). Be careful not to rub her chin as it may be sore.

You could also smooth a barrier cream, such as petroleum jelly, on her chin at bedtime and before you take her out and about. This may help protect her skin from further irritation (BNFC 2018).

How long will teething last?

There’s no set date when your baby's first tooth will arrive. Most babies start teething at around six months, but it can happen at any time.

Some babies are born with a tooth, whereas others have to wait until after their first birthday (NHS 2019). It’s likely, though, that your child should have all her milk teeth by the time she's three years old (ADA nd, DHSV 2010, VDH 2018).

Girls often get their teeth slightly earlier than boys (DHSV 2010). Your baby is likely to get nearly one new tooth a month between six months and 33 months of age (DHSV 2010, VDH 2018). So that’s quite a bit of time spent teething over two years!

More about teething

• Check out our photos of teething signs and symptoms.
• Use our handy teething guide to discover when your baby's teeth are likely to come in and fall out.
• Find out how to care for your baby's new teeth.
• Read BabyCenter parents' tips for soothing your baby's teething distress.