Teething 101 for Parents: Normal Signs, Red Flags, and Gentle Support

Teething is one of the most universal developmental stages in infancy, yet it remains a source of uncertainty and worry for many parents. Nearly all babies will experience some degree of discomfort as their first teeth erupt, typically beginning between 4 and 7 months of age. Much of this process is entirely normal, and understanding what to expect can help parents support their baby with confidence.

What’s Normal During Teething

As teeth start moving upward through the gums, babies often show predictable signs of irritation. Increased drooling is one of the earliest markers. You may also notice your baby chewing on their hands or toys more frequently, as counterpressure on the gums can be soothing. Mild fussiness, changes in sleep patterns, and a slight decrease in appetite are common and usually temporary. Some parents feel small bumps on the gums or notice that the gum tissue looks slightly swollen or firmer than usual.

Low-grade temperature elevation can occur, but true fever—defined as a temperature of 100.4°F (38°C) or higher—is not caused by teething. Multiple studies have confirmed that teething does not cause high fevers, diarrhea, vomiting, persistent congestion, or rashes outside of mild skin irritation from drooling. When symptoms like these arise, it is important to evaluate for an unrelated illness rather than attributing everything to teething.

What’s Not Normal

Teething should never cause significant systemic symptoms or make a baby appear truly ill. Red flags include sustained fever, difficulty breathing, poor feeding that lasts beyond a day, vomiting, diarrhea, rash over the whole body, or signs of dehydration such as fewer wet diapers. These warrant medical guidance. Additionally, if erupting teeth appear bluish or blood-filled under the gums, this is often a benign “eruption cyst,” but parents should still check in with a pediatrician to ensure no intervention is needed.

Safe & Effective Ways to Manage Discomfort

There are several well-established strategies that help ease the discomfort of teething and support infants through this normal developmental phase. Cold is one of the most effective. Parents can offer a chilled (not frozen solid) teething ring or a washcloth cooled in the refrigerator. The cool temperature helps numb the irritated gums and reduce inflammation. Firm rubber teething toys can also provide soothing counterpressure.

For babies who are newly eating solid foods, chilled purées or soft cold foods such as applesauce or yogurt can offer additional relief. Gentle gum massage using a clean finger for 1–2 minutes at a time can be remarkably calming, particularly before naps and bedtime. If your baby is drooling heavily, apply a barrier ointment such as petroleum jelly or a gentle emollient to protect the chin and cheeks from irritation.

Medication can be used when discomfort is more pronounced. Acetaminophen is safe for infants over 2 months, and ibuprofen can be used for babies older than 6 months. Dosing should always be based on weight, and parents should avoid older medicated teething gels containing benzocaine or lidocaine, as these products can be unsafe for infants. Modern Orajel products have been reformulated to contain alternative, safer ingredients like chamomile and calcium phosphate.

Homeopathic teething tablets and amber teething necklaces are often not recommended due to safety concerns and lack of evidence, although most homeopathic products are generally safe due to the dilutional nature of the products. If you elect to use them, try to ensure you are purchasing from a reputable source.

When Teething Might Affect Sleep

It is common for babies to wake more frequently during periods of active teething, but prolonged sleep disruption should prompt a broader review of sleep routines rather than assuming teething is the only cause. Offering comfort briefly, using cold teething tools before bedtime, and maintaining consistent sleep practices will usually help your infant settle back into their normal rhythm.

Integrative Pearls for Teething Support

A few gentle, holistic practices can complement traditional approaches. Chamomile is widely used in integrative pediatrics for its calming and anti-inflammatory properties. Parents can offer 1–2 teaspoons of weak, cooled chamomile tea to babies over 6 months or use chamomile-based topical balms sparingly along the jawline (never inside the mouth). Some families find benefit from infant-safe herbal gum rubs containing chamomile or calendula; choose reputable brands formulated specifically for babies.

For those familiar with acupressure, light pressure along the cheeks near the base of the ears or gentle circular massage along the jawline can help relax the muscles surrounding the gums. Another integrative approach is to use a warm bath in the evening on difficult days, which can decrease whole-body tension and improve sleep.

While teething can feel stressful in the moment, it is a natural, healthy sign of development. With a clear understanding of what to expect and a toolkit of safe and soothing measures, parents can help their babies navigate this stage with greater comfort and ease.