Complete Baby Teething Guide: Drooling, Fever, and Pain Relief

Your baby is suddenly drooling more and putting everything in their mouth. They're waking at night and fussy... Is teething starting? Drooling is very common during teething, and some babies sleep less soundly.

What is Teething?

Teething is the discomfort babies experience when their baby teeth push through the gums. The gums become swollen and itchy before teeth emerge, making babies uncomfortable.

Eruption Order and Timeline

Babies get 20 baby teeth in total. Most start with the bottom front teeth, then move to the top front, the sides, the molars, and finally the canines. The full set is usually in place between about 2 and 3 years.

Order	Teeth	Age	Count
1	Lower central incisors	6-10 months	2
2	Upper central incisors	8-12 months	2
3	Upper lateral incisors	9-13 months	2
4	Lower lateral incisors	10-16 months	2
5	First molars	13-19 months	4
6	Canines	16-23 months	4
7	Second molars	23-33 months	4

Plenty of babies go out of order, top teeth first, or a molar showing up before a lateral incisor. What matters is that all 20 arrive, not the sequence they arrive in.

💡 Some babies get teeth at 4 months, others after their first birthday. Don't worry if it's late!

Is Drooling at 3-4 Months Teething?

Usually not. The salivary glands mature at around 3-4 months, which is why babies suddenly drool and start gnawing on their fists at that age. It looks exactly like a tooth is coming, but the first tooth typically arrives closer to 6 months.

So heavy drooling at 3-4 months is normally just ordinary development, not teething. Once you can feel something hard along the gum ridge, or see a pale patch under the surface, a tooth really is on its way.

Rarely, a baby is born with a tooth, or cuts one within the first month. It happens in only a few births out of several thousand. A loose natal tooth can come out and be inhaled, and it can cut the nipple during feeding, so have a pediatric dentist take a look if your baby has one.

Teething Symptoms

Common signs of teething:

• Excessive drooling - bibs get wet quickly
• Chewing on everything - fingers, toys, anything
• Swollen gums - red and sensitive to touch
• Sleep disruption - waking frequently at night
• Increased fussiness - irritable and crying
• Ear pulling - gum pain radiates to ears
• Decreased appetite - refusing breast or bottle

Not Teething Symptoms

A fever of 100.4°F or higher(38°C) or diarrhea is not caused by teething. See your pediatrician.

Why Molars Are the Hardest

First molars arrive at 13-19 months and second molars at 23-33 months. Many parents are caught off guard here, "the front teeth were never this bad." There are three reasons.

1. Four come in at once Incisors arrive two at a time. Molars push through in all four corners together, so there are simply more sore spots.

2. There is more gum to break through An incisor has a thin edge that slices the gum fairly easily. A molar has to bring its whole wide chewing surface up through the tissue, which tends to drag on for several days rather than one or two.

3. Your child can now tell you about it A toddler cutting molars is walking and talking. When it hurts they cry and protest clearly, so it feels more intense from the parent's side too.

The remedies shift a little at this age. Your child is eating table food now, so cold water from a cup, or soft chilled foods, can help. Skip hard raw pieces such as apple or carrot, which are still a choking risk at this age, and stay with your child while they eat. Gum massage still works. If your child pushes your hand away, don't force it.

💡 More night waking during molars can be teething. But this age also overlaps with separation anxiety and sleep regression, so check whether the gums actually look swollen before you settle on an explanation.

How to Help

1. Cold Items

Chilled teethers work best. Refrigerate (not freeze) and offer to soothe gum pain.

• Refrigerate 15-30 minutes (don't freeze)
• Offer a clean, cold wet washcloth
• For babies eating solids: chilled soft fruit such as melon, with you watching

2. Gum Massage

Gently rub gums with clean finger. Pressure relieves pain.

3. Things to Chew

Provide safe teethers or soft toys. Chewing itself relieves gum pressure.

4. Wipe Drool Often

Drool left on chin/neck causes drool rash. Wipe gently with soft cloth.

5. Pain Relief if Needed

For severe discomfort, infant acetaminophen can help; ask your pediatrician for a weight-based dose. A fever is not from teething, so have it checked first.

What to Avoid

• Teething gels with benzocaine or lidocaine - benzocaine can cause methemoglobinemia, a serious and sometimes fatal drop in the blood's ability to carry oxygen, and lidocaine has been linked to seizures; the FDA warns against these gels
• Homeopathic teething tablets or gels - some have contained belladonna; the FDA warns against them
• Amber necklaces - choking and strangulation hazard
• Frozen teethers - too cold can damage gums

Frequently Asked Questions (FAQ)

Q: Does teething cause fever?
A: Teething can nudge your baby's temperature up slightly, but not to a fever. A temperature of 100.4°F (38°C) or higher, or diarrhea, is not caused by teething and can signal an illness, so call your pediatrician. For mild discomfort, infant acetaminophen can help when recommended by your pediatrician.

Q: How long does teething last?
A: Teething usually causes 3-7 days of discomfort per tooth, and the pain eases once the tooth breaks through the gum. Common signs during this stretch include heavy drooling and disrupted sleep. Cold teethers and gentle gum massage can soothe the gums.

Q: My baby wakes too much at night. What can I do?
A: Teething can hurt more at night, which can disrupt sleep. Try a gentle gum massage with a clean finger before bed, or offer a teether chilled in the fridge for 15-30 minutes. Consider infant acetaminophen with your pediatrician's guidance if needed.

Q: Is a late first tooth a problem?
A: Most cases are normal; some babies get their first tooth at 4 months, while others don't until after their first birthday. The bottom front teeth typically come in around 6-10 months. If there are still no teeth by 15 months, consult a dentist, but a late start usually isn't a concern.

Track Teeth with BebeSnap

When the first tooth appears, record it with a photo:

• Log the date in growth records
• Add a note: "First tooth!"
• Look back at your parenting timeline later

References

• AAP HealthyChildren - Teething
• Mayo Clinic - Teething: Tips for soothing sore gums