9 Baby Teething Symptoms To Know

A baby's first teeth usually appear around 6 to 10 months and continue to come in until just before age 3. These chompers help your child talk and eat solid foods, says Tanny Josen, DDS, a pediatric dentist at Kid Island Dental in Long Island, New York.

Although cutting teeth is an important developmental milestone, it can be painful for babies and their caregivers. Here, experts break down the teething process from timing to teething symptoms to help you recognize the signs that your baby is about to have some new pearly whites.

Teething Symptoms in Babies and Toddlers

So, how can you tell if your baby is cutting a tooth? Teething pain is usually most severe in the days before a tooth cuts through the gums. A child's reaction to teething depends upon many factors, including their tolerance for pain, personality, and gum density, says Michael Hanna, DDS, a spokesperson for the American Academy of Pediatric Dentistry. That said, most babies and toddlers experience the following signs and symptoms of teething.

Swollen gums

Swollen gums is a common teething symptom. If your child's gums are swollen and you can feel at least one tooth-sized lump, that means teething is in progress. When a tooth is moving and about to erupt through the gumline, the surrounding tissue can become tender and inflamed, leaving your baby with swollen, sore gums.

Gently rub your baby's gums or give them something cold to chew on, like a chilled, wet washcloth. You also can use solid (not liquid filled) chilled teething rings. Keep in mind, too, that the American Academy of Pediatrics advises against using any topical medicated teething gels as some of the ingredients in these can be dangerous to babies.

Chewing, biting, and sucking

Because your child's gums are irritated, you might see them gnawing on just about anything—toys, crib rails, and even their own fists. Keep any objects they could choke on far away from their reach. Offer your baby a teething ring that they can safely gnaw on to help alleviate their discomfort.

Rubbing their gums, ears, and cheeks

Your baby might rub their gums to relieve pressure from their teething symptoms. They might also pull their ears and fidget with their cheeks—especially when their molars appear. (Note that yanking on ears can also signal an ear infection, so it's important to bring up this symptom with your pediatrician.)

Drooling

No one knows why teething babies produce so much saliva, says Dr. Hanna. However, the theory is that the increase of muscle movement in the mouth during this teething period simulates chewing, activating the salivary glands. Excess drool can also cause occasional gagging or coughing.

Drool rash or mouth rash

Continual wetness from excess drooling can cause a rash around the mouth, chin, or neck. Drool rashes are harmless, although they can feel tender and uncomfortable for babies.

To prevent a drool rash—or to help clear one up—wipe up drool whenever possible. Create a barrier on the skin by applying petroleum jelly, which can help keep moisture in and prevent drool from sitting on the skin.

Irritability and nighttime fussiness

Not surprisingly, teething makes many babies crankier and fussier than usual. "Teething babies may be edgy or hard to settle at naptime and bedtime because of throbbing gums, but it's a dull pain, so you can usually distract them during the day," says Ari Brown, MD, a pediatrician and co-author of Baby 411.

Note, however, that if your baby is grumpy all day long, appears uninterested in other activities, and is not acting like themselves, there might be another cause for their increased irritability, so it's best to contact your pediatrician.

Decreased appetite

Some kids lose their appetite and refuse to eat or drink while teething. This teething symptom should be short-lived, though.

Low-grade fever

This is characterized by a fever of less than 100.4 degrees Fahrenheit, taken rectally, and can be caused by gum inflammation. If low-grade fever is accompanied by a runny nose, a bout of diarrhea, or other strange symptoms, call your pediatrician to rule out an infection of some kind. Teething doesn't cause these symptoms, says Jill Lasky, DDS, a pediatric dentist at Lasky Pediatric Dental Group in Los Angeles.

There are four categoric elevations of a fever, with the low-grade being the lowest or mildest type. Check out the table below to see the general guidelines on what is considered a low (or high) fever.

Teething and Tooth Eruption Timeline

So when can you expect teething to start? Tooth development actually begins during pregnancy, with tooth buds forming under a fetus's gums around the second trimester of pregnancy. While all you'll see is gums, babies are born with all 20 primary or "baby" teeth below their gumline.

Eventually, the roots begin to grow, forcing the crown up. "The tooth puts pressure on the tissues above it, and they slowly begin to break down," says Dr. Hanna. "The tissue gets thinner and thinner until it breaks and the tooth pops through."

The first teeth to come in are usually the two bottom front teeth (central incisors) sometime between 6 to 10 months, followed by the four upper teeth (central and lateral incisors) sometime between 8 and 13 months. Because these are thinner with a knifelike edge, they often slide through fairly easily.

After your baby's first birthday (between 13 and 19 months), the first molars will start to arrive in the back of the mouth; then come the canines (the pointed teeth between the molars and incisors) between 16 and 23 months. Then around age 2 (between 23 and 33 months), the second molars come in, behind the first set. "Teething molars are often much more painful because they are a big, fat, broad-surfaced tooth," says Dr. Hanna. "Those are the ones where you tend to see bulging gums."

In some cases, fluid can build up, creating a bluish cyst over the unerupted molar. When the tooth breaks through and pops the cyst, your baby may wind up with a mouthful of blood, but it looks a lot worse than it is, says Dr. Hanna. "Once the sac erupts and the fluid comes out, it's over. The situation has corrected itself."

When to Visit the Pediatrician

Until fairly recently, experts widely thought that teething was responsible for practically every cough, sneeze, and cry in a baby's first years. But experts now say that if your baby has worrisome symptoms, it's best to have their pediatrician examine them to rule out something more serious. That's because the tiny open wounds in the gums that result from the teeth erupting make it more likely for the baby to catch a little bug, explains Dr. Lasky.

Contact your pediatrician if any of the following symptoms are present:

• High fever, diarrhea, or vomiting
• The gums are red or blue instead of pink (this usually indicates an eruption cyst; although most cysts are benign, it's best to have them checked)
• The gums have lesions or bumps
• Your baby is refusing to eat and drink for more than a couple of hours
• They have rashes on their body
• Your child appears ill