IasoraTeething symptoms and myths: what's normal and what isn't
In short: most babies get their first tooth at around 6 months. Teething can mean drooling, red gums, chewing on everything and broken sleep. It does not cause a fever of 38 °C or more, diarrhoea or a rash on the body. If your baby is ill, don't put it down to teeth — get them checked at the clinic.
It's not teething. Take your baby to the clinic if they:
- Have a fever of 38 °C or higher (under 3 months: go now).
- Have diarrhoea, especially with a dry mouth, no tears or fewer wet nappies.
- Are vomiting, refusing feeds, or floppy and unusually sleepy.
- Are crying far more than usual and can't be settled.
- Have a rash on the body, a cough or fast breathing.
- Turn pale, grey or blue, struggle to breathe or become very drowsy after a teething gel — call an ambulance (10177, or 112 from a cellphone).
When do babies start teething?
Most babies start at around 6 months. Some start before 4 months and some after 12 months, and both are normal. A few babies are even born with a tooth.
| Teeth | Usual age |
|---|---|
| Bottom and top front teeth (central incisors) | around 6 months |
| Teeth either side (lateral incisors) | around 8 months |
| First back teeth (first molars) | around 12 months |
| Canines | around 18 months |
| Second molars | around 24 months |
Bottom teeth usually come before the top ones, and most children have all 20 milk teeth by 2 to 3 years. If your baby has no teeth by their first birthday, mention it at the next clinic visit and have it noted in the Road to Health Book — it is rarely a problem.
Normal teething symptoms
Some teeth arrive with no fuss at all. Others bring:
- Red, swollen or sore gums where the tooth is coming through.
- Lots of drool.
- Chewing and gnawing on fingers, toys, everything.
- One flushed cheek, or a dribble rash around the mouth and chin.
- Rubbing the ear on the same side.
- Being grizzly, clingy and sleeping badly.
- Feeling a little warm, but under 38 °C.
These signs usually last a few days around each tooth.
Teething myths: what teeth don't cause
"It's just her teeth" is one of the most common things parents hear — and one of the riskiest, because it can delay care for a child who is actually ill.
- High fever. Teething does not cause a fever of 38 °C or more. A fever means something else is going on, usually an infection. See fever in babies and children.
- Diarrhoea. There is no evidence that teething causes diarrhoea. Babies this age put everything in their mouths, so they pick up more germs — that, not the tooth, is the likely cause. Diarrhoea can dehydrate a baby quickly: see diarrhoea and dehydration in children.
- Rashes on the body. Drool can irritate the skin around the mouth, but a rash on the tummy, back or limbs is not from teething. See rashes in babies and children.
- Non-stop crying. Sore gums make babies grumpy, but not inconsolable for hours.
- Coughs, colds and vomiting. Also not caused by teeth.
The simple rule: if your baby is sick, don't blame the teeth. Treat it as you would at any other time.
How to soothe a teething baby safely
- Rub the gums gently with a clean finger.
- A firm teething ring. Chilling it in the fridge can help — but not the freezer, as frozen-hard rings can hurt the gums.
- A clean, damp, chilled facecloth to chew on.
- From 6 months, if your baby is eating solids: cold pieces of soft fruit such as melon or mango, always with an adult watching.
- Wipe drool off the face often to prevent a rash.
- Cuddles, play and distraction.
- If your baby is really uncomfortable, ask a pharmacist or the clinic about a sugar-free paracetamol syrup at the right dose for their age and weight. Paracetamol is suitable from 2 months and ibuprofen from 3 months, unless a health worker says otherwise.
As soon as the first tooth appears, start brushing it with a soft baby toothbrush and a smear of fluoride toothpaste.
What to avoid
Don't use:
- Amber teething necklaces, bracelets or anklets, or any teething jewellery. They are a choking and strangulation risk. Never tie anything round your baby's neck, including a teething ring.
- Numbing gels with benzocaine or lidocaine for young babies. They can cause a rare but dangerous blood reaction (methaemoglobinaemia), and drool washes them away anyway. Only use a gel if a health worker recommends a product made for babies.
- Alcohol rubbed on the gums.
- Honey before age 1, on a dummy or on the gums. It can cause infant botulism, a serious illness.
- Rusks, biscuits and sugary snacks to chew: most contain sugar and can rot new teeth.
- Homeopathic teething tablets or gels: some have caused serious side effects.
- Liquid-filled teethers: they can split and leak.
When to see a nurse or doctor
Teething itself doesn't need treatment. But see your clinic or GP if:
- Your baby has a fever of 38 °C or more. If you have recently been to a malaria area (parts of Limpopo, Mpumalanga or KwaZulu-Natal, or a neighbouring country), say so.
- They have diarrhoea lasting more than a day, or any signs of dehydration.
- They are crying more than usual, or more often, or anything seems more than mild teething discomfort.
- The gum is very swollen or has pus, or your baby stops feeding.
Not sure whether it's teeth or something else? Our guide to baby colic and crying may help — and when in doubt, get your baby checked.
Sources
- Baby teething symptoms — NHS
- Tips for helping your teething baby — NHS
- Teething: 4 to 7 Months — AAP — HealthyChildren.org
- Foods to avoid giving babies and young children — NHS
- High temperature (fever) in children — NHS
- NICD warns of malaria season — SAnews (South African Government News Agency)
- Know who you can call in an emergency — Western Cape Government
This article is general information, written by the Iasora team from the sources above. It does not replace a consultation or the judgement of a health worker who sees your child. If in doubt, go to your nearest clinic.
