Teething explained

When teeth come through

Most babies get their first tooth at around six months, but there is a wide normal range. Some babies are born with a tooth, while others do not get their first until they are a year old or more — both can be perfectly normal. The bottom front teeth usually appear first, followed by the top front teeth, and the rest gradually come through over the next couple of years. By around two and a half to three years, most children have a full set of about twenty baby teeth. The exact timing varies a lot from child to child and often runs in families. If you are worried that teeth are very late, your health visitor or dentist can offer reassurance, but late teething alone is usually nothing to worry about.

Signs of teething

Teething often causes a few days of discomfort around the time each tooth comes through. Common signs include sore, red gums where the tooth is pushing up, a flushed cheek, dribbling more than usual, chewing and gnawing on fingers or toys, being more fretful, unsettled or clingy, and sometimes disturbed sleep. Some babies go off their food a little. These symptoms tend to come and go with each new tooth rather than lasting for weeks on end. It helps to know that teething causes mild, local discomfort — not serious illness. If your baby seems genuinely unwell, has a high fever, diarrhoea or other worrying symptoms, it is important not to blame teething, as these need to be checked separately.

Soothing a teething baby

There is a lot you can do to comfort a teething baby. Something firm to chew on often helps, such as a clean teething ring — some can be cooled in the fridge (not the freezer, as very hard, frozen objects can hurt the gums). For babies over six months, a cool, healthy snack to gnaw on, such as a piece of chilled soft fruit or vegetable, can soothe, under supervision. Gently rubbing the sore gum with a clean finger can help too. Wiping away dribble helps prevent a rash around the mouth. Extra cuddles and distraction go a long way. If your baby is in pain, a pharmacist can advise on suitable infant painkillers. Follow the instructions on the packet carefully and use the correct type for your baby's age.

What to avoid

Some traditional teething remedies are not recommended and can be harmful. Avoid teething gels that contain unsuitable ingredients; if you want to use a gel, ask a pharmacist for advice about a suitable, sugar-free option and use it as directed. Do not use amber teething necklaces or bracelets, as they can be a choking and strangulation risk and there is no good evidence they work. Never tie anything around a baby's neck. Avoid giving sweet foods, drinks or juices to soothe teething, as these can cause tooth decay in the new teeth. Do not use adult painkillers or anything not intended for babies. If in doubt about any product or remedy, a pharmacist, health visitor or GP can guide you towards what is safe and effective.

When it is not just teething

It is a common myth that teething causes serious illness, and this can be dangerous if it leads parents to overlook a poorly baby. Teething does not cause a high fever, diarrhoea and vomiting, a cough or cold, or a baby being generally very unwell. If your baby has these symptoms, do not assume it is teething — look for another cause and seek advice. Contact your GP or NHS 111 if your baby has a high temperature, seems unwell, is not feeding, or you are worried. Follow the usual baby red-flag advice: a baby who is very floppy, hard to wake, struggling to breathe, or has a rash that does not fade under a glass needs urgent help. Teething should never delay getting a genuinely unwell baby checked.