Teething in Babies: The Complete Nurse’s Guide to Symptoms, Myths, Relief & When to Worry

As a primary health care nurse, I see teething as one of the many concerns from worried parents.

It often starts with small changes—more drooling, unsettled sleep, or a baby suddenly refusing feeds—and quickly turns into worry.

Many parents ask me the same question in different ways:
“Is my baby teething, or is something wrong?”

That confusion is completely normal.

Here is the most important thing I want you to know right away:

Teething is a normal developmental stage. It may cause mild discomfort, but it does NOT cause high fever, severe diarrhoea, or serious illness.

Most babies start teething between 4 and 7 months, although some start earlier or later, and both are normal.

In this guide, I will help you understand exactly what teething looks like, what is NOT caused by teething, and when to worry.

What is teething in babies?

Teething in babies is the natural process where teeth push through the gums, usually starting around 6 months. It can cause drooling, chewing, mild gum swelling, irritability, and sleep changes, but it does not cause high fever or serious illness.

What is happening during teething?

Teething happens when a baby’s teeth begin moving through the gums.

It usually starts with the lower front teeth and then the upper front teeth.

In clinic, what I often reassure parents about is this: some babies show clear signs of discomfort, while others show almost none at all. Both patterns are normal and do not reflect how “painful” teething is.

What is actually happening is not severe pain, but pressure and sensitivity in the gums as the tooth moves upward.

What are the normal signs of teething?

Normal teething symptoms include increased drooling, chewing on objects, mild gum swelling, slight irritability, and temporary changes in feeding or sleep. These symptoms are usually mild and come and go.

What parents usually notice in real life

In my experience as a PHC nurse, parents rarely notice just one symptom. Instead, they describe a combination of small changes.

Babies often start drooling more than usual because saliva production increases and they have not yet developed the ability to manage it well. At the same time, they begin chewing on fingers, toys, or anything they can reach because pressure on the gums feels soothing.

You may also notice the gums look slightly red or fuller than usual. Some babies become more clingy, wanting to be held more often, especially in the evenings or at night. Sleep can become lighter, with more frequent waking, and feeding patterns may shift—some babies feed more for comfort, while others temporarily feed less because of gum sensitivity.

These changes usually come and go rather than staying constant.

What teething does NOT cause (Myth-busting)

One of the most important things I teach parents is what teething does NOT explain.

Teething is often blamed for illnesses that are actually unrelated. While mild discomfort is normal, teething does not cause high fever, severe diarrhoea, persistent vomiting, chest infections, severe rashes, or extreme lethargy.

If your baby has any of these symptoms, it is very unlikely it is teething and should be assessed.

In practice, when babies show these signs, we often find another cause such as a viral infection.

Can teething cause fever or diarrhoea?

Teething does not cause true fever or diarrhoea. A temperature above 38°C or persistent loose stools is usually caused by infection, not teething.

A slight temperature increase may sometimes occur due to gum inflammation, but this is mild and not considered a true fever.

Related reading:

Can Teething Cause Fever? What Parents Need to Know

Teething and Diarrhoea: Is It Really Caused by Teething?

Why babies become unsettled during teething

One of the most common things I hear from parents is the following:
“My baby has completely changed—it must be teething pain.”

What is actually happening is a combination of gum pressure and developmental changes. The tooth moving through the gum creates sensitivity, and babies respond the only way they know how—by seeking comfort.

This often shows up as crying, wanting to be held, increased feeding for comfort, or disturbed sleep.

Importantly, this stage is uncomfortable, but not harmful.

Teething vs illness

Teething usually causes mild irritability, drooling, chewing, and slight sleep changes without fever. Illness often includes high fever, poor feeding, vomiting, diarrhoea, or a baby who seems unusually unwell.

In clinic, I always encourage parents to look at the “whole baby” rather than a single symptom.

Teething babies are still generally alert, interactive, and responsive, even if they are a bit more unsettled.

Sick babies often look visibly different—they are quieter, less responsive, and not themselves.

Related: Teething vs Illness: How to Tell the Difference

Safe ways to help a teething baby

Most babies do not need medication for teething. Simple comfort measures are usually enough.

Chilled teething toys can help because pressure on the gums provides relief. A clean, damp, cool cloth for chewing is also soothing. Gentle gum massage with a clean finger can help reduce discomfort.

Many babies also settle with extra feeding, whether breastfeeding or bottle feeding, because sucking is comforting. And sometimes the most effective remedy is simply holding your baby more during this phase.

When It’s Not Teething: Warning Signs to Watch For

There are situations where symptoms should not be attributed to teething.

If your baby has a fever above 38°C, refuses all feeds for several hours, has persistent vomiting or diarrhoea, shows signs of dehydration such as fewer wet nappies or dry mouth, is unusually sleepy or difficult to wake, has breathing difficulties, or has a high-pitched or inconsolable cry, medical advice should be sought promptly.

Teething alone should never make a baby seriously unwell. It is important to know when to take your baby to the hospital or clinic.

How long does teething last?

Teething happens in stages over several months. Each tooth may cause mild symptoms for a few days before and after it breaks through the gum.

The process is not continuous pain but rather short episodes of mild discomfort spread over time.

Teething timeline

Teething usually begins around 6 months, starting with the lower front teeth, followed by the upper front teeth. Side teeth and molars come later, usually between 9 and 20 months.

However, I always reassure parents that timing varies widely. Some babies start as early as 3 months, while others begin closer to 12 months, and both are still normal development.

In my experience as a Primary Health Care Nurse

One of the most common misunderstandings I see in clinic is assuming that all changes at this age are caused by teething.

At the same time teething begins, babies are also

• exploring their environment
• putting objects in their mouths
• experiencing minor viral infections
• going through sleep pattern changes

This overlap is why teething often gets blamed for everything.

When we step back and look at the full picture, teething is usually only part of what is happening.

Frequently asked questions

Can teething cause high fever?

No. High fever is usually caused by infection, not teething.

Why is my baby so irritable during teething?

Gum pressure may cause temporary discomfort, which makes babies clingier and more unsettled.

Can teething affect sleep?

Yes. Mild sleep disruption is common but temporary.

Do all babies show teething symptoms?

No. Some babies show very few or no symptoms at all.

When should I worry about teething?

When symptoms go beyond mild discomfort or include red flag signs such as high fever, dehydration, or poor feeding.

If you found this post helpful, you might also like:

Baby Not Eating During Teething: What’s Normal, What’s Not, and When to Worry

Teething and Breastfeeding: Why Babies Bite, Feed Less, and Refuse the Breast

Baby Pulling Ears While Teething: What It Means and When to Worry