A new tooth can mean tender gums, extra dribble and a baby who wants to chew everything within reach. Some babies barely seem bothered; others need more comfort for a while.
Do not assume fever, diarrhoea, vomiting or a baby who seems unwell is “just teething”. Teeth can be coming through at the same time as an infection, and blaming symptoms on teething can delay care.
When do baby teeth come through?
The first tooth often appears around six to ten months, although timing varies. The lower front teeth commonly arrive first, and most children have all 20 baby teeth by about three years. A tooth chart is a rough guide, not a deadline for your baby.
Book a dental visit when the first tooth appears or by the first birthday, whichever comes first. If there are still no teeth at one year, the visit is a useful opportunity to check development. The Australian Dental Association’s baby oral-health guide explains normal variation and early checks.
What might teething look like?
- Tender or swollen gums where a tooth is appearing
- More drooling and a stronger urge to bite or chew
- Gum rubbing and mild fussiness
These signs are not proof that every unsettled spell is teething. Drooling and putting hands in the mouth also happen as babies develop. Check the whole picture: are they alert, breathing comfortably, taking their usual milk feeds and having wet nappies?
If feeding or sleep changes significantly, the pain seems severe or your baby is difficult to settle, ask a health professional to assess them rather than waiting for a tooth to appear.
When to get medical help
Call 000 if your baby has severe breathing trouble, turns blue, is unresponsive or is very difficult to wake, or has a seizure.
A baby under three months with a temperature of 38°C or higher needs urgent medical assessment at a hospital emergency department. At any age, seek prompt medical advice for fever with an unwell baby, persistent vomiting or diarrhoea, much less feeding, fewer wet nappies, unusual sleepiness or a worrying rash. Do not use the presence of a new tooth to explain these away.
Seek urgent dental or medical care for facial swelling, pus, a mouth injury or persistent mouth pain. If swelling interferes with breathing or swallowing, call 000. Royal Children’s Hospital fever guidance and Healthdirect’s dental infection advice explain when assessment is needed.
Simple ways to soothe sore gums
- Offer closeness. A cuddle, quiet play or a change of activity may help an unsettled baby.
- Massage gently. Wash your hands and rub the sore gum with a clean finger, without forcing your baby’s mouth open.
- Try something cool. Offer an age-appropriate teething ring cooled in the fridge, or a clean, cool damp washcloth, while closely supervising.
- Keep it safe. Check the teether for damage and follow its cleaning instructions. Avoid loose parts, liquid-filled toys and anything tied around the neck.
Do not freeze teething rings or put ice directly on the gums. Cold and hard are not the same thing: a chilled, suitable teether is a better option than a rock-hard frozen object. Pregnancy, Birth and Baby recommends gentle gum rubbing and cooled, rather than frozen, teethers.
If your baby is already eating solids, offer familiar soft foods suited to their feeding skills. Teething is not a reason to start solids early. Do not give chunks of raw apple or other hard foods to bite on as a remedy; pieces can break off and cause choking. Keep your baby upright and supervised for food.
Remedies to avoid
Avoid amber necklaces and teething jewellery. Beads can become choking hazards and necklaces can strangle a child. There is no need to wear a necklace to soothe gums. The ACCC warning explains the risks.
Do not use numbing mouth gels or teething gels as a routine remedy. Products can be swallowed, and anaesthetic gels can numb the throat and make swallowing unsafe. Avoid teething tablets, including homeopathic products, unless your baby’s doctor specifically recommends a suitable product. “Natural” on a label is not a safety check.
Do not rub alcohol on gums or give aspirin to a baby. Avoid sweetening dummies with honey, sugar or jam. Honey must not be given under 12 months because of the risk of infant botulism. Sydney Children’s Hospitals Network describes unsafe teething remedies.
What if your baby still seems sore?
Ask a pharmacist or doctor whether pain relief is appropriate for your baby’s age, weight and health, and how to use the exact product safely. Do not combine products or use an adult preparation on your own. If discomfort persists or keeps returning, have your baby checked instead of repeatedly treating presumed teething.
Continue usual breastmilk or formula feeds. Seek help if pain is interfering with drinking; fluids and comfort matter more than trying to get extra solid food into a sore mouth.
Start caring for each new tooth
Begin gentle brushing twice a day as soon as a tooth appears. You do not need to wait until it is fully through or until there are several teeth. For the routine and Australian toothpaste guidance, see how to brush baby teeth.