How to Know If Baby Is Teething: 5 Sure Signs

If you’re a new parent, “is this teething?” becomes one of those questions you ask yourself on repeat, usually at 2am while your baby is grizzling into your shoulder. It’s a genuine milestone and most parents are keen to spot it early. But there’s a lot of guesswork involved, and a fair few myths floating around that can lead parents to reach for medicine or remedies before they’re actually needed.

Here’s a useful starting point: just because your baby is drooling at four months old does not automatically mean teething has started. Around three to four months, a baby’s salivary glands mature and start producing much more saliva. This is partly your baby’s body getting ready for solid food further down the line, not necessarily a sign that a tooth is about to appear. So drool alone isn’t proof.

What Teething Actually Means

Teething is the process where your baby’s first teeth push up through the gums and become visible in the mouth. It’s not a single event, it’s a drawn out process that can run from around six months right through to your child’s third birthday, by which point most children have their full set of 20 baby (primary) teeth.

That said, timing varies a lot from baby to baby. Some start showing signs as early as three months. A small number of babies are even born with one or two teeth already through, which is harmless but does need a quick check by your paediatrician or health visitor. Others don’t get their first tooth until closer to their first birthday, and that’s entirely normal too. There’s no need to worry unless your child has no teeth at all by around 18 months, in which case it’s worth mentioning to your doctor.

Most babies get their two bottom front teeth (the lower central incisors) first, followed by the top front teeth. After that, teeth tend to appear in pairs, working outward and backward along the gum line, though again, plenty of babies do things in their own order.

5 Signs Your Baby Is Teething

Not every baby reacts the same way, and some barely seem bothered at all. Genuinely, some babies cut a full set of teeth with hardly a grumble. But here are the signs most commonly linked with teething.

1. A Visible Bump or White Line on the Gum

This is the most reliable sign there is. Run a clean finger gently along your baby’s gum line, or have a look under a good light, and you might feel or see a firm little bump, or a pale white line where the tooth edge is close to breaking through. Once you spot this, you can be fairly confident you’re dealing with teething rather than something else.

2. Drooling and Chin Rash

Increased drooling is common once teething is properly under way, and it tends to be more constant than the general drooling of the four month stage. The extra saliva can irritate the skin around your baby’s chin, cheeks and neck, leading to a red, slightly rough patch. A thin layer of a gentle, fragrance free barrier cream can help protect the skin, and it’s worth wiping and drying the area a few times a day rather than leaving it damp.

3. Constant Chewing and Gnawing

Babies chew on everything from their own fists to the corner of a muslin cloth when a tooth is on its way. The pressure of biting down seems to ease the discomfort under the gum. This is a good cue to offer a proper teething toy rather than let them chew on something unsuitable.

4. Ear Tugging and Cheek Rubbing

Because the nerves in the jaw, ear and cheek are closely connected, some babies pull at their ear or rub their cheek and jaw on the same side as an emerging tooth. This is usually harmless. However, ear pulling combined with a fever, a smelly discharge, or the baby seeming genuinely unwell in themselves can also point to an ear infection, so if you’re at all unsure, it’s worth getting your GP or health visitor to take a look, just to rule it out.

5. Disrupted Sleep and Increased Fussiness

Gum discomfort tends to be worse when your baby is lying down, which is part of why teething often shows up as broken sleep, more night waking, and general clinginess or fussiness during the day. Some babies want to nurse or feed constantly because sucking eases the pressure. Others go off feeding altogether because sucking makes the sore gum hurt more. Both reactions are normal and usually settle once the tooth comes through.

What Teething Does Not Cause

This is worth being clear on, because it’s a common source of confusion. A well known study review by the American Academy of Pediatrics found that while mild gum irritation, drooling and a slightly raised temperature can go along with teething, teething itself does not cause high fever, diarrhoea, vomiting, or a body rash. If your baby has a temperature over 38°C (100.4°F), is unusually lethargic, has diarrhoea, or seems properly unwell, treat it as illness rather than teething and get medical advice. It’s easy to put everything down to teeth when your baby is unsettled, but it’s genuinely better not to assume, especially with younger babies.

What Actually Helps

There’s no need to overcomplicate this. A few simple, low risk things tend to work well for most babies:

• Something to chew on. Solid silicone or rubber teething rings, or a clean, chilled (not frozen solid) teething toy, give your baby something safe to bite down on.
• Gum massage. A clean finger rubbed gently over the sore gum can genuinely help, and lets you check for emerging teeth at the same time.
• Cold, not frozen. A clean, damp washcloth left in the fridge (not the freezer) for a short while makes a good, safe teething aid. Fully frozen items can be too hard and risk hurting the gums.
• Cold food, if they’re already on solids. Chilled purée, yoghurt or a cold banana can be soothing for older babies already weaning.

If your baby seems genuinely uncomfortable and these steps aren’t enough, ask your pharmacist, GP or health visitor about an appropriate dose of infant paracetamol or ibuprofen for their age and weight. Always follow the dosing instructions on the packet exactly, and check with a health professional first if your baby is under three months old or has any underlying health conditions.

What to Avoid

A few things are worth steering clear of, even though they’re widely sold:

• Teething gels with benzocaine or lidocaine. The FDA and other health bodies advise against these for infants and young children, as the local anaesthetic can be swallowed and, in rare cases, has been linked to a serious blood condition. Speak to your pharmacist before using any topical teething gel.
• Homeopathic teething tablets or gels. Some products in this category have previously been recalled after inconsistent or higher than labelled amounts of belladonna were found in them. Regulators in several countries, including the FDA, have advised against their use in babies. It’s best to give these a miss and stick to the simpler methods above.
• Amber teething necklaces or bracelets. These are popular online but pose a genuine choking and strangulation risk, and there’s no good evidence they actually relieve teething pain. Paediatricians generally advise against them.

When to Check In With Your Doctor

Teething is uncomfortable, but it shouldn’t make your baby seriously unwell. Contact your GP or health visitor if your baby has a high fever, seems unusually drowsy or floppy, is refusing feeds altogether, has diarrhoea or vomiting, or if you’re simply not sure whether something else is going on. It’s always better to get it checked than to wait it out assuming it’s “just teeth”.

Teething is a slow, sometimes messy, entirely normal part of your baby growing. It rarely goes perfectly to any chart or timeline, and every baby handles it a little differently. Keep an eye out for the real signs, keep a few simple comfort measures on hand, and trust your instincts if something feels off enough to need a doctor’s opinion.