Your baby is drooling, chewing on everything, and suddenly waking up at night after weeks of decent sleep. It is easy to blame teething, and sometimes that is exactly what is going on. But teething also gets blamed for a lot of things it does not cause.

This guide covers the common signs of teething, how it can affect sleep, safe ways to comfort your baby, the remedies to avoid, and the symptoms that point to something else entirely.

When Does Teething Start?

Most babies get their first tooth somewhere around 6 months of age, though the timing varies widely. Some babies start earlier, and some do not cut a tooth until after their first birthday. Both are usually normal.

The bottom front teeth typically come in first, followed by the top front teeth. Molars tend to arrive later, often in the second year, and many parents find those more uncomfortable for their child. By around age 3, most children have all 20 baby teeth.

Common Signs of Teething

Teething symptoms tend to be mild and show up in the few days around when a tooth breaks through the gum. Common signs include:

  • Extra drooling, sometimes with a mild rash on the chin or cheeks
  • Chewing or gnawing on hands, toys, and anything within reach
  • Swollen or tender gums, sometimes with a visible bump where the tooth is coming in
  • Irritability or fussiness, especially in the days right before a tooth appears
  • Mild changes in eating, such as pulling off the breast or bottle
  • A slightly raised temperature in some babies, but not a true fever

Keep in mind that babies between 4 and 12 months also drool and put things in their mouths as a normal part of development. Drooling alone does not mean a tooth is on the way.

How Teething Affects Sleep

Discomfort can make it harder for a baby to settle or to fall back asleep between sleep cycles. You might notice:

  • More night wakings than usual
  • Shorter naps
  • Extra fussiness at bedtime
  • Wanting more comfort or feeding at night

The good news is that the disruption usually lasts only a few days around each tooth, not weeks at a time. If your baby's sleep has been off for weeks with no tooth in sight, it is worth looking for other causes, like a sleep regression, a nap transition, or a schedule that no longer fits.

Safe Ways to Comfort a Teething Baby

During the day

  • Gum massage. With a clean finger, gently rub your baby's gums for a minute or two. The pressure often brings relief.
  • Chilled (not frozen) teething rings. Solid rubber teethers or rings chilled in the refrigerator can soothe sore gums. Avoid frozen ones, which can be too hard and cold for delicate gums, and avoid liquid-filled teethers that can leak or break.
  • A cool, damp washcloth. Many babies love chewing on a clean, chilled washcloth.
  • Cold foods for older babies. If your baby is already eating solids, chilled purees or yogurt can help. Always supervise closely and avoid hard foods that could be a choking hazard.
  • Wipe away drool. Gently patting the chin dry throughout the day helps prevent drool rash.

At bedtime and overnight

  • Offer relief before bed. A gum massage or a few minutes with a chilled teether before starting the bedtime routine can take the edge off.
  • Keep the routine steady. A predictable bedtime routine gives your baby a sense of security even when they are uncomfortable.
  • Comfort, but keep it calm. It is completely fine to respond more during a rough teething stretch. Keep the lights low and interactions quiet so night stays night.
  • Remove teethers from the crib. Teething toys, necklaces, and anything else should be taken out before your baby sleeps. The crib should stay empty: baby on their back, on a firm, flat surface, with no loose items. Our safe sleep guide covers the details.
  • Try not to start new habits you do not want to keep. Extra comfort for a few nights is fine. Just be aware that teething nights end, and you can gently return to your usual approach once your baby feels better.

Pain relievers

If your baby seems truly miserable, ask your pediatrician whether an over-the-counter pain reliever is appropriate and what dose to use for your baby's age and weight. Do not give any medication without checking first, especially for babies under 6 months.

Teething Remedies to Avoid

Some popular teething products carry real risks. Both the U.S. Food and Drug Administration (FDA) and the American Academy of Pediatrics (AAP) advise against the following:

  • Teething gels and creams with benzocaine or lidocaine. The FDA warns against using these for teething in young children. Benzocaine has been linked to a rare but serious condition that reduces the amount of oxygen in the blood. The gels also wash away quickly and offer little benefit.
  • Amber teething necklaces and bracelets. There is no reliable evidence that they relieve pain, and jewelry of any kind poses strangulation and choking risks. The FDA and AAP both recommend against them.
  • Homeopathic teething tablets. The FDA has warned parents not to use them.
  • Frozen or hard objects that could injure gums, and any small item that could be a choking hazard.
  • Rubbing alcohol or home remedies on the gums.

When It Is Probably Not Teething

Teething is common, which makes it an easy explanation for any fussiness. But teething does not cause serious illness. According to the AAP, teething does not cause high fevers, diarrhea, or a runny nose. If your baby has symptoms like these, something else is likely going on.

Call your pediatrician if your baby:

  • Has a fever, especially any fever in a baby under 3 months
  • Has diarrhea, vomiting, or a rash on the body
  • Is pulling at their ears along with fever or unusual fussiness
  • Is not feeding well or has fewer wet diapers than usual
  • Is unusually sleepy, hard to wake, or inconsolable
  • Seems to be in pain that lasts for more than a few days
  • Has not gotten any teeth by around 18 months

Trust your instincts. If your baby's crying sounds different, or something just seems off, it is always okay to call. Our guide to understanding baby cries can also help you tune in to what your baby might be telling you.

Other Reasons Your Baby Might Be Waking

If your baby's sleep has changed and teething does not quite fit, consider these common culprits:

  • Developmental leaps, such as learning to roll, sit, crawl, or stand
  • Schedule changes, like needing longer wake windows or dropping a nap
  • Hunger during a growth spurt
  • Illness, such as a cold or ear infection
  • Environment, such as a room that is too bright, too warm, or noisy

Keeping an Eye on Things at Night

During a rough teething stretch, many parents find a monitor helpful for telling the difference between a brief whimper and a baby who truly needs comfort. BlinkBaby uses on-device cry detection to send a notification when your baby is actually crying, so you can rest between wake-ups instead of listening for every rustle.

The Bottom Line

Teething can make sleep bumpy for a few days at a time, but it rarely causes long-term sleep problems. Offer safe comfort like gum massage and chilled teethers, keep the crib empty, skip the numbing gels and amber necklaces, and talk to your pediatrician about pain relief if needed. And if your baby has a fever, diarrhea, or seems truly unwell, remember that teething is probably not the cause. Call your pediatrician. Each tooth eventually breaks through, and the good nights come back.