If your baby is teething, chances are they’re fussy and irritable. And you may notice that your baby feels a little warmer than usual. But can teething cause fevers?
The short answer is no. Teething does not cause true fever in infants. However, it can lead to a slightly elevated temperature (under 100.4 F) for unknown reasons.
Here, we break down the signs of teething and when you should worry about a fever.
When Do Babies Start Teething?
Babies typically start teething between three and 12 months old. Teething happens when primary teeth (also known as baby teeth) push through the gums and become visible.
Babies are born with 20 primary teeth below the gum line. Some get their first tooth as early as 3 months, while others are still toothless on their first birthday. But for most babies, their first teeth start to break through the gums around 6 months.
The two bottom front teeth usually appear first, followed by the four front upper teeth. The molars (the larger teeth toward the back of the mouth) come in later. The eyeteeth (the pointy teeth in the upper jaw) appear last.
By the time your child is 3 years old, they should have a full set of 20 baby teeth, none of which should cause a fever.
Teething is a natural process that every baby goes through. Though it causes more discomfort in some babies than others, it shouldn’t cause severe or long-lasting pain.
Teething Symptoms
A tooth pushing through the gums can cause tenderness and discomfort. But babies have a range of reactions to teething. Some don’t seem bothered by a new tooth, while others are cranky for days.
Signs of teething include:
- A desire to chew on things.
- Disrupted sleeping.
- Drooling.
- Irritability and fussiness.
- Rubbing the gums or ears.
- A shift in eating patterns.
- Slightly elevated temperature (under 100.4 F).
- Tender, swollen gums.
What Is Fever in a Baby?
A fever is a baby’s reaction to infection. The fever stimulates the immune system to fight the infection. Higher temperatures in the body may also make it more difficult for germs to grow.
Doctors consider 100.4 F or higher a true fever. If a baby younger than 3 months old has a rectal temperature of 100.4 F or higher, this is serious and needs evaluation. You should call your doctor or go to the emergency room right away.
If your child is older than 3 months and has a fever of 102.2 F or higher, call your doctor. Likewise, if your child has had a fever for more than two or three days, check in with your doctor.
If your baby has a fever, your doctor may recommend baby acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). (Caveat: You should never give ibuprofen to children under 6 months old.)
However, you may not need to treat a fever. If your child eats, drinks, and plays normally, the fever is fighting the infection without causing discomfort.
When Is a Fever Cause for Concern?
If your baby is teething and has a fever, something else is likely causing the high temperature. If you blame teething for fever, crying, or other signs of illness, you may delay treatment for a real problem.
Call the doctor if your child has:
- A fever accompanied by a rash.
- A fever lasting more than three days.
- Painful urination.
- Persistent vomiting or diarrhea.
Pay attention to these symptoms:
- Dehydration signs, including reduced urination, lethargy, or lack of tears while crying.
- Refusal to drink liquids.
- A temperature of 102.2 F or higher (if they are 3 months or older).
Seek emergency care if your child has:
- A temperature of 100.4 F or higher (if they are younger than 3 months).
- Blue lips, a blue tongue, or blue nails.
- Difficulty breathing.
- Limpness or an inability to move.
- Persistent crying that doesn’t stop.
- A purple rash that looks like bruises.
- A seizure.
- Severe abdominal pain.
- A stiff neck or severe headache.
- Unresponsiveness or extreme drowsiness.
- Unusual fussiness or irritability.
Note: You are the best judge of when your child’s behavior doesn’t seem quite right. Err on the side of caution and call the doctor if you’re not sure.
Easing Your Baby’s Teething Discomfort
Not all babies suffer discomfort when teething. But if your child seems especially irritable and fussy, you can take these steps to ease teething pain.
Massage the gums
Rubbing your baby’s gums with a clean finger is often enough to relieve discomfort. You can do this as often as you like. For children over 12 months, you can rub the gums with a piece of ice wrapped in a wet cloth.
Bonus: Rubbing your baby’s gums will help prepare them for brushing their teeth and other good oral health habits.
Offer a teething device
A teething baby can get relief from chewing on a hard object. Use a teething ring, pacifier, or wet washcloth. Chilling (not freezing) these items beforehand can help soothe sore gums.
Don’t use ice, popsicles, or hard foods as teethers. They can cause frostbite or create a choking hazard.
Don’t use so-called “teething necklaces” sold online. The U.S. Food and Drug Administration (FDA) has not approved them, and they may also pose choking hazards.
Ask your doctor about pain medicine
If your baby still seems to suffer, ask your pediatrician if giving them some mild pain medicine is OK. Tylenol (or Advil if your baby is over 6 months old) may help a child with teething discomfort.
Don’t use over-the-counter teething gels. Most have benzocaine, an ingredient that can cause choking and allergic reactions in babies. Likewise, don’t rub your baby’s gums with alcohol (even if your older relatives insist that it cures teething pain).
The good news is that teething pain is temporary. For most children, it passes in a few days.