Teething gets blamed for almost everything that happens between 6 and 12 months. Some of the time it's right; a lot of the time it isn't. The useful thing for parents is knowing the small handful of signs that genuinely point to teething, and the longer list of symptoms that don't — because the second list is where missed illnesses hide. For the wider picture, see our complete guide to child health.
The Signs That Actually Point to Teething
Heavy drooling. Saliva production goes up around tooth eruption, and babies this age haven't yet got the hang of swallowing it efficiently. The chin, neckline of the babygro, and front of the bib stay constantly wet. Sometimes it produces a contact rash on the chin, cheeks, and the fold under the chin — that's irritation from saliva sitting on the skin, not an allergic reaction. A barrier ointment (Vaseline, Bepanthen, Sudocrem) at nappy-change times settles it.
Chewing and mouthing everything. A teething baby chews fingers, the corner of muslins, the strap of the high chair, your shoulder. Counter-pressure on the gum from chewing partly cancels the sensation of the tooth pushing through from below — it's a self-administered pain relief that genuinely works.
A visible patch on the gum. If you look inside the mouth, the gum over the erupting tooth looks slightly raised and a bit redder than the gum either side. Sometimes you can feel the hard edge of the tooth before you see it. Occasionally a small bluish or purple blister sits over the eruption site (an "eruption cyst") — looks alarming, isn't, resolves when the tooth breaks through.
A day or two of fussiness before the tooth comes through. Mildly unsettled, harder to put down, more clingy than usual. The key word is mild. It's an edge of irritability, not screaming for hours. As soon as the tooth is through the gum, the fussiness lifts.
A bit more night waking around eruption. Usually a night or two of extra waking, not weeks of disrupted sleep. If a baby's sleep has been getting steadily worse for a fortnight, that's almost certainly something else (a sleep regression, a viral illness, a developmental leap, or a routine that needs adjusting).
Rubbing the cheek or pulling at the ear on the affected side. The gum nerve supply runs into the side of the face, so discomfort can refer up the jawline. This is worth knowing because it's the symptom most often confused with ear infection. The rule of thumb: ear infection usually involves a fever and gets dramatically worse when the baby is laid flat (so they cry the moment they're put down). Teething ear-rubbing is incidental and not associated with a temperature.
The Pattern That Confirms It
The defining feature of teething isn't any one symptom — it's the timeline. Over a few days the baby gets fussier and droolier; the gum looks angry over a particular spot; a tooth appears; the fussiness lifts within a day. If you can run your finger along the gum and feel a hard edge that wasn't there last week, the case is closed.
If the symptoms don't resolve when the tooth is through, or if they were always more severe than the picture above, the problem isn't teething. It's something else, and the teething is a coincidence.
What Teething Does Not Cause
The evidence on this is now reasonably settled — controlled studies that have actually tracked daily symptoms in babies with cameras-on-gums and prospective records consistently fail to find a link between tooth eruption and any of the following:
- A temperature above 38°C. A trivial rise of a few tenths of a degree may occur in some babies right around eruption; a true fever does not. A feverish teething baby has a fever from another cause — most often a viral illness, sometimes an ear infection or UTI.
- Diarrhoea. Genuinely common parental belief; not supported by the data. Loose stools during teething are typically a coincidental viral gastroenteritis (also extremely common at this age).
- Vomiting beyond the occasional gag on saliva.
- A body rash (the local drool rash on the chin doesn't count — that's contact irritation).
- A runny nose or persistent cough.
- Inconsolable crying lasting hours. Teething produces grumpy babies, not babies in real distress.
- Reduced wet nappies. That's a sign of dehydration or illness.
The reason this matters is the timing. Tooth eruption clusters at 6–12 months, which is exactly the same window in which babies start to encounter their first respiratory viruses, ear infections, gastroenteritis, roseola, and urinary infections. They overlap constantly. "It's just teething" gets used as the catch-all explanation, and that delay sometimes costs a same-day GP appointment that would have changed things.
When to Get Them Seen
Anything from the "not teething" list above warrants assessment for another cause. In particular, get a same-day GP review if:
- Any fever in a baby under 3 months
- Fever ≥39°C in a 3–6 month old, or any fever lasting more than 5 days
- Persistent ear pulling with fever, or worsening when laid flat
- Vomiting that won't settle, green/yellow vomit, or fewer wet nappies
- A non-blanching rash (does not fade under pressure on a glass)
- Drowsiness or floppiness, or "not themselves" in a way that's beyond ill-and-tired
- Difficulty breathing, fast breathing, sucking-in around the ribs
What Helps the Real Symptoms of Teething
A teething ring chilled in the fridge (not the freezer — frozen rings are too hard and bruise the gum); cold cucumber sticks or a chilled flannel for babies who are weaning; a clean finger pressed firmly along the gum ridge; a barrier cream for drool rash; weight-appropriate paracetamol or, in babies over 3 months and over 5 kg, ibuprofen, used at night when the discomfort is genuinely interrupting sleep. Teething gels containing lidocaine or benzocaine are no longer recommended (poor evidence of benefit, real risk of overdose). Amber teething necklaces are a strangulation and aspiration hazard and should not be used.
The lasting reassurance is that teething is mild, local, and self-resolving. If what you're seeing doesn't fit that, trust the instinct that it's something else and get them seen.
Key Takeaways
The reliable signs of teething are local and short-lived: heavy drooling, chewing on anything in reach, a swollen patch of gum where the tooth is coming through, mild fussiness peaking the day or two before it erupts, a bit more night waking, and sometimes face or ear rubbing on the affected side. The pattern is the giveaway — the discomfort builds, the tooth appears, the fussiness lifts. What teething does NOT cause: temperatures above 38°C, diarrhoea, vomiting, body rashes, runny nose or cough, or inconsolable crying for hours. The trap is timing — 6–12 months is also when babies meet their first viruses and ear infections. Attributing every symptom to 'just teething' is the single most common reason a real illness gets seen too late.
