Teething Fussiness All Day: Teethers, Gum Gels or a Cold Cloth, What's Safe and Actually Helps

Your usually cheerful baby is suddenly fussy all day, drooling so much you change their shirt several times a day, chewing on hands, cloths and toys, and waking up crying more at night. One glance and the grandparents say, “Teeth are coming, for sure.”

This stage is hard on moms too. And when you look online, there are gum gels, amber necklaces and every kind of teether, and you don’t know what to trust. Let’s go through what actually helps and is safe, what doctors ask you to avoid, and when symptoms are “more than just teething.”

When do babies start teething, and which teeth come first?

Quick Answer: Most babies start teething around 6 months, but some start before 4 months and some after 12 months, and both are normal. The bottom front teeth usually come first.

The NHS gives a rough order:

Tooth	Usually around
Central front teeth (often bottom before top)	6 months
Teeth either side of the front teeth	8 months
First molars	12 months
Canines	18 months
Second molars	24 months

Most children have all their baby teeth by 2 to 3 years. If your baby turns 1 without a single tooth, don’t panic, but mention it at the next check-up.

What are the signs of teething?

Quick Answer: Red, sore gums, lots of drool, wanting to chew, fussiness, poor sleep, one flushed cheek, ear rubbing and a drool rash around the mouth. Some babies have no symptoms at all.

Symptoms listed by the NHS and AAP:

• Red, swollen, sore gums where the tooth is coming
• More drooling, leading to a red rash around the mouth and chin
• Wanting to bite and chew everything
• Fussiness, irritability, trouble sleeping
• One flushed cheek, rubbing the ear on the same side as the tooth

For drool rash, gently dab away drool often with a soft clean cloth and use an absorbent bib, changing it when wet.

Does teething really cause fever or diarrhea?

Quick Answer: There may be a slight rise in temperature below 38°C, but a true fever and diarrhea aren’t caused by teething. If your baby has these, look for another cause.

This is the most common belief we hear: “Teething gives them a temperature,” “Teething gives them loose stools.” The grandparents say it out of love and experience, but here’s what the medical sources say:

• The NHS says there may be a slightly raised temperature below 38°C, and there’s no evidence teething causes diarrhea
• The AAP says teething doesn’t cause fever or diarrhea, and doesn’t cause unusual amounts of crying

This matters because 6 to 12 months is also when babies start putting things in their mouth, meeting more people, and getting sick more often. Assuming it’s “just teeth” can mean missing an infection that needs treatment.

Safe ways to help that actually work

Quick Answer: Gently rub the gums with a clean finger, offer a firm teether with no liquid inside, or a chilled damp cloth, without freezing anything solid.

What the FDA and AAP recommend:

• Gum massage. Wash your hands well and gently rub the gums in circles with a finger or knuckle. Many babies love it
• A firm teether. Rubber or plastic with no liquid or gel inside. The FDA stresses don’t freeze it, and stay with your baby the whole time they’re chewing
• A cold cloth. Wet a clean cloth, wring it out, chill it in the fridge and let your baby chew. The AAP warns against anything frozen solid, which can hurt sore gums
• After 6 months, the AAP says cold water sips from a soft-spouted sippy cup can help
• At bedtime, a comforting warm bath, a massage and the same routine every night help. See also 4-month-old waking often

If your baby has started solids, chilled soft steamed vegetables or fruit can soothe gums too, but choose soft pieces you can squash with your fingers and always supervise. Read about safe food pieces in Baby’s first meal.

What do doctors ask you to avoid?

Quick Answer: Gels or rubs with benzocaine or lidocaine, homeopathic tablets or gels, all teething necklaces and bracelets, liquid-filled teethers, and rubbing alcohol on the gums.

Avoid	Why
Numbing gels with benzocaine	The FDA warns they can cause methemoglobinemia, where blood carries much less oxygen, which can be fatal
Rubs with lidocaine	The FDA warns of heart problems, seizures and severe brain injury, especially if too much is applied or swallowed
Homeopathic tablets or gels	The AAP advises against them, especially those containing belladonna
Teething necklaces or bracelets: amber, wood, marble, silicone	The FDA has reports of deaths and serious injuries from choking and strangulation
Liquid-filled teethers	The AAP advises against them
Alcohol on the gums	The AAP advises against it

The AAP also says most numbing gels don’t help much anyway, because drool washes them away quickly. Baby gum products sold in Thailand come in many formulas, some with numbing agents and some herbal. Always ask a pharmacist or doctor before putting anything on your baby’s gums.

For pain or fever medicine, don’t go by what you’ve heard. Ask the doctor about the right type and dose for your baby’s weight. The AAP says moderate use is considered safe, but frequent use can cause problems.

Call the doctor or go to the hospital if…

Quick Answer: A fever of 38°C or higher, diarrhea lasting more than a day, unusual crying, or any other symptom that worries you. Don’t assume it’s just teething.

Go to the hospital now if…

• Drowsy, hard to wake, refusing milk or drinking very little
• Trouble breathing or fast breathing
• Seizures
• Lips or skin turning pale, gray or bluish after a numbing gel was used on the gums (call 1669)
• So much diarrhea or vomiting that your baby pees less, has a dry mouth or cries without tears

Call the doctor if…

• Fever of 38°C or higher
• Diarrhea for more than a day
• More crying than usual that won’t settle, or ear pulling with fever
• Very swollen gums, pus, or sores in the mouth
• Your baby is 12 months and still has no teeth (bring it up at a check-up)

Once the first tooth arrives, you can start keeping it clean. Ask the doctor or dental staff at the hospital about how to brush and which toothpaste suits your baby’s age at the next visit. The big picture of the first year is in Your baby’s first year guide, and if you’re in Chiang Mai, see Pediatric hospitals and clinics in Chiang Mai.

Teething passes one tooth at a time. The nights of crying and chewing soggy cloths will one day turn into the cutest two-toothed smile in the world.