The Teething Alibi: Telling Gum Trouble From Something More

Your baby is dribbling like a tap, chewing their fist and sleeping like a caffeinated squirrel. The internet says teething. Your mum says teething. The lady in the supermarket says teething. But teething has become the default explanation for every baby wobble — and that can make it easy to miss something that needs a second look.

This isn’t a scare story. Most teething is ordinary, self-limiting and manageable at home. The trick is knowing what gum trouble can plausibly explain, what it can’t, and when to pick up the phone.

A quick reality check

Teething usually begins around six months, though some babies start earlier and others later. A few sail through with barely a whimper. Others seem to feel every tooth on the way through. Both are normal.

The evidence on teething symptoms is a bit muddier than the folklore suggests. Lots of dribbling, gumming, chewing and mild fussiness are fair enough. A true fever, diarrhoea, vomiting or a genuinely unwell baby are not things to file under teething and wait out.

The useful question isn’t ‘could this be teething?’ It’s ‘is this behaviour typical for my baby, and are there any features that need checking?’

What teething can reasonably explain

Some babies get sore, swollen gums and want to gnaw everything in sight. You might notice:

• heavy dribbling and a soggy bib
• chewing fists, toys, muslins, your shoulder — anything going
• mild grumbling and clinginess
• brief sleep blips, especially around new teeth
• a drool rash on the chin, cheeks or neck
• slightly reduced interest in feeds if their mouth feels sore

A slightly raised temperature can sometimes crop up around teething, but a proper fever is a different matter. If your baby is hot to the touch and has a temperature of 38°C or higher, don’t assume it’s just a tooth. That is especially important in young babies.

What teething doesn’t explain

Teething should not be used as an alibi for a baby who is genuinely unwell. Take a closer look if you see:

• a fever, especially in a baby under three months
• vomiting or diarrhoea
• a rash that doesn’t fade when you press a glass against it
• breathing that is fast, noisy or laboured
• unusual drowsiness, floppiness or difficulty waking
• persistent crying that you can’t settle, or a baby who seems in serious pain
• poor feeding, fewer wet nappies or signs of dehydration
• a bulging or sunken soft spot, a stiff neck, or a baby who is clearly not themselves

In the UK, current NHS advice is clear: a temperature of 38°C or higher in a baby under three months needs urgent advice. For babies aged three to six months, a temperature of 39°C or higher also needs checking. If you are worried at any age, you can call 111 or your GP. If your baby has difficulty breathing, is floppy, unresponsive or has a seizure, call 999.

Soothing without the gimmicks

Start simple. A clean finger to gum, a chilled — not frozen — teething ring, and plenty of cuddles can do a lot. Keep teethers clean, check them for cracks, and avoid anything hard enough to hurt sore gums or small enough to be a choking risk.

If your baby is dribbling heavily, pat the skin dry and use a barrier cream on the chin and neck to protect against drool rash. Change soggy bibs before they irritate the skin.

For pain, paracetamol or ibuprofen can be appropriate if your baby is old enough and the dose is right for their weight. Paracetamol is generally suitable from two months, and ibuprofen from three months and over 5kg, but always follow the label and ask a pharmacist or clinician if you’re unsure. Don’t use them just because a tooth might be coming — use them if your baby seems uncomfortable.

Teething gels are not usually recommended by NHS clinicians these days. If you do decide to use one, choose a sugar-free product, check the age limits with a pharmacist and never use it more than the label says. Some ingredients are not suitable for very young babies.

Amber teething necklaces, bracelets and anklets are not recommended. The risk of choking or strangulation is real, and there is no reliable evidence that they help. The same goes for anything worn around the neck, wrist or ankle, especially during sleep. If a well-meaning relative buys one, it’s fine to smile, say thank you and quietly put it away.

Teething granules and powders are popular, but the evidence is limited. Check the ingredients and sugar content, and ask a pharmacist if you’re unsure. They should never replace a proper check if your baby seems unwell.

Health visitor or GP?

Your health visitor is a good first call for ongoing feeding worries, weight concerns, sleep struggles or a persistent drool rash. Your GP is the right port of call for a fever, vomiting, diarrhoea, unusual crying, ear pulling with other symptoms, or a baby who just isn’t right.

Keep the numbers handy — your red book is a good place — and trust your instincts. You know your baby’s normal. If something feels off, it probably deserves a conversation rather than another dose of teething gel.

The bottom line

Teething is a phase, not a diagnosis. It can explain a soggy bib, a gnawed muslin and a few broken nights. It cannot explain a genuinely unwell baby. So soothe what you can, skip the unsafe gadgets, and pick up the phone when your gut says something needs a second look.