Teething has a reputation for causing almost any odd symptom that shows up around those months — high fever, diarrhea, colds. The reality is narrower: teeth do hurt and cause discomfort, but most of those other symptoms have a different cause that's worth not overlooking.
When it starts
The first tooth usually appears between 4 and 7 months, though the normal range is much wider: some babies start at 3 months, others not until after their first birthday. The most common order is bottom central incisors first, then the top ones, moving backward from there — but every baby has their own pace, and it's not a sign of anything if the order is different.
Real symptoms
- Excessive drooling — one of the clearest, earliest signs.
- Wanting to chew on everything — the pressure eases gum discomfort.
- Swollen or reddened gums, sometimes with a small white bump visible where the tooth is about to break through.
- Irritability and crying with no clear cause, often in spells.
- More broken-up sleep than usual for a few days.
- May eat a bit less due to discomfort while sucking or chewing.
What's NOT teething
It's common to blame teeth for symptoms that actually have a different origin. Available evidence indicates teething does not cause:
- High fever (100.4°F/38°C or more) — at most, a slight rise.
- Diarrhea or vomiting.
- Cough, heavy congestion, or rashes on the body (beyond some irritation around the mouth from constant drooling).
If any of these show up, look for another cause instead of waiting for it to pass "because of the teeth."
How to bring relief
- Cold teething rings — from the fridge, not the freezer (too cold can hurt the gum).
- Gentle gum massage with a clean finger.
- Acetaminophen, if the pain warrants it and at the dose the pediatrician recommends based on weight.
- Skip benzocaine gels — not recommended for babies due to the risk of rare but serious side effects.
- Patience with sleep — keep the usual routine, even if there's an extra wake-up or two for a few days.
Sleep log — a real screen from the Alfonso app.
Log it and confirm it's really the tooth
Create your baby's profile in 30 seconds, no account or password needed, and note sleep and symptoms — to see if the discomfort actually lines up with a tooth coming in, or whether it's worth looking for another cause. Syncs automatically with your partner.
Frequently asked questions
Does teething cause a high fever?
It shouldn't. It may raise the temperature slightly, but a real fever is almost never just from teeth.
At what age does the first tooth come in?
Between 4 and 7 months generally, with a normal range from 3 months to past a year.
What order do teeth come in?
Bottom central incisors first, then top ones, moving backward — with variation between babies.
Keep reading
ℹ️ This article is informational and doesn't replace a pediatrician's judgment. If there's a real fever, diarrhea, or other symptoms that don't fit simple teething, always check with a healthcare professional.