Teething Symptoms vs Illness: How to Tell the Difference

Every time your baby goes off their food, runs warm, or has an unsettled night, someone will say "it''s just teething" . Sometimes it is. Often it isn''t. As a Maternal Health Nurse, the most common question I get from parents of 4–18 month olds is some version of: "Is this teething, or is my baby actually sick?" Mistaking an illness for teething can delay care. Mistaking teething for an illness sends families to the GP for no reason. This guide walks through what the evidence actually says, what teething does and doesn''t cause, and the red flags that mean it''s time to stop blaming the molars. When does teething usually start? Most babies cut their first tooth between 4 and 10 months , with the bottom front two central incisors usually appearing first. A handful of babies are born with a tooth; others won''t have one until after their first birthday. Both are normal. By age 3, most children have all 20 baby teeth. Teething happens in waves , not constantly. A tooth typically causes noticeable symptoms for about 3–5 days before it erupts , then settles. Symptoms lasting weeks or months without a tooth emerging are almost certainly something else — usually a developmental leap, a sleep regression, or a virus. What teething does cause Large studies including a well-cited 2016 review in Pediatrics have looked at thousands of teething episodes. The symptoms reliably linked to teething are: Drooling — often heavy enough to soak bibs and cause a chin or chest rash from saliva. Chewing and biting everything — fingers, toys, your shoulder. Counter-pressure on the gum genuinely helps. Red, swollen gums over the spot where the tooth is about to push through. Mild irritability and grizzling , especially in the late afternoon and at bedtime. A slight rise in temperature — usually under 38°C. This is a low-grade warmth, not a true fever. Disturbed sleep for a few nights around an eruption. Reduced appetite for solids for a day or two sucking still feels fine; chewing hurts . What teething does NOT cause This is where parents are most often misled. The evidence is clear: teething does not cause any of the following , and assuming it does can delay diagnosis of something treatable. A true fever of 38°C or higher. If your baby''s temperature crosses 38°C, treat it as illness, not teething. See our Baby Fever Guide for what to do. Diarrhoea. Loose, watery, frequent stools…