Teething: Signs, Eruption Order, and Ways to Soothe Your Baby

Teething is one of the most talked-about stages of a baby’s first years. One morning you notice your baby is more unsettled than usual, constantly putting their hands in their mouth and drooling more. Then a small white edge appears, and the first tooth arrives. It is an exciting moment — and, for many families, the start of a tiring few months.

Parents face plenty of questions during this period: Is the fever from teeth? Is diarrhoea normal? Which products are safe? Do amber necklaces work? The answers to some of these are quite different from popular belief.

In this article, the dentists at Bilim Dental Clinic in Maltepe, Istanbul — including our paediatric dentist — explain when teeth start to come through, the order in which they appear, which symptoms are normal, how to soothe your baby safely, and when to see a doctor.

When Does Teething Start?

In most babies, the first tooth appears around six months. The normal range is wide, though: some babies get their first tooth at four months, while others have none until twelve months. Occasionally a baby is born with a tooth.

Much of this variation is genetic. Babies whose parents got teeth late often do the same. For premature babies, timing is usually judged by corrected age.

As a general rule, a baby with no teeth at all by 12–18 months should be assessed by a paediatric dentist or paediatrician. Usually nothing is wrong, but a check provides reassurance.

In What Order Do Baby Teeth Appear?

There are 20 baby teeth, and in most children all of them are in place by around two and a half to three years. The order varies, but the general pattern is:

The lower front two teeth usually come first, followed by the upper front teeth. Teeth arriving in a slightly different order is rarely a concern, and a few months early or late is still normal.

Teething Symptoms: 7 Common Signs

Every baby experiences teething differently. Some show almost no discomfort; others are unsettled for several days. The most common signs are:

1. More drooling, which can cause redness or a rash on the chin and neck
2. Chewing on everything and wanting to bite
3. Swollen, red gums, sometimes with a bluish-purple bump (an eruption cyst, which usually resolves by itself)
4. Irritability and crying, especially in the days before a tooth appears
5. Disturbed sleep
6. Reluctance to feed
7. Rubbing the ears or cheeks

Symptoms usually begin a few days before the tooth breaks through and ease soon afterwards. Discomfort is often more noticeable with canines and molars.

Is Fever or Diarrhoea Caused by Teething?

This is one of the most common misconceptions. Research shows that teething may cause a slight rise in temperature, but a true fever of 38°C or higher should not be attributed to teeth. Likewise, significant diarrhoea, vomiting, rash, or cough are not expected teething symptoms.

This period coincides with the fading of antibodies passed on from the mother and with babies putting everything in their mouths, so infections are common. Dismissing fever or diarrhoea as “just teeth” can mean an infection is missed.

See a paediatrician promptly if your baby has:

• A temperature of 38°C or higher
• Diarrhoea, vomiting, or refusal of fluids
• Fewer wet nappies, or no tears when crying
• Unusual drowsiness or difficulty waking
• Sores or blisters in the mouth
• A rash, cough, or breathing difficulty

If your baby is very drowsy, struggling to breathe, or has a seizure, go to a hospital emergency department.

Safe Ways to Soothe a Teething Baby

Massage the gums. Gently rubbing the gums with a clean finger or a damp, clean muslin is soothing.

Offer a chilled (not frozen) teether. A solid, one-piece teething ring cooled in the fridge relieves sore gums. Frozen teethers become too hard and can hurt the gums.

A cold, damp cloth. Wet a clean cloth, chill it in the fridge, and let your baby chew on it under supervision.

For babies on solids: cold yoghurt or purées can be soothing.

Wipe away drool. Keep the chin and neck dry with a soft cloth to prevent rash.

Pain relief: if your baby is very unsettled, a painkiller recommended by your paediatrician can be given at the correct dose for their weight. Always check the medicine and dose with your doctor.

Comfort and cuddles. Simple as it sounds, extra attention helps babies settle.

When Sleep Falls Apart

Sleep is often the hardest part. Babies may wake frequently or struggle to settle. Treating this as temporary, and not overhauling routines, makes it easier to return to normal afterwards.

A gentle gum massage before bed, a calm and consistent bedtime routine, and a comfortable room temperature all help. When your baby wakes, try settling them before offering a feed, so a new link between feeding and sleep is not created. If your baby is very unsettled and cannot sleep, a painkiller recommended by your paediatrician can be given before bed.

If sleep problems last for several weeks, your baby cries constantly, or feeding drops noticeably, consider that it may not be the teeth and see your paediatrician. Ear infections, for example, can also cause ear rubbing and irritability.

Molars in the Second Year

Many families notice that a baby who coped easily with the first teeth becomes much more unsettled between one and two years, when the molars arrive. Molars are broad and press on a larger area of gum. Toddlers also express discomfort more clearly — refusing food, pointing to their mouth, or wanting to chew constantly.

At this age, choose hard toys carefully to avoid choking. Chilled (not frozen) teethers, cold fruit purées, and yoghurt still help. Once the molars are through, the deep grooves on their chewing surfaces are prone to decay, so brush them carefully.

Feeding and Sugar During This Period

The move to solid food coincides with the first teeth, which makes this a critical window for preventing decay. Avoid giving sugary drinks, juice, or sweetened food, and make water the main drink.

Falling asleep with a bottle, or sipping milk or juice from a bottle all day, causes rapidly progressing decay — especially on the upper front teeth. Encouraging a move to an open cup around one year reduces this risk. Regular mealtimes, rather than snacks spread through the day, give teeth time to recover from acid attacks.

Products and Practices to Avoid

Teething necklaces and bracelets (amber, wood, silicone): the US Food and Drug Administration has warned that these carry a risk of choking and strangulation, and deaths have been reported. There is no scientific evidence that amber relieves pain. They are not recommended.

Teething gels containing benzocaine: not recommended for children under two, as benzocaine has been linked to a rare but serious condition that dangerously reduces the blood’s ability to carry oxygen. These gels also wash away quickly, so their effect is limited.

Homeopathic teething tablets: their effectiveness has not been proven, and warnings have been issued in the past about inconsistent ingredients in some products.

Hard foods: carrot sticks, crackers, or bread crusts that can break into pieces are a choking risk.

Rubbing alcohol, honey, sugar, or clove oil on the gums: traditional but unsafe. Honey can cause a serious form of poisoning in babies under one year.

Dipping a dummy or bottle teat in something sweet: this starts the risk of decay the moment teeth appear.

Caring for Teeth From the Very First One

Oral care starts as soon as the first tooth appears. Even before that, wiping the gums with a clean, damp cloth after feeds is a good habit.

Once teeth come through:

• Brush twice a day with a baby toothbrush or finger brush
• Use a smear the size of a grain of rice of fluoride toothpaste (until age three)
• The most important brush of the day is the one before bed
• Do not put your baby to sleep with a bottle; prolonged contact with milk or juice causes “bottle decay”
• If night feeds continue, keep up oral care

Good brushing habits for the whole family are covered in our guide to toothbrush replacement and brushing technique.

Why Baby Teeth Matter

Baby teeth are often dismissed because “they will fall out anyway.” In fact, they play vital roles in chewing, speech development, facial growth, and holding space for the permanent teeth. Losing a baby tooth early can cause the permanent teeth to come in crowded, which may later mean orthodontic treatment.

Decay in baby teeth can also cause pain, infection, and damage to the developing permanent tooth beneath.

When Is the First Dental Visit?

Paediatric dental organisations agree that the first visit should take place within six months of the first tooth appearing, and by the first birthday at the latest. It is an introduction and advice session, not a treatment appointment.

At this visit, the dentist:

• Checks the development of the teeth and gums
• Shows parents the right way to brush
• Gives guidance on feeding, bottles, and dummies
• Advises on fluoride use
• Helps your child get used to the dental environment early and positively

This early visit is one of the most effective ways of preventing dental anxiety later on.

Dummies, Thumb Sucking, and Tooth Development

Sucking is natural and comforting for babies. But long-lasting dummy use or thumb sucking can affect the shape of the teeth and palate, and may encourage mouth breathing. Gently phasing out the habit after about two to three years is generally recommended. We discuss the wider effects of breathing habits on growth in our article on mouth breathing in children.

Frequently Asked Questions

How long does teething last?

For each tooth, symptoms usually start a few days before it appears and ease shortly afterwards. The whole set of baby teeth takes around two and a half to three years to come through.

Does teething cause fever?

It may cause a slight rise in temperature, but 38°C or higher should not be put down to teeth — speak to your paediatrician.

Why does my teething baby have diarrhoea?

There is no strong evidence that teething causes diarrhoea. Infections are common at this age because babies put things in their mouths; if there is diarrhoea, consult your doctor.

Can I use a teething necklace?

No. They carry a risk of choking and strangulation, and there is no evidence they relieve pain.

There’s a purple swelling on the gum — is that normal?

A bluish-purple bump where a tooth is coming through is usually an eruption cyst and resolves when the tooth appears. If it grows or bothers your baby, have it checked.

My baby is one and has no teeth — should I worry?

Usually not; no teeth by twelve months is within the normal range. If there are still none by eighteen months, an assessment is recommended.

Is it too early for toothpaste?

No. A rice-grain smear of fluoride toothpaste is recommended from the first tooth.

Can I give my baby painkillers?

If needed, a painkiller recommended by your paediatrician can be given at the right dose for your baby’s weight. Do not guess the dose.

The teeth are coming in crooked — what should I do?

Baby teeth often look crooked as they come through and usually straighten on their own. If you are concerned, see a paediatric dentist.

Does teething make breastfeeding harder?

Some babies are reluctant to feed or may bite during this time. Massaging the gums with a cold cloth before feeding can help.

Children’s Dentistry at Bilim Dental Clinic in Maltepe

The teething period is when the foundations of your child’s oral health are laid. In this article we answered the questions parents ask most: the order teeth appear, the symptoms, safe ways to soothe, products to avoid, and the first dental visit. Our paediatric dentist, Dt. Zeynep Ece Okur, welcomes families for first visits — you can find her on our team page, and our care during pregnancy is covered in dental care during pregnancy.

At our clinic, we provide services in all areas of oral and dental health — from aesthetic dentistry and implant treatments to orthodontics, prosthetic applications, and children’s dentistry — using modern technology and evidence-based, scientific approaches. Our experienced team of dentists creates a personalized treatment plan for every patient, aiming to build healthy, natural, and aesthetic smiles.

The dentists who will accompany you throughout this process:

• Dt. Ali Enes Öztürk
• Dt. Salman Taştan
• Dt. Hüseyin Kaya
• Uzm. Dt. Burak Güleç (Orthodontics Specialist)
• Dt. Cem Karaman
• Dt. Ayşe Sizer Çakar
• Dt. Zeynep Ece Okur (Pediatric Dentist)

For your baby’s first dental visit, we invite you to Bilim Dental Clinic on Bağdat Caddesi in Maltepe, Istanbul. You can book through our contact page and follow our latest updates on our Instagram account.

WhatsApp: +90 538 977 89 01