Baby teething or ill

Most parents who believe a child is teething will give them a few extra cuddles and some painkillers before getting on with life as usual, but it can be difficult to tell if a baby really is “only teething” or if they have a more serious illness.

Parents often diagnose teething when they notice symptoms like a fever, irritability, drooling and diarrhoea, even if they can’t feel or see a tooth. However, symptoms are so wide and varied that researchers haven’t been able to find a list of signs which would accurately predict teething. To help you work out what is really going on, here is my list of teething “symptoms.”


It is very common for both parents and health professionals to attribute a fever to teething. However there is little evidence of a link. Studies have found a very slight rise in temperature (to around 36.8˚C) on the day a tooth erupts and possibly the day after. A fever higher than this, which lasts for more than a day without a tooth appearing, is highly unlikely to be caused by teething.


Studies have found that some babies experience slight diarrhoea on the day a new tooth erupts. As with fever, however, severe diarrhoea or symptoms that last longer than a day are likely to have another cause.


A nappy rash might be associated with teething, especially if the baby has diarrhoea, but severe rashes and rashes on other parts of the body are not.

Sleep disturbance

A baby may experience some disruption to her sleep around the time a tooth emerges. However, this would normally be linked with other teething symptoms during the day and should only last for a night or two. If your baby is happy during the day but has disturbed nights it is worth considering other possible causes.

Minor Symptoms

Drooling, rubbing gums, biting, chewing, slight loss of appetite (on the day a tooth emerges) and general irritability have all been found to be linked with teething. Having said that, no one symptom is always present. One baby will teeth without showing any of these signs while another might be very grumpy, gnawing on everything in sight. These symptoms may last for up to a week. If a tooth has not emerged in that time it is worth considering other possibilities.

How can you tell?

The simple answer is that you can only tell your baby is teething when a tooth erupts. If symptoms such as diarrhoea and loss of appetite are severe or last for more than a day without a tooth appearing do not assume your child is teething, treat them as you would for any stomach bug. A fever is not a symptom of teething and you should always look for other causes.

The good news is that babies tend to behave similarly for each tooth, and in my experience teething symptoms can even run in families. So if your baby’s first tooth is accompanied by lots of dribble and a day or two of grumpiness that is what you can expect in future, anything else is worth further investigation.


  • Challenging parents’ myths regarding their children’s teething. Owais AI, Zawaideh F, Bataineh O. Int J Dent Hyg. 2010 Feb;8(1):28-34.
  • Symptoms associated with infant teething: a prospective study. Macknin ML, Piedmonte M, Jacobs J, Skibinski C. Pediatrics. 2000 Apr; 105(4 Pt 1):747-52.
  • Parents’ and medical personnel’s beliefs about infant teething. Sarrell EM, Horev Z, Cohen Z, Cohen HA. Patient Educ Couns. 2005 Apr; 57(1):122-5.
  • Teething and tooth eruption in infants: A cohort study. Wake M, Hesketh K, Lucas J. Pediatrics. 2000 Dec; 106(6):1374-9.
  • Prospective Longitudinal Study of Signs and Symptoms Associated With Primary Tooth Eruption. Ramos-Jorge J, Pordeus IA, Ramos-Jorge ML, Paiva SM. Pediatrics. 2011 Aug 8. [Epub ahead of print]

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