Is It Teething, or Is Your Baby Sick?

Medically Reviewed by Zilpah Sheikh, MD on September 12, 2023
5 min read

Chances are you’re cheering as your baby masters each new skill, whether it's rolling over, clapping, or sitting up.

But there’s one milestone you may not look forward to: teething. It can be a challenge, and it can make your normally happy, playful baby cranky and uncomfortable.

Teething tends to happen at around 6 months of age, the same time that children naturally start to get sick more often. The immune protection they got in the womb begins wearing off.

It can be hard to tell what’s causing your little one discomfort. Is it teething? Or an illness?

Give your pediatrician a call whenever you're concerned, but certain symptoms can offer clues. 

When your baby begins teething, you'll probably notice some changes in their behavior. During teething, it's normal if your baby:

Is crankier than usual. You might notice them fussing or wanting to be held or comforted more often. About two-thirds of teething babies show signs of fussiness.

Drools all the time. Expect some slobber as your baby's teeth begin pushing outward. More than half of all babies drool when teething, recent research shows. Sometimes all that extra saliva can cause a rash to develop on their chin, cheeks, and neck.

Gnaws on things. An even more common symptom, according to that same research, is gum irritation. It affects more than 85% of teething babies.

Your child may respond by biting or chewing on toys or other objects. Or you may see them rubbing their gums or cheeks. They may feel better after gumming a cold washcloth, pacifier, or teething ring.

Is less interested in solids. If your baby has already started on solid foods, you may notice that they want them less in the days leading up to a new tooth. As long as your child is still drinking plenty of breast milk or formula, it’s not something to worry about.

Can teething cause fever?

Fevers are often thought to be linked to teething, but evidence shows that’s not really true.

In a 2011 study, Brazilian researchers had dentists check on 47 babies every day for 8 months. They found that the children had slight increases in temperature on the day a tooth erupted and the day before. But they didn’t have what doctors would call a fever, which in a child is 100.4 F (38 C) or above.

Teething is usually uncomfortable. But there are symptoms that could indicate that your baby is going through something more serious. It may be the case that they're sick, especially if your baby:

Is so fussy that you can't comfort them. The phrase “cutting a tooth” makes it sound like your little one will have severe, stabbing pain, but teething pain is pretty mild. A bit of extra fussiness is normal. But if your baby cries so much that they can’t sleep or be consoled, see your doctor.

Has a high fever. A temperature of 100.4 F (38 C) or above likely points to an infection. But keep in mind that a teething baby who's constantly putting their hands in their mouth may have picked up a germ here and there, so your child could be getting a tooth and have a cold. If the temperature is higher than 102 F (39 C) and you have other concerns including fussiness, then consult with your child’s doctor.

Has no appetite for solids or liquids. Some babies reject solids while a new tooth is pushing its way through. But if your child is also refusing to nurse or take a bottle, talk to your pediatrician.

Has a runny nose, cough, vomiting, or diarrhea. There’s no evidence that teething causes any of these issues. It’s more likely that your child has a bug.

Has a rash that’s not just on their face. Lots of drooling can sometimes cause a rash around your child’s mouth, but one that spreads to cover their torso, arms, or legs could be caused by an illness.

Symptoms continue for more than a few days. Irritability, gum rubbing, and a slightly raised temperature may be due to teething—but only in the days right before and after a tooth’s arrival.

So if your little one seems miserable for several days in a row and you still don’t see a tooth, then there’s probably something else going on. Reach out to your child’s doctor.

If your baby is teething, the best way to calm them is to put pressure on their gums. You can massage them with a clean finger or give your baby a rubber teething ring to chew on.

Cool objects feel good to a teething baby. But it can hurt their gums if it's too cold. Putting a teething ring in the freezer can also make it break open and leak. Instead, put the ring in the fridge until it's cool. If you don't have a teething ring, stick a wet washcloth in the fridge instead.

Don't use gels that you rub on your baby's gums or teething tablets. They don't typically help, and some have belladonna (a poisonous plant) or benzocaine (a medicine that numbs their gums), and both can be harmful. The FDA has warned against these because of the possibility of a dangerous side effect: they can lower the amount of oxygen in the bloodstream.

If your baby is over 6 months old, you may be able to give them ibuprofen (Children's Motrin) or acetaminophen (Children's Tylenol) to help with teething pain. But check with their doctor first.

Teething babies can be cranky, and they often are. But watch for signs that your child is really sick. Call your doctor if your baby:

  • Is under 3 months old and has a temperature over 100.4 F (38 C)
  • Is over 3 months old and has a fever over 102 F (39 C)
  • Has a fever that lasts longer than 24 hours
  • Has diarrhea, vomiting, or a rash with the fever
  • Is very sleepy or looks sick
  • Can't be soothed

Teething can be a frustrating time for both you and your baby. Remember that this is just another phase. In the meantime, keep your baby as comfortable as possible. And when those first teeth pop up, brush them each day with a soft-bristled children's toothbrush to keep them healthy.