Teething - understanding and supporting your baby through this milestone

Teething is one of the most memorable milestones in early childhood. For some babies, it arrives quietly with little discomfort; for others, it brings fussiness, disrupted sleep and a big increase in drool. Understanding what is normal, what is not, and how to soothe your baby can make a significant difference for both parents and caregivers. This guide explores the teething process, common symptoms, myths, practical soothing techniques, a South African perspective, and when to seek medical help.

What is teething?

Teething refers to the period when a baby’s first teeth (primary teeth) emerge through the gums. For most babies, this begins between 4 and 7 months, but timing varies widely. Some infants may cut their first tooth as early as 3 months or as late as 12 months. The full set of 20 primary teeth will usually appear by around age 3. Genetics, feeding patterns and individual development all influence timing — so variation is completely normal.

Common signs and symptoms of teething

Every baby is different, but typical signs include:

• Increased drooling: Excess saliva is one of the earliest signs.
• Chewing or biting: Babies chew on their hands, toys or clothing to relieve gum pressure.
• Gum swelling or redness: Gums may appear bumpy or slightly inflamed.
• Irritability or fussiness: Discomfort peaks just before the tooth breaks through the gum.
• Changes in sleep patterns: Some babies become restless or wake more often.
• Mild decrease in appetite: Due to gum tenderness.
• Rubbing ears or cheeks: Nerve pathways in the face and gums are interconnected.

These symptoms tend to come and go in waves.

Important symptoms that are not caused by teething

Research (including South African Medical Journal studies) shows that teething does not cause:

• High fever (over 38°C)
• Severe diarrhoea
• Vomiting
• A widespread rash
• Persistent cough
• Lethargy or weakness
• Refusal to drink fluids

If these symptoms occur, they are likely due to infection or illness - not teething.

Why teething can be difficult for babies

As teeth move towards the surface, the gums stretch and become sore. Babies experience a mix of pressure, heat and irritation. Factors that may worsen discomfort include:

• Hot South African summer temperatures
• Dehydration
• Sleep disruption
• Excess drool causing chin or neck rashes

Understanding these sensitivities helps caregivers support babies more effectively.

Ways to soothe teething

1. Gum massage: Gently rub the gums with a clean finger. This counter-pressure often provides immediate relief.
2. Chilled teething rings: Cooling soothes inflammation. Tips: Use chilled (not frozen) teething rings; Avoid hard frozen objects as they can injure gum tissue.
3. Offer safe teething toys: Choose age-appropriate, BPA-free toys designed for chewing. Many South African parents also use soft silicone fruit feeders with cold fruit.
4. Maintain good oral hygiene: Begin oral care before teeth erupt: Wipe gums with a soft cloth; Once teeth appear, use a small, soft toothbrush; Use a smear of fluoride toothpaste (rice grain size) — recommended by dental authorities worldwide. Oral hygiene reduces gum irritation and prevents early childhood decay.
5. Absorb excess drool: Drool can irritate the skin. Keep the chin and neck clean and dry to prevent rashes, especially in warm climates.
6. Offer comfort and reassurance: Holding, rocking and cuddling help calm an irritable baby. Emotional comfort is just as important as physical soothing.
7. Use pain relief only when necessary: Consult a healthcare professional before using medication. Paracetamol may be appropriate in some cases for pain relief. Avoid: Home remedies with unknown ingredients.

South African-specific considerations

• Hot climate and teething: Babies may become fussier during summer months. Keep them cool, hydrated, and dressed in light clothing.
• Cultural remedies: South African families use diverse soothing traditions — but always ensure remedies are safe and contain no harmful substances.
• Nutritional stage: Teething often overlaps with the introduction of solids (around 6 months). Soft, cold foods like chilled purées or yoghurt can soothe the gums.
• Load shedding: Parents should keep rechargeable fans, safe lighting and soothing toys accessible for night-time teething episodes.

Common myths about teething

• Myth 1: Teething causes high fever: A slight rise in temperature is normal, but high fever is usually illness.
• Myth 2: Babies must chew on hard objects: This can damage gums. Soft, chilled objects are safer.
• Myth 3: Diarrhoea is caused by teething: Not supported by evidence — seek medical care if diarrhoea persists.
• Myth 4: Baby teeth don’t matter: Healthy baby teeth are essential for speech, nutrition and proper spacing of adult teeth.

Frequently asked questions (FAQs)

Q: When will my baby’s first teeth appear?
Most commonly between 4–7 months, but every child is different.

Q: How long does teething last?
Each tooth may cause 2–3 days of increased discomfort.

Q: How many teeth should my baby have by age 1?
Usually 2–4 teeth, but this varies.

Q: Can teething affect sleep?
Yes, temporarily. Offer comfort and consider mild pain relief if advised.

Practical teething checklist

• Offer chilled teething rings
• Use a clean finger for gum massage
• Wipe drool frequently
• Keep baby hydrated
• Avoid sugary foods
• Brush teeth as soon as they appear
• Watch for non-teething symptoms
• Provide comforting cuddles
• Keep baby cool in hot weather
• Use pain medication only if advised

When to seek medical help

Seek a doctor or clinic visit if your baby:

• Has a fever above 38°C
• Refuses food or fluids
• Has diarrhoea or vomiting
• Appears unusually lethargic
• Has a rash that spreads
• Cries inconsolably
• Shows signs of dehydration
• Has swelling affecting the entire face

These symptoms suggest illness, not teething.

References

• South African Medical Journal (SAMJ) – Teething Myths and Evidence
• Nationwide Children’s Hospital – Infant Oral Care

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