Teething: What Actually Helps (and What Is a Waste of Money)

Your baby is drooling everywhere, chewing on everything, waking up at 3am screaming, and someone at the baby group just told you it is all because of teething. The amber bead necklace will fix it, apparently.

Here is the reality: teething is real, it is uncomfortable, and there are things that genuinely help. But the baby product industry has also built an entire cottage economy around parents who are desperate and sleep-deprived. Some of what gets sold is useless. Some of it is actively unsafe. This guide cuts through both.

This is not the vague "every child is different, trust your instincts" approach. This is what the evidence says, what the NHS recommends, and what actually worked at 3am when nothing else did.

When Does Teething Actually Start?

The short answer: earlier than you think, and later than you worry. Most babies get their first tooth somewhere between 4 and 7 months, but the normal range stretches from 3 months all the way to 12 months. Some babies are born with a tooth already through (neonatal teeth, rare but not unheard of). Some hit their first birthday with a completely empty gum. Both are fine.

Genetics plays a significant role. If you or your partner teethed early, your baby probably will too. It is not a reflection of nutrition, development, or anything you are doing right or wrong.

As a rough guide to the full timeline, here is when each set of teeth tends to arrive:

Teeth	Typical age (months)	What to expect
Lower central incisors (front bottom two)	6 to 10	Usually the first to arrive. Often the least painful.
Upper central incisors (front top two)	8 to 12	The classic baby smile teeth.
Upper lateral incisors	9 to 13	Fill in the gaps either side of the top front teeth.
Lower lateral incisors	10 to 16	Same pattern, bottom row.
First molars (top and bottom)	13 to 19	Larger surface area. These tend to cause more discomfort.
Canines (top and bottom)	16 to 23	Sharp, pointy. Often cause noticeable irritability.
Second molars (top and bottom)	23 to 33	The biggest teeth. Often the worst for sleep disruption.

By about age 3, your child will have a full set of 20 primary teeth. So yes, teething is basically a two-and-a-half year process. That is not a phase. That is just life with a small child for a while.

The one thing worth flagging: if there are still no teeth by 18 months, mention it to your GP or dentist. It is almost certainly nothing, but it is worth a quick check to rule out rare conditions like hypodontia (missing teeth) or vitamin D deficiency.

Real Teething Symptoms

Teething does cause discomfort. The gum tissue is being pushed apart by a tooth forcing its way through, which is about as pleasant as it sounds. A 2016 systematic review published in Pediatrics (Massignan et al.) analysed data from over 3,500 tooth eruptions and identified the following genuine symptoms:

• Drooling. A lot of it. More than you thought a small face could produce. Have a bib on at all times. The drool can also cause a rash around the chin and neck, so keep the area dry.
• Gnawing and chewing. On everything. Toys, your fingers, the sofa corner, their own fist. The pressure from biting down counteracts the pressure from the tooth pushing up.
• Gum rubbing and fussiness. Increased irritability, especially in the day or two right before a tooth breaks through. This is the peak discomfort window.
• Mild sleep disruption. More wakings, harder to settle. Particularly with the first few teeth and the molars later on. If your baby was sleeping through and suddenly is not, check their gums.
• Red or swollen gum patch where the tooth is coming through. You can sometimes see a bluish-white bump under the gum surface, or feel a hard ridge with your finger.
• Slightly raised temperature. The operative word is slightly. Up to 37.5C. Not a proper fever. That same Pediatrics review confirmed that teething can cause a minor temperature increase but not a true fever above 38C.
• Decreased appetite. The sucking motion can aggravate sore gums, so some babies temporarily reduce their milk intake during an active eruption.

One thing to note for the night shift: teething pain often seems worse at night. There is less distraction, cortisol levels are lower, and your baby is lying down, which can increase blood flow to the gums. This is why teething feels like a sleep problem first and a dental problem second.

The Teething Myths Worth Killing

There are a few things that get blamed on teething that are not caused by teething. This matters, because attributing real symptoms to teething can lead to missed diagnoses. A 2019 study in the British Dental Journal found that parents frequently attributed fever, diarrhoea, and rashes to teething, delaying medical attention for the actual cause.

What Actually Works

Good news: there are things that do genuinely help. They are not glamorous, and none of them are particularly expensive. The evidence base is not enormous (teething is not exactly a hot area for clinical trials), but these are the approaches backed by the NHS, the British Dental Association, and the available research.

Cold teething rings

This is the most consistently supported option. The cold numbs the gum tissue slightly, and the pressure from chewing provides counter-pressure that relieves the sensation of the tooth pushing through. Put a silicone teething ring in the fridge (not the freezer) for 20 to 30 minutes before giving it to your baby.

The distinction between fridge and freezer matters. A frozen teething ring can get hard enough to damage gum tissue and emerging teeth. Chilled is the target, not frozen solid. If you do not have a teething ring, a cold damp flannel works just as well and costs nothing. Some parents keep several in the fridge on rotation.

Worth having two or three teething rings so you always have a cold one ready. At 3am, the last thing you want is to wait 20 minutes for one to chill.

Gentle gum massage

Clean your finger, then use the tip to apply gentle, firm pressure to the gum where the tooth is erupting. Most babies respond well to this. Some will grab your finger and start chewing on it immediately, which tells you the pressure is helping. Do it for 30 to 60 seconds at a time.

You can also try a finger-shaped silicone gum brush, which serves double duty: it massages the gums and starts introducing the concept of having something brush-like in their mouth, which makes the transition to a toothbrush easier later.

Paracetamol and ibuprofen

When your baby is clearly in pain, not just a bit fussy, infant paracetamol (Calpol or equivalent) and infant ibuprofen (Nurofen for children) are both appropriate options. The NHS lists both as suitable for teething pain. The key points:

• Dosing is by weight, not age. Check the packaging carefully and use the syringe that comes with it. Do not guess. Overdosing paracetamol is dangerous, and underdosing means you are giving your baby medicine that is not doing anything.
• Ibuprofen is not suitable under 3 months (or under 5kg), and should not be given to babies with kidney problems, asthma, or certain other conditions. When in doubt, paracetamol is the safer default.
• Do not give both at the same time unless a healthcare professional has told you to alternate them for a specific reason. If one is not working, speak to your pharmacist before adding the other.
• Do not use adult versions. Ever. The concentrations are different, and the doses are not equivalent. Always use the infant formulation.

Reserve medication for when your baby is genuinely distressed, not as a precautionary measure. But do not be precious about it either. If your child is in pain, managing that pain is the right call. There is no virtue in letting a baby suffer because you want to avoid medicine.

Distraction and cold food

Boring but true. Getting outside, a bath, extra cuddle time, a change of scenery. Teething discomfort is real but it is also intermittent. A baby who is engaged and distracted is a baby who is not focused on the discomfort in their gum.

As your baby gets older and starts on solids, cold food can help too. Chilled cucumber sticks, cold apple slices, a piece of cold mango. Keep them large enough that they cannot be swallowed whole and stay in the room while they eat. If you are at the solid food stage, the introducing solid foods guide covers what is safe and when.

What Does Not Work (and What Is Unsafe)

The list of things that get marketed at teething parents is long. Here is what to skip, and why.

Teething gels containing lidocaine or benzocaine

These are not recommended for children under 2. The NHS advises against them, and the MHRA (Medicines and Healthcare products Regulatory Agency) has issued specific guidance on this. The active ingredients are local anaesthetics that can cause methemoglobinaemia in young children, a rare but serious condition that reduces the blood's ability to carry oxygen. The US FDA issued a similar warning and required manufacturers to stop selling benzocaine products for children under 2.

Beyond the safety risk, the evidence that they even work for teething pain is weak. Saliva washes the gel off the gums within minutes, so any numbing effect is extremely short-lived. You are taking a real risk for a questionable benefit.

Some gels marketed for teething in the UK use a herbal formulation or a different active ingredient like choline salicylate. Always check what is in it before buying. If it contains lidocaine, benzocaine, or a -caine anything, leave it on the shelf.

Amber teething necklaces

There is no mechanism by which an amber bead necklace could relieve teething pain. The theory is that the amber releases succinic acid when warmed by body heat, which then somehow acts as an anti-inflammatory. This does not happen at any meaningful level. A 2019 study in BMC Complementary Medicine and Therapies specifically tested whether Baltic amber releases succinic acid at skin temperature and found no clinically relevant release. Multiple other studies have reached the same conclusion: the purported mechanism simply does not work.

More importantly: any necklace worn by a baby is a strangulation and choking hazard. If a bead comes loose, it is a choking risk. If the necklace catches on something, it is a strangulation risk. The NHS, the AAP (American Academy of Pediatrics), and the Royal Society for the Prevention of Accidents all recommend against them. There is no benefit to weigh against that risk. Do not use them, and if someone gifts you one, say thank you and put it in a drawer.

Teething rusks and biscuits

These are mostly sugar. The constant contact of sweet, sticky food with newly erupting teeth is not a great start for your baby's dental health. They may provide temporary distraction through chewing, but so does a teething ring, which does not rot teeth. If you want something your baby can chew on, a cold carrot stick or cucumber baton is a better option.

Whisky, brandy, and other alcohol

Still gets mentioned at family gatherings. A small amount of alcohol is not harmless for an infant. The liver of a small baby cannot process it the way an adult's can. Even a tiny amount can be toxic relative to their body weight. The answer is no, regardless of what worked for someone's children in the 1980s.

Homeopathic teething tablets and powders

No evidence they work beyond placebo. Some formulations have been subject to serious safety concerns: the US FDA issued warnings about certain brands of homeopathic teething tablets containing belladonna (a toxic plant extract) at inconsistent and potentially dangerous levels, leading to product recalls. In 2017, the FDA reported over 400 adverse events, including seizures and deaths, linked to homeopathic teething products.

The evidence bar for giving something to a baby should be higher than "someone online said it worked." Pass.

When to See a Dentist for the First Time

The guidance from the British Dental Association is: as soon as the first tooth appears, or by your child's first birthday, whichever comes first. NHS dental care is free for children under 18, so there is no financial barrier. You can find an NHS dentist accepting child patients through the NHS website or by calling your local dental practice.

The first appointment is not really about checking for problems. It is about familiarising your child with the environment, the chair, the lights, the dentist's face. Children who start going early, when nothing is wrong, tend to be far more relaxed about dental appointments for the rest of their lives. Children who first encounter a dentist when something hurts tend to carry that association for years.

Brushing those first teeth

Start brushing as soon as the first tooth appears. Use a baby toothbrush with soft bristles and a tiny smear of fluoride toothpaste (at least 1000ppm fluoride). Not a full stripe like you would use for yourself. A smear the size of a grain of rice. From age 3, increase to a pea-sized amount.

Brush twice a day: morning and just before bed. The bedtime brush is the important one, because saliva flow drops during sleep, and saliva is your baby's natural defence against acid and bacteria. After the bedtime brush, no more milk or food. Water only.

This is a two-person job at first. One of you holds the baby, the other brushes. It will not be graceful. Your baby will probably clamp their jaw shut, turn their head, or try to eat the toothbrush. All normal. Keep at it. Consistency matters more than technique at this stage.

Teething and the Bigger Picture

This feeds into a point worth making about baby milestones month by month: teething is often treated as its own isolated event, but it is happening at the same time as a lot of other development. Babies at the typical teething age are also starting to sit, starting to explore objects, and approaching their first attempts at solid food. Keep the full picture in mind.

Teething and sleep

Teething does disrupt sleep. Particularly the molars, which are large teeth and cause more pressure. The disruption tends to be worst in the day or two before the tooth breaks through the gum surface, after which things usually settle quickly.

If your baby's sleep has been gradually deteriorating over weeks, teething is probably not the primary cause. Sleep at this age is complicated. The 4-month sleep regression survival guide and why is my baby crying checklist cover the full range of what might be going on at 3am. For the general state of exhaustion, the sleep deprivation survival guide is worth reading.

The mistake is assuming that because teething is happening, teething is responsible for everything. It is one variable among many.

Teething and feeding

Some babies go off their milk during active teething because the sucking motion puts pressure on sore gums. If this happens, try offering milk at a slightly different temperature (some babies prefer it cooler during teething), or switch temporarily to a cup if your baby is old enough. The appetite drop is usually short-lived and resolves once the tooth breaks through.

If your baby is refusing feeds for more than a couple of days, or showing signs of dehydration (fewer wet nappies, dry lips, lethargy), contact your GP. That is beyond normal teething territory.

Keeping Things in Perspective

Teething is genuinely unpleasant for some babies and barely noticeable for others. A lot of it comes down to individual variation. The babies who sail through seem to have parents who are then confused when other parents describe it as a difficult period. Both experiences are real.

What you can control: having chilled teething rings ready before the first tooth arrives, knowing what actually works when your baby is clearly uncomfortable, knowing what to skip, and knowing when to reach for the Calpol without guilt.

If you are at the stage where your baby is also becoming more aware of the world around them and asserting preferences strongly, you are probably starting to encounter the early signs of what comes next. The toddler tantrums guide is worth reading before you need it rather than during a particularly loud moment at a supermarket.

And if you have just become a dad and everything feels like a lot, the how to soothe a crying baby guide and the what you need for a newborn guide cover the basics you will actually use.

FAQ

When does teething start in babies?

Most babies get their first tooth between 4 and 7 months, though anywhere from 3 to 12 months is normal. Some babies are born with a tooth already through. If there are no teeth by 18 months, mention it to your GP or dentist.

Does teething cause fever?

No. The NHS is clear: teething does not cause fever. A 2016 systematic review in Pediatrics confirmed that teething may cause a slight temperature rise but not a true fever above 38C. A temperature above 38C needs to be assessed properly. Blaming fever on teething can lead to missing real illness.

What actually helps a teething baby?

Cold teething rings (chilled, not frozen), gentle gum massage with a clean finger, and age-appropriate paracetamol or ibuprofen when the baby is clearly in pain. These are the interventions with actual evidence behind them.

Are teething gels safe for babies?

Teething gels containing lidocaine or benzocaine are not recommended for children under 2. The NHS and MHRA advise against them. The active ingredient can cause methemoglobinaemia in young children, and the evidence they work is weak. The US FDA issued a similar warning.

When should my baby first see a dentist?

As soon as the first tooth appears, or by their first birthday at the latest. NHS dental care is free for under-18s. The British Dental Association recommends starting early so your child becomes familiar with the environment before any work ever needs doing.

Are amber teething necklaces safe?

No. There is no scientific mechanism by which amber relieves pain. The claim that succinic acid is released at body temperature has been tested and found to be false. Any necklace on a baby is a strangulation and choking hazard. The NHS, AAP, and RoSPA all recommend against them.