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Teething is such a big mystery for parents! You never know when a tooth is going to pop up and they could be teething off and on for 2+ years. It may have you constantly questioning if each off day is due to a tooth, when really, babies just have off days with no rhyme or reason.

In this blog post, we will take a look at the relevant research that has been found about teething, teething remedies, and how to maintain baby’s sleep (or not let it become a total train wreck from one tooth!).

First, what does research support as evidence that a tooth is about to cut?

meta-analysis of research about teethingwas performed and their findings were, “Gingival irritation (86.81%), irritability (68.19%), and drooling (55.72%) were the most frequent [symptoms].”

 Another study regarding signs and symptoms of primary tooth eruptionconcluded that, “There was no association between teething and symptoms such as fever or diarrhea. Low birth weight children may have more teething symptoms. Teething rings, cuddle therapy and rubbing the gums were the most effective methods to reduce symptoms.”

A very in depth study was conducted with 47 noninstitutionalized infants (ie, receiving care at home) between 5 and 15 months of age) was performed and they determined that “Irritability, increased salivation, runny nose, loss of appetite, diarrhea, rash, and sleep disturbance were associated with primary tooth eruption. Results of this study support the concept that the occurrence of severe signs and symptoms, such as fever, could not be attributed to teething.”

According to this study regarding teething symptoms in babies, “Daily symptom data were available for 19 422 child-days and 475 tooth eruptions. Symptoms were only significantly more frequent in the 4 days before a tooth emergence, the day of the emergence, and 3 days after it, so this 8-day window was defined as the teething period. 

Increased biting, drooling, gum-rubbing, sucking, irritability, wakefulness, ear-rubbing, facial rash, decreased appetite for solid foods, and mild temperature elevation were all statistically associated with teething. 

Congestion, sleep disturbance, stool looseness, increased stool number, decreased appetite for liquids, cough, rashes other than facial rashes, fever over 102 degrees F, and vomiting were not significantly associated with tooth emergence.”

Basically, kids may have a mild increase in temperature due to inflammation prior to cutting a tooth, but not a high fever- that is usually related to something else!

To recap, teething symptoms include:

  • Increased biting or sucking to soothe
  • Fussiness
  • Some disrupted sleep
  • Less hunger
  • Rash around their mouth from drooling
  • Mild elevated temperatureRed or swollen gums

What are the most effective teething remedies?

Honestly, the best way to get through teething would be to provide some TLC! As stated above, the most effective remedies were teething rings (cold or just something to chew on), cuddles, and massaging their gums.

Unfortunately, homeopathic remedies, amber necklaces, and numbing agents are not recommended due to little evidence of effectiveness or safety. Instead, you can use the following tips safely to alleviate some of the pain associated with teething:

  • Massaging their gums

  • Cold spoon or washcloth

  • Gnawing on a cold carrot, cucumber, breastmilk/formula popsicles, or frozen fruits in silicone feeders

  • Teething toys or pacifiers

  • Analgesics if approved by your pediatrician (Motrin or Tylenol)

Teething & Sleep

Some mild sleep disturbances can come with teething. It may be more painful at night because they feel those symptoms more when there are fewer distractions, and they’re also tired!

Another reason pain may seem worse at night has to do with the increased levels of two cytokines that were found in the study referenced above. IL-1beta and TNFalpha are cytokines that were found to correlate with fever and sleep disturbances in teething babies. 

So how do we stay on the course with sleep?

  • Maintain a consistent routine and offer sleep just like before

  • Relaxing wind down routines before naps and bedtime

  • Try to have good habits in place before teething begins

  • If you give medications, try to give it 30 mins before bedtime

  • White noise is a good distraction, plus it’s very soothing

  • A lovey if your baby is over 12 months old

  • Incorporate teething toys or things to chew on in the bedtime routine

  • Stay calm, don’t panic!

  • Utilize baby wearing for naps if they’re struggling in order to keep them rested

From all the research listed above, at most, symptoms are noticed 4 days before a tooth erupts and up to 3 days after the tooth erupts.

One study even noted that symptoms were more prominent the day the tooth erupted and the day after!

So in short, teething should not affect sleep for that long. It should not be weeks or months of “teething pains” without a tooth showing up. We can stop blaming teething if there isn’t a tooth within 8 days, essentially!


About the author: Ashley Olson is a certified pediatric sleep consultant & certified breastfeeding counselor, owner of Heaven Sent Sleep, and passionate about helping new parents, experienced parents, desperate and sleep-deprived parents form healthy sleep habits for their children.


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