Teething tends to loom large in the minds of both new and experienced parents as they brace for the discomfort, drooling, and usually (at least) a few tears. But it’s important to remember that a fever isn’t an official symptom of teething, despite what you may have read or heard from friends and family.
In fact, believing that an elevated temperature is just a regular part of teething, rather than a sign of sickness, could mean your little one might not get the quick care she needs to fight off an illness or infection.
To help, we’ve got the low-down on the link, if any, between fevers and teething, as well as how you can tell whether your baby is actually sick or just cutting a cute Chiclet in her mouth.
Can teething cause a fever in babies?
No, teething does not cause an actual fever, which is defined as a rectal reading of 100.4 degrees Fahrenheit or higher in a baby 3 months of age and up, or 101 degrees F or more in older infants and kids.
"Teething may result in small rise in temperature, but rarely does it cause a true fever," says What to Expect Medical Review Board member Michelle Kelman, DDS, a pediatric dentist in Los Angeles.
Can babies get a low-grade fever when they’re teething?
It's possible. The uptick that happens in some teething babies' temps could be classified as a very low-grade fever, of between about 99 and 100 degrees F.
An in-depth review of 16 studies performed by Pediatrics, the journal of the American Academy of Pediatrics (AAP), found that cutting teeth can cause a slight rise in babies’ temperature, but not an actual fever.[1]
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But if the thermometer shows a reading higher than that, or your baby has other symptoms of a viral or bacterial infection (like vomiting, diarrhea, and/or cold or flu symptoms), chances are that something else is going on.
"If your baby's fever is above 100.3, it's more likely due to a cold or illness rather than teething" and warrants a call or visit to the pediatrician, explains Dr. Kelman.
How can you tell if your baby’s fever is from being sick vs. teething?
Teething usually begins in babies who are 4 to 7 months old, with most little ones showing a pearly white at around 6 months.[2]
To help you decide if a low-grade fever is connected to new baby teeth coming in, watch for these signs of teething:
Fussiness. She may fuss or cry more than usual, whine, and seem generally irritable and more clingy.
Irritated gums. “You might notice redness and swelling of the gums,” says Dr. Kelman.
Drooling. Teething is a messy business, so keep cloth diapers around to catch the drips.
Coughing. All that saliva may make your little one cough and splutter.
Rash. The drool from teething can lead to a red, chapped chin; mouth; and even chest.
Gnawing. To relieve teething soreness, some babies bite and chew on anything they can. “Babies will stick fingers in the mouth or use a teething toy to soothe the ache,” says Dr. Kelman.
Less of an appetite and fewer Zzzs. It can hurt to nurse or take a bottle, and the discomfort that can accompany teething may keep your baby up at night.
Ear pulling or cheek rubbing. Because of the gum pain, you might see these behaviors in your baby as a way to ease the pain.
When it comes to an elevated temp because your baby is sick, watch for a higher reading on the thermometer and a different set of symptoms.
“If a baby is sick, there are often other symptoms such as a runny nose, respiratory infection, diarrhea, or vomiting,” notes Dr. Kelman.
Keep in mind that a “low-grade fever is coincidental with teething, and it’s important to look for other signs of illness in your baby” to determine what’s going on, she says.
Aside from using cold compresses, teething rings, and other tried-and-true remedies to help relieve the discomfort of teething, you can also use infant acetaminophen (Tylenol) in babies 3 months and older. Remember never to use teething gels in babies or toddlers under age 2.
When to call the doctor
Keep an eye on your little one and get in touch with the doctor if you notice the following:
An actual fever, as indicated on the thermometer, based on your baby’s age
A low-grade fever that lingers for more than three days
Runny stool that lasts for more than two bowel movements
A loss of appetite, or your baby refuses to feed for more than a few days
Excessive crying or irritability
Ear infection signs, such as pain when lying down or chewing, or pus around the ear
“Remember, if you are having a difficult time managing your baby’s irritability when teething — for example, a cool teething ring or towel isn’t soothing enough, and there is no fever — you can still call your pediatrician or local pediatric dentist and ask for advice,” says Dr. Kelman.
She says that it’s vital that parents call the pediatrician right away when their babies seem to have an actual fever rather than a slightly elevated temp due to teething.
“If your child is experiencing a true fever and is under 2 months of age, you should call your doctor right away,” advises Dr. Kelman. “The same goes for a baby with symptoms like persistent diarrhea and/or vomiting, wheezing, or shortness of breath.”
It’s hard not to worry when your baby's new teeth cause her to be fussy, irritable, and flushed. But try to remember that it’s par for the course, and she'll get past this stage. In the meantime, you can call your pediatrician or dentist for tips on treating teething and reassurance.
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