We're sure you've heard it a million times before, but your child's crankiness could be caused by teething. It could also be caused by an illness, by the misplacement of his favorite blue bunny or something else altogether. On their own, the symptoms of teething—drooling, chewing and irritability chief among them—can be hard to distinguish from other issues. But when your child displays more than one of these signs, you can safely bet a new tooth is on its way.
What Teething Looks Like
"Teething typically starts between 5 to 12 months, but it's not unheard of for it to occur earlier or later," says pediatrician Edward Kulich, based in New York City. "Common signs of teething are drooling, irritability, putting the hands and fingers in the mouth, and chewing on whatever is available, which may include the crib rail or other pieces of furniture and toys."
If you can get your child to let you peek into his mouth, you may see that his gums are red and swollen, and may even be able to see the white of a tooth pushing through.
A low-grade fever of 101 degrees Fahrenheit or under is a common side effect of teething. While parents may associate diarrhea with teething, an Australian study in the journal Pediatrics refutes this connection.
And keep in mind that not all kids respond to tooth eruptions with hysterics. "Some kids are not affected to a significant extent by teething, while some get very cranky," Kulich notes.
What Teething Doesn't Look Like
Don't worry about teething starting before you have to. "I don't ever recall a parent who has not asked me around the three-month mark if their child is teething, because they start drooling and putting their hands in their mouth," Kulich says. "Around three months, saliva production increases and is frequently mistaken for teething, but it's very uncommon to teethe at that age."
Once your child does begin teething, be mindful not to write off all unusual symptoms as part of teething. "Any other symptoms like rash, cough, vomiting, diarrhea, and a general departure from a child's normal activity usually indicates an illness and not teething," Kulich explains. A high fever is also not a normal part of tooth eruption. "It's an established fact that teething can cause a low-grade temperature, but anything over 101.0 should be evaluated by a medical professional, and it's much more likely you are dealing with an infection when the fever reaches that number or higher."
Life with a little one always comes with surprises, and that includes teething symptoms. Your child may display the same symptoms every time a tooth erupts—or he may not. "Most kids will be consistent with their symptoms, but may react differently at 6 months to their first teeth, than at 18 months when molars start to make their appearance," Kulich says.
You can't speed up teething or its associated symptoms. What you can do is soothe your child's discomfort. "Topical anesthetics have been shown to be washed away by saliva in five to six seconds and are generally not effective," says Kulich, who advises parents to give teething children refrigerated—not frozen—teething rings. He also sometimes recommends acetaminophen or ibuprofen to parents of teething tots; still, you should speak to your pediatrician before giving your child any medication. Rubbing the swollen gums with a clean finger and providing cold food like yogurt can also help ease teething pain.