Teething: A Tooth Does Not Cause a Fever

Key takeaways

According to MedlinePlus, teething does NOT cause a fever and does not cause diarrhoea. If your child has a fever or loose stools, the cause is still there and nobody has found it yet — usually an infection.
According to NHS, within the picture of teething a child's temperature may rise slightly but stays below 38°C. That figure is not a reassurance threshold; it is the line at which you stop attributing a fever to a tooth.
Safe soothing is simple: wipe the dribble away, rub the gums with a clean finger or a cool damp cloth, give a firm rubber teething ring to chew, and offer cool soft food.
Three things to avoid: gels or medicines rubbed on the gums of a child under two; aspirin, including placed on the gums; and anything tied around a child's neck. According to the US FDA, teething jewellery such as amber necklaces has caused deaths and serious injuries from strangulation and choking.
According to MedlinePlus, baby teeth usually start to come through when a child is six to eight months old, with all twenty in place by thirty months. Coming through earlier or later within that span is normal.
Look at the gums before concluding anything. The gum where a tooth is about to come through is usually swollen and tender to the touch; if there is nothing to see on the gums and the child is still unwell, do not stop at the word “teething”.

In Vietnam, “the baby has a fever because of teething” is a phrase so familiar that parents hear it and settle down to wait. That is the most dangerous thing about teething. According to MedlinePlus, teething does not cause a fever and does not cause diarrhoea; if your child has a fever or diarrhoea and you are worried, contact your child's health care provider. Which means that when a child really does have a fever, the tooth does not explain it, and whatever is causing it has not been found.

Recognising it: what teething looks like

Teething is normal, not an illness. Know its picture, so that when something ELSE comes into it, you see it at once.

According to NHS the signs of teething are: the gum where a tooth is coming through is sore and red; more dribbling than usual; chewing and gnawing on anything within reach; one flushed cheek; a rash on the face; rubbing at an ear; being more fretful than usual; not sleeping well. MedlinePlus adds a child refusing food.
According to NHS the temperature may rise slightly but stays BELOW 38°C. That figure is not a reassurance threshold — it is a line: above it, stop blaming the tooth.
According to MedlinePlus, teeth usually start to come through when a child is six to eight months old, with all twenty baby teeth in place by thirty months.

Easily confused: fever and loose stools are NOT caused by teething

According to NHS, some people think teething causes symptoms such as diarrhoea, but there is no evidence to prove it. MedlinePlus puts it more bluntly: teething does not cause fever, it does not cause diarrhoea. The rule: coinciding in time is not causing. Fever in children, and the red flags of fever, already have their own article on this site — that is where to read the list of danger signs carefully.

What to do now

Wipe the dribble. According to NHS, if teething is making your baby dribble more than usual, gently wiping their face helps prevent a rash.
Rub the gums. According to the US FDA, if your child's gums are swollen and sore, gently rub the gums with your finger; MedlinePlus adds that a clean, cool, damp cloth can be used as well.
Give a teething ring to chew. According to NHS it gives your baby something safe to chew, eases the discomfort and takes their mind off the pain. According to FDA, choose a FIRM rubber one, not the sort with liquid inside.
Cool the teething ring in the fridge compartment. According to NHS, never put a teething ring in the freezer: once it is frozen solid it will damage your baby's gums.
According to MedlinePlus, give your child cool soft foods such as apple sauce or yoghurt.
Keep a day-by-day note of where the gum is swollen and how the child is feeding and sleeping; take the child's health record book with you to any appointment.

Things you must NOT do

Do NOT tie a teething ring or anything else around your child's neck: NHS calls it a choking hazard, and MedlinePlus says the same.
Do NOT rub gels or pain medicines on the gums of a child under two. According to MedlinePlus, gum gels are only for children aged two and over, and should not be used if your child is younger than that. According to the US FDA, products containing benzocaine can cause a serious, sometimes fatal condition called methemoglobinemia, in which the oxygen-carrying capacity of red blood cells falls sharply.
Do NOT give a child aspirin. According to MedlinePlus, never give your child aspirin, and do not place it on the gums or teeth either; and do not rub alcohol or spirits on your child's gums.
Do NOT use homeopathic teething tablets or drops. According to the US FDA, this group of products can be dangerous for children.
Do NOT bring a fever down and then wait until morning because you think it is the tooth. A fever medicine makes a child more comfortable but does not touch whatever is causing the fever.

When you must go to hospital

GO TO EMERGENCY CARE or call 115 (the emergency number in Vietnam) NOW if your child has any of the following: choking, something stuck in the throat, no sound when crying, or anything in the mouth or around the neck; lips, skin or fingertips turning grey or blue; rapid breathing, laboured breathing, the chest sucking in; drowsy and hard to wake, not rousing however much you call, or floppy; seizures; refusing the breast completely, unable to drink anything; a fever in a baby under three months old; a gel or any medicine has just been put on the gums and the child has gone pale, is breathing fast, is listless. — BE SEEN WITHIN 24–72 HOURS if: your child has a fever, loose stools, vomiting, a cough or a runny nose — not caused by teething, so the cause needs finding; a gum swollen in one spot, with pus or bleeding; ulcers or white patches in the mouth; a child crying inconsolably, feeding much less, and not improving. — If you are unsure, ring and ask before deciding on your own.

The first tooth is through: what to start doing

According to CDC, before your child has teeth, wipe the gums with a soft clean cloth in the morning after the first feed and again just before bed; once teeth have come through, move to a small-headed soft-bristled brush with plain water.
According to CDC, for children under two, ask a doctor or dentist before using fluoride toothpaste.
According to CDC, take your child to a dentist before their first birthday so that anything abnormal is picked up early, and ask about fluoride varnish as soon as the first tooth is through.

To be clear about our part: Y Te Xanh (GreenCare) does not take on home care for newborns and small children, and does not treat children's teeth — that belongs to paediatricians and dentists. What we can do is a remote consultation by video call so you can decide between being seen now and waiting for an appointment; it is not a substitute for your child's routine checks. With a sign in the box above, go in first and ring afterwards.

The signs of teething, the below-38°C mark, teething rings and the freezer follow the NHS page on teething. Teething not causing fever or diarrhoea, the age range, gum gels and aspirin follow MedlinePlus. Children's oral care follows the public materials of the US CDC; benzocaine, rubbing the gums and teething jewellery follow the US FDA. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.

Sources

CDC — Oral Health Tips for Children
NHS — Teething

Frequently asked questions

My child has a fever while teething — is the tooth causing it?

No. According to MedlinePlus, teething does not cause a fever and does not cause diarrhoea; if your child has a fever or diarrhoea and you are worried, contact your child's health care provider. According to NHS, within the picture of teething the temperature may rise slightly but stays below 38°C. Put together, those two give an easy rule: a slight rise may coincide with teething, but a real fever always has another cause that has not been found. Teething age also happens to be the age when children start crawling, putting their hands in their mouths and going to nursery, so catching infections is ordinary. The trap is not the belief itself — it is the several nights parents spend reassured and waiting while an infection runs on. Fever in children has its own article on this site; read the red flag section there.

Should I put a pain gel on my child's gums?

For a child under two, no. According to MedlinePlus, gum gels can only help with pain briefly in children aged two and over, and these things should not be used if your child is younger than two. According to the US FDA, products containing benzocaine can cause a serious, sometimes fatal condition called methemoglobinemia, in which the oxygen-carrying capacity of red blood cells falls sharply. According to NHS there is also little evidence that gum gels work. Many tubes sold in Vietnam list their ingredients in a foreign language, so if you cannot read the label, do not apply it. The things to do first are rubbing the gums and offering a firm rubber teething ring.

Can I give my child a pain medicine?

There are products suitable for children, but who takes one, when, and how much are for a doctor or pharmacist to decide — do not estimate from age or weight. According to NHS, paracetamol (acetaminophen) can be used to relieve teething symptoms in young children from two months of age, and ibuprofen from three months; NHS notes choosing a sugar-free form. According to MedlinePlus, never give your child aspirin, and do not place aspirin on the gums or teeth. Take the actual bottle you have with you to the appointment or the pharmacy, so that whoever is prescribing knows what the child has already had.

Are amber necklaces or neck cords for teething safe?

No, and this is something to stop using altogether. According to the US FDA, they have received reports of deaths and serious injuries in children, including strangulation and choking, from teething jewellery such as amber necklaces. According to MedlinePlus, do not tie a teething ring or anything else around your child's neck; NHS likewise says never to tie a teething ring around a child's neck because it is a choking hazard. There are two separate routes to harm: the cord tightening while the child sleeps or turns over, and a bead coming loose and being inhaled. Both happen when nobody is watching. If one is in use in your house, take it off now, even if the child has worn it for months without incident.

At what age does teething start — should I worry if my child is later than that?

According to MedlinePlus, teething usually begins when a child is between six and eight months old, with all twenty baby teeth in place by thirty months. The two lower front teeth usually come first, then the two upper front teeth. That span is wide, so coming through a little earlier or later is not something to deal with urgently. What is worth asking about is a child who has passed that age range with no teeth at all, or teeth coming through abnormal in shape or colour. According to CDC, take your child to a dentist before their first birthday so that signs of anything abnormal are picked up early — that is the occasion to ask about this, rather than waiting to see.

My teething child is fretful at night and off the breast — how do I know when to be seen?

Eating less and sleeping poorly are part of the teething picture: according to MedlinePlus, refusing food and difficulty sleeping are common signs. But there is a line: feeding LESS is not the same as refusing the breast COMPLETELY and being unable to drink anything — the latter is a reason to go now, whether or not a tooth is coming through. Three other things also mean going now even while a child is teething: drowsy and hard to wake, seizures, and lips or skin turning grey or blue. According to NHS, you know your child best — if there is any symptom that worries you, seek medical advice. That sentence is more reliable than any list: you do not have to prove your child is ill before you are allowed to be seen.

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Teething in babies: a tooth does not give your child a fever