Does Teething Cause Fever? AAP Guidelines

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Does Teething Cause a Fever? What Parents Need to Know

For many parents, the arrival of a baby’s first tooth is a milestone marked by fussiness, drooling, and a baby who feels warm to the touch. It’s common to wonder if these symptoms, particularly a rise in temperature, are caused by teething. However, medical evidence clarifies a critical distinction between a “teething warm-up” and a true medical fever.

Key Takeaways:

  • Teething does not cause a true fever.
  • The American Academy of Pediatrics (AAP) defines a fever as a rectal temperature of 100.4°F (38°C) or higher.
  • Avoid using benzocaine or lidocaine products for teething pain due to serious safety risks.
  • Safe alternatives include gum massage and firm rubber teething rings.

The Truth About Teething and Temperature

It is a common misconception that cutting teeth causes a high fever. Whereas teething can make an infant feel slightly warm, it does not push a baby’s temperature into the fever range. According to the American Academy of Pediatrics (AAP), any temperature of 100.4°F (38°C) or higher, measured rectally, is considered a fever.

Teething may cause a slight increase in body temperature, sometimes reaching 99–100°F, but this is below the clinical threshold for a fever. If your baby has a temperature of 100.4°F or higher, it is likely caused by something else, such as a viral or bacterial infection. Since teething typically begins around 4 to 7 months—the same age babies start losing maternal immune protection and catching more colds—parents often mistake a coincidental illness for teething symptoms.

Recognizing Common Teething Symptoms

Teething is a normal part of development, with most infants having a total of 20 “baby teeth” by the age of three. While the experience varies for every child, the FDA notes that occasional symptoms include:

Recognizing Common Teething Symptoms
  • Mild irritability
  • Increased drooling
  • A strong urge to chew on hard objects
  • A low-grade rise in temperature (but not a true fever)

Safe Ways to Soothe Teething Pain

When infants experience gum discomfort, parents should prioritize safe, non-medicinal interventions. The AAP recommends the following methods to ease the pain:

  • Gum Massage: Gently rub the infant’s gums with a clean finger.
  • Firm Teething Toys: Provide a teething ring made of firm rubber for the baby to chew on.
  • Alternative Feeding: If a baby refuses a bottle or breast due to discomfort, try offering milk or formula via a spoon, cup, or syringe for a short period.

Dangerous Products to Avoid

Some over-the-counter products marketed for teething can be hazardous. The FDA warns parents against using topical medications containing benzocaine or lidocaine, as well as certain homeopathic teething tablets.

The Risk of Benzocaine

Benzocaine is a local anesthetic found in products such as Orajel, HurriCaine, Anbesol, and Cepacol. These should not be used for teething because they can lead to a rare but potentially fatal condition called methemoglobinemia. This condition significantly reduces the oxygen-carrying capacity of red blood cells, posing a severe risk to infants.

Summary and When to Call the Doctor

While teething is a challenging phase for both baby and parent, it should not cause a significant spike in temperature. If your child exhibits a rectal temperature of 100.4°F or higher, do not dismiss it as “just teething.” A true fever requires a closer look from a healthcare provider to rule out underlying infections.

FAQ: Teething Quick Guide

Question Answer
When does teething usually start? On average, between 4 and 7 months of age.
What is the fever threshold for infants? 100.4°F (38°C) or higher, measured rectally.
Are teething gels safe? No, those containing benzocaine or lidocaine are dangerous and not recommended.

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