How to tell the difference between a teething baby and a sick baby

Sometimes the irritation from teething and the symptoms of an illness are similar. Here's how to tell what your baby's really going through.
baby crying and sucking on finger

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Typically, first teeth appear between six and eight months of age. Bottom front teeth usually come in first, followed by the top front teeth. You’ll normally see the first molar soon after your baby turns one. That amounts to many months of second-guessing symptoms.

It’s not always teething
Joana Ramos-Jorge, a paediatric dentist in Brazil, recently conducted an eight-month study of baby tooth eruptions and teething symptoms. In her practice, Ramos-Jorge had noticed that parents frequently came to her seeking dental care for their teething babies, when in reality the children were ill with something else, like a virus.

Her study found that symptoms associated with teething included rashes, drooling, runny noses, short-lived diarrhea, crankiness, loss of appetite and mild temperatures. The symptoms were never severe, and they weren’t prolonged, often beginning the day a pearly white popped through and lasting until the day after. Babies with illnesses experienced more persistent symptoms.

Symptom longevity
Carl Cummings, a Montreal paediatrician, agrees with this assessment. “The longer the symptom lasts, the less likely it is to be from teething,” he says. If a baby is fretful four or five nights instead of one or two, if diarrhea continues for more than a day, or if a fever is higher than 38.5°c, you should be calling the doctor instead of blaming an incisor. “Teething is the interpretation you arrive at after you’re pretty sure it’s nothing else,” Cummings adds.

Try acetaminophen
In general, a baby who chomps everything in sight and is drooling like nobody’s business is most likely cutting a tooth. For discomfort caused by a mild fever, first try giving your baby acetaminophen. If she’s teething, she’ll feel better. (And if it doesn’t provide relief, something else is likely going on.) Cummings also suggests offering chilled teething rings and comforting your baby by carrying her around. The U.S. Food and Drug Administration recommends that parents not use teething gels or tablets because they pose a risk to your baby’s health.

A version of this article appeared in our September 2012 issue with the headline “Tooth truths,” pp. 82. 

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Teething symptoms and solutions
7 teething myths
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