Quick Answer
No. True fever, defined as a temperature at or above 38°C (100.4°F), is not caused by teething. This is one of the most persistent myths in infant care, and the evidence is consistent: multiple studies examining the relationship between tooth eruption and temperature have found that teething may be associated with a very slight elevation in body temperature (typically less than 0.5°C above baseline), but not with a fever by any clinical definition. A baby who has a temperature at or above 38°C while teething has a fever from another cause and needs to be assessed for that cause rather than having the fever attributed to teething.
What the Evidence Shows
Several prospective studies have tracked infants through the teething period and measured temperature and symptom patterns around the time of each tooth eruption. The findings are consistent: a mild temperature elevation of less than 0.5°C above the child's own baseline may occur in the one to two days immediately before and after a tooth breaks through the gum, likely due to local gum inflammation. However, this elevation does not meet the clinical threshold for fever and is not detectable by touch or a casual measurement in most cases.
A Cochrane-adjacent systematic review of teething symptoms found that while parents commonly report fever as a teething symptom, objective temperature measurements do not support this. The disconnect is likely explained by the timing coincidence: the primary teething period (roughly six to thirty months) overlaps heavily with the period of highest exposure to common infections in infants, as maternal antibody protection wanes and the child's own immune system encounters new pathogens at nursery, playgroups, and through older siblings. A fever that appears while a tooth is erupting is most likely a viral infection that happened to coincide with teething, not a consequence of it.
What Teething Does Cause
The symptoms that have reasonable research support as genuinely associated with teething are more localised and milder than fever:
- Increased drooling. The most consistently documented teething symptom. Drooling typically increases in the weeks before a tooth erupts and can cause a mild facial rash from skin contact with saliva
- Gum irritation and rubbing. The gum over an erupting tooth is swollen and tender, and babies characteristically chew on objects, fingers, and anything within reach to apply counter-pressure
- Mild irritability. The discomfort of gum inflammation can cause a baby to be more fussy than usual, particularly in the day or two immediately around eruption
- Disrupted sleep. Gum discomfort at night can increase waking, though significant or persistent sleep disruption is more likely to have another cause
- Reduced appetite. Some babies eat and drink less during active teething due to gum sensitivity, particularly with foods or bottles that put pressure on the gum
Diarrhoea is another commonly reported teething symptom that lacks strong research support. Like fever, loose stools during the teething period are more likely attributable to the increased mouthing behaviour (which increases exposure to pathogens) than to teething itself.
When to Call a Doctor
A fever above 38°C (100.4°F) in an infant always warrants assessment, regardless of whether the baby is teething. Specific situations requiring prompt contact:
- Any fever in a baby under three months old: this is a medical emergency requiring same-day assessment
- Fever above 39°C (102.2°F) at any age
- Fever lasting more than two to three days
- Fever accompanied by other symptoms: significant lethargy, rash, difficulty breathing, persistent vomiting, or refusal to feed
- Any situation where the parent is concerned, regardless of temperature reading
Do not delay seeking assessment for fever by assuming teething is the cause. The two can coincide, but one does not cause the other.
Managing Genuine Teething Discomfort
For the symptoms that teething does genuinely cause (gum tenderness, irritability, drooling), the approaches with the most evidence or practical support are:
- Chilled (not frozen) teething rings. Cold reduces gum inflammation and provides counter-pressure. Frozen teethers can be too hard and cold and may damage gum tissue; a refrigerated (not frozen) ring is more appropriate
- Gentle gum massage. A clean finger applied with gentle pressure to the swollen gum area can relieve discomfort briefly
- Age-appropriate pain relief. Infant paracetamol or ibuprofen (ibuprofen from six months) at appropriate doses can be used for genuine teething discomfort. These are more reliably effective than topical teething gels, most of which contain either benzocaine (not recommended for infants due to the risk of methaemoglobinaemia) or lidocaine (which can numb the throat and affect swallowing), and which wash off quickly with saliva anyway
Key Takeaway
Teething does not cause fever. A temperature at or above 38°C (100.4°F) in a teething baby has another cause and needs to be assessed as such. The mild temperature elevation sometimes associated with teething is below the clinical fever threshold and not detectable by touch in most cases. The symptoms teething genuinely causes are localised: increased drooling, gum tenderness, mild irritability, and mouthing behaviour. Manage these with chilled teething rings, gentle gum massage, and infant paracetamol or ibuprofen if needed. Never attribute a fever to teething and delay seeking assessment on that basis.
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This article is for informational purposes only and is not a substitute for professional medical advice. A fever above 38°C (100.4°F) always warrants assessment by a doctor, regardless of whether your baby is teething.