Teething Symptoms in Children: What Is Considered Normal

When a child is teething, parents often hear the same thing: "it's the teeth." But not every fussiness and not every reddened gum is explained by teething. Let's calmly sort out what is considered normal and what is not: there is little reliable data on exactly which symptoms teething causes, so here we will focus on the timing and the process itself.

When teeth begin to erupt

Human teeth erupt twice. The first period is the 20 primary teeth, lasting roughly from 6 to 24–30 months of life. The second period is replacement by permanent teeth, from 5 to 14 years. Wisdom teeth appear at 17–25 years or do not appear at all. The timing and order are sometimes disrupted, most often with wisdom teeth. There are known cases of children born with 1–2 primary teeth already erupted. Since the second half of the 20th century, teething has become earlier, which is attributed to acceleration. Primary teeth erupt approximately up to 24–30 months, meaning at 2 years the process may still be ongoing.

What the gum looks like before teething

There is little reliable information on exactly what the gum looks like before a tooth appears. It is known that eruption is the gradual appearance of the crown above the surface of the alveolar process of the jaw and the gum, and the process ends when the entire crown up to the neck is visible above the gum. Therefore, a "normal" appearance of the gum before eruption cannot be described here: there is no reliable information about it.

Main symptoms of teething in children

There is little reliable data on exactly which symptoms teething causes. This does not mean that children do not experience discomfort, but there is no confirmed data on itching, salivation, or fussiness as signs of teething. Therefore, we will list what is known for certain — the timing and number of teeth.

• 20 primary teeth appear from 6 to 24–30 months
• Replacement by permanent teeth occurs from 5 to 14 years
• Wisdom teeth erupt at 17–25 years or do not erupt at all
• There are known cases of birth with 1–2 primary teeth already erupted

Pain during teething: primary and permanent teeth

Pain during teething is not mentioned in reliable descriptions. Pain is usually described as a symptom of dental diseases, not of natural teething. Therefore, we cannot state that pain is an obligatory part of the process. If a child is fussy, they can be seen by a dentist.

Which symptoms are not associated with teething

Historically, too much was attributed to teething. As early as 1842 in London, it was listed as the cause of death for 4.8% of children under one year and 7.3% of children aged 1 to 3 years. It is now clear: teething is a natural process, and mortality may sometimes have been caused by treatment methods that included leeches on the gum and cauterization of the back of the head. A 1938 textbook recommended lancing the gum, and soothing powders could contain mercury. These historical examples show what attributing extra symptoms to teething and dangerous treatment methods led to.

When to see a doctor

If anything about your child's teeth or gums worries you, consult a dentist. The doctor will ask about symptoms, examine the teeth, perform probing if necessary, and in some cases an X-ray may be needed. This is the standard approach for dental diseases, and it helps rule out problems unrelated to teething.

Teething itself is not a reason to call an ambulance. Call 103 or 112 only if the child's condition is life-threatening.

This material is for reference and does not replace a doctor's consultation: if in doubt, it is better to have your child seen by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer