Somewhere right now, a baby has a runny nose, a low-grade fever, diarrhea, a rash, trouble sleeping, and is generally miserable, and somewhere right now, someone’s grandmother is nodding sagely and saying “it’s just teething, honey.”
I would like to formally introduce that grandmother to a pediatrician named Dr. R.S. Illingsworth, who wrote back in 1975 the single most quotable sentence in all of pediatric dentistry: “Teething produces nothing but teeth.”
Fifty-one years later, we’re still fighting this battle, and teething is still getting blamed for approximately every symptom an infant can produce short of a broken arm.
The Actual Evidence, Which Nobody Reads at 3 A.M.
Here’s what teething has actually been shown to do: cause mild gum discomfort, a little drooling, and maybe a slight — and I mean slight — bump in temperature, for a narrow window of about eight days total: four days before a tooth erupts, the day of, and three days after (Macknin et al., Pediatrics, 2000). That’s it. That’s the whole résumé.
That same Macknin study followed 125 babies through 475 individual tooth eruptions and found that temperatures nudged up slightly during teething — but stayed well below what anyone would actually call a fever. A separate study reached the same conclusion: teething could raise temperature marginally, but it did not cause true fever (Massignan et al., Pediatrics, 2016). So if your baby’s thermometer reads 100.4°F or higher, I have some breaking news: the tooth is not the problem. Something else is going on, and it deserves an actual look, not a teething ring and a shrug.
And yet. A survey of mothers found that literally 100% of participants attributed at least one symptom to teething. Fever was blamed 70% of the time. Diarrhea, 68.5%. Sleep disturbance, 63.5% (Qatar Medical Journal). Somewhere between “tooth erupts” and “baby has explosive diarrhea,” an entire mythology got built with zero supporting evidence — and the same research found it’s not just parents. A significant number of doctors, dentists, and pharmacists are still attributing these symptoms to teething too, despite the evidence not being there (Qatar Medical Journal).
Why Everyone Falls For It (Including Some of My Colleagues)
The reason this myth is so durable is almost elegant: teeth erupt slowly and continuously for about two years, from roughly 6 to 30 months of age — which happens to be the exact window when babies are also picking up every virus daycare, siblings, and the produce aisle have to offer (Qatar Medical Journal). A tooth is basically always “coming in” during infancy. So whatever illness shows up in that stretch gets assigned to the nearest visible culprit — the tooth — instead of the actual, unglamorous, invisible virus that caused it. It’s less “correlation implies causation” and more “correlation is unavoidable because the correlated event lasts two years.”
There’s also a genuinely dark historical footnote here: in previous centuries, infant mortality peaked during the exact age range when teething occurs, so physicians of the era assumed teething itself was dangerous and could be fatal (Qatar Medical Journal). It wasn’t the teeth. It was, overwhelmingly, infectious disease in an era before vaccines and antibiotics. But the reputational damage was done, and “teething is dangerous” got baked into folk wisdom for the next two hundred years.
The Part Where This Stops Being Funny
Here’s where my sarcasm runs out: because everyone believes teething causes real suffering, an entire industry of “teething remedies” sprang up to treat symptoms that were never caused by teething in the first place — and some of them have killed children.
Benzocaine-containing gels like Orajel were marketed directly at parents rubbing something onto sore gums. The FDA now warns these products should never be used in children under two, full stop, because they can exacerbate methemoglobinemia — a condition where the blood loses its ability to carry oxygen — and it can be fatal (FDA). Between 2009 and 2017 alone, the FDA identified 119 cases of benzocaine-associated methemoglobinemia, including the death of a four-month-old infant given the product specifically for teething pain (FDA Letter Regarding Benzocaine).
Then there’s Hyland’s homeopathic teething tablets, which contained belladonna — deadly nightshade — at inconsistent and sometimes dangerously high doses. The FDA linked these tablets to 10 infant deaths and over 400 adverse events, including seizures, before a nationwide recall in 2017 (FDA Recall Notice; STAT News). Let that sink in: babies died from a product marketed to treat a set of symptoms the tooth was never actually causing. We built a genuinely dangerous industry to medicate a myth.
What I Actually Tell Parents
If your baby is drooling more than usual and gnawing on everything within reach, that’s teething, and it’s uncomfortable but manageable. Rub the gums with a clean finger. Give them a chilled (not frozen — frostbite is a real thing) teething ring or a cold washcloth. That’s the entire evidence-based treatment plan, straight from the American Academy of Pediatrics (abc7chicago.com). No gels. No tablets. No amber necklaces, which the FDA also warns against — not because of belladonna this time, but because they’ve caused strangulation and choking deaths (FDA).
If your baby has an actual fever — 100.4°F or higher — diarrhea, a rash, or is unusually lethargic, that is not a tooth doing that. That is an illness doing that, and it deserves a real evaluation, not a dismissal because there happens to be a molar on the way. The eight-day window around an actual eruption is the only time frame where mild, tooth-related symptoms have any business showing up. Everything outside that window, and most things more dramatic than “a little fussy and drooly” inside it, is not teething. It’s just an infant being an infant, catching what infants catch, on a schedule that happens to overlap with a two-year parade of incoming teeth.
Dr. Illingsworth was right in 1975 and he’s still right now. Teething produces teeth. It does not produce fevers, diarrhea, rashes, or the excuse we’ve all been using to avoid taking a genuinely sick baby seriously.
Any advice or information given in this blog should not supersede consultation with your pediatrician or practitioner of choice. Every child is unique, and medical decisions must be made in partnership with the healthcare provider who knows your child’s full history. This blog is intended for educational and informational purposes only, not as a substitute for personalized medical care.
If you are looking for medical advice that is evidence-based, ethically grounded, and uncompromised by industry influence, you are in the right place.
Sources:
Mothers’ false beliefs and myths associated with teething, Qatar Medical Journal (2020)
FDA: Safely Soothing Teething Pain in Infants and Children
FDA Letter Regarding Benzocaine
FDA: Standard Homeopathic Company Nationwide Recall of Hyland’s Baby Teething Tablets
Homeopathic teething tablets tied to infant seizures recalled, STAT News (2017)
Teething tablets may be linked to 10 children’s deaths, FDA says, ABC7 Chicago (2016)