Introduction

Teething is a natural process by which a baby’s first teeth erupt through the gums. This is also known as odontiasis. Most babies get their first tooth around six months of age and have a full set of 20 deciduous teeth (also known as milk teeth) by 36 months. However, every baby is different. Some babies can be born with their first teeth, while others only start teething after 12 months.

Teething can be a frustrating and stressful time for both babies and parents. Many people believe that teething can cause problem behaviour and health issues, and often resort to using a variety of methods and remedies to try to alleviate symptoms. Many beliefs are false, and some treatments can result in serious injury or toxicity. It is therefore essential to distinguish fact from fiction. We have debunked the myths around teething so that you can ensure your baby is off to a healthy start. 

Common Teething Myths 

For centuries, teething has been attributed to a wide range of symptoms, including irritability, high fever, diarrhoea, systemic illness, and poor sleep.¹ Before modern medicine, teething was even attributed to convulsions and death. In 1894 a renowned dentist known as Dr Thrasher, wrote ‘So deadly has teething become that one third of the human family die before 20 deciduous teeth have fully appeared’.² 

Throughout the ages, many cures and potions have been suggested for teething, for example rubbing substances such as hare’s brain, mercury and lead onto inflamed gums.² Ironically, many of these substances were poisonous and directly contributed to the high death rates in babies during these times. In the 16^th century, a popular treatment was to cut a cross on the baby’s gum above where the tooth was about to erupt.² Thankfully, many of these bizarre rituals have now been abandoned. However, many cultures still have superstitions and traditional beliefs around teething, which can have detrimental consequences to an infant’s health.

Myth 1: Teething causes extreme pain

Fact

Teething can lead to local gum inflammation and discomfort, but should not cause extreme pain.

Scientific evidence

The most common signs of teething reported by scientists are local discomfort, irritation and drooling.¹ This is caused by the pressure of the emerging teeth on the gums. Babies experiencing severe pain should see a health care practitioner as soon as possible, as there could be something more serious underlying. The colloquial term “cutting a tooth” sounds like an extremely painful process, but in reality, teething pain is usually mild.   

Myth 2: Teething causes high fevers

Fact

Tooth eruption may cause a slight increase in body temperature, but does not result in high fevers.

Scientific evidence

While some babies may have a slight increase in body temperature while teething, it is usually mild and not a cause for concern.^1,3 A fever above 38˚C should never be ignored, especially if accompanied by other concerning symptoms such as difficulty feeding, poor appetite, fast breathing, drowsiness, lethargy, or seizures.⁴ These symptoms may indicate an underlying illness that requires prompt medical attention. 

Myth 3: Teething can cause diarrhoea

Fact

While some parents may notice slight changes in their baby’s bowel movements during teething, there is no conclusive evidence directly linking diarrhoea to teething.

Scientific evidence

There is no strong evidence that teething causes diarrhoea.⁵ Around the age of teething (approximately 6 months), babies start to crawl and put objects and dirty hands in their mouths, which could introduce germs that cause diarrhoea.^1,5 Since diarrhoea is the third leading cause of death in children under the age of five,⁶ other potential causes should be considered rather than simply attributing the diarrhoea to teething.

Myth 4: Teething causes systemic illnesses

Fact

While teething and systemic illness may occur around the same time, one does not cause the other. 

Scientific evidence

Around 6 months of age, babies normally have a lowered immune system due to their decreasing passive immunity resulting from a loss of antibodies they receive from the mother. This can make babies more susceptible to infections and illness.⁵ It also coincides with the time when the first milk teeth typically erupt. While systemic illness and teething may occur around the same time, one does not cause the other.⁷ Incorrectly attributing illness to teething can cause a delay in seeking proper medical care, which can have serious and even fatal consequences.

Myth 5: Rubbing alcohol or honey onto the gums is a safe treatment option 

Fact 

Both alcohol and honey can be dangerous for your baby and should be avoided.

Scientific evidence

Moderate alcohol exposure in babies can affect their motor and brain development.⁸ Alcohol rubbed onto the gums can also increase the risk of hypoglycaemia (low blood sugar levels).⁵

Honey should never be given to infants under one year of age, as it could cause infant botulism.⁹ This is a rare but serious disease which is caused when the spores of a specific bacterium, called Clostridium botulinum, are swallowed. Although there are many potential sources of infection, contaminated honey has been associated with many cases.  

Myth 6: All teething gels are safe

Fact 

Experts have warned that many licensed teething products contain sucrose or numbing agents, which may cause potential harm to your baby’s health. 

Scientific evidence

Milk teeth are particularly susceptible to decay since the outer layer of the tooth has less mineral content than permanent teeth.⁸ Teething products containing sucrose (which is simply the chemical name for sugar) may lead to tooth decay and should therefore be avoided.

Teething products often contain numbing agents such as lidocaine or benzocaine. There have been cases of poisoning when babies were given too much or accidentally swallowed the gel.^8,10 The risk of overdose is higher in the gels that have stronger concentrations of these ingredients. It is safest to avoid teething gels containing numbing agents altogether or choose those with the lowest possible concentration.^8,11 

Myth 7: Cutting the gums can help teeth erupt faster or cure illness

Fact

There is no evidence that cutting the gum helps teeth erupt faster or cure illness. Cutting the gums is dangerous, painful and should never be performed.  

Scientific evidence

The practice of creating an incision on the gums over the erupting teeth or extracting the tooth bud remains widespread in some communities in East and Central Africa. The traditional healers believe that this could cure a range of illnesses, such as diarrhoea.¹² This practice can have serious short- and long-term consequences, including severe infection and death.¹² 

Myth 8: Teething causes sleep disturbances

Fact

Most experts agree that teething does not cause significant sleep disturbances.

Scientific evidence

There is no strong evidence that teething causes significant sleep disturbances.¹³ Incorrectly attributing teething to poor sleep could lead parents to overusing teething gels and pain killers. It is important to consult with professionals, such as a paediatrician or qualified sleep coach, if sleep problems are highly disruptive or persistent, as there may be an underlying issue.

Myth 9: Amber or Tlismi teething necklaces soothe teething pain

Fact 

The claim that wearing amber or Tlismi teething necklaces can soothe teething pain is unfounded. Using any type of necklace placed around your baby’s neck can be dangerous and should be avoided or only used under direct supervision. 

Scientific evidence

There is no scientific evidence that amber or Tlismi teething necklaces soothe teething pain. ^14,15 Studies have shown that the risks of using teething necklaces far outweigh any benefits. They have been associated with the following risks: 

• Choking hazard if the beads come loose
• Swallowing of the beads
• Strangulation hazard
• Injury to the gums
• Source of harmful bacteria^14,15

What treatments work?

If your baby seems uncomfortable, you could try one of the following safe treatment strategies to help relieve discomfort: 

• Textured teething rings 
• Liquid-filled teething rings, which have been chilled in the refrigerator 
• Gentle gum massage with a clean finger, wet gauze or cool spoon
• Sugar-free teething biscuits, breadsticks or rusks (only if already eating solids)
• Fresh and frozen fruit and vegetables (such as peeled cucumber or frozen banana, or frozen bagels)
• Pain relief medication only when advised by a doctor⁵

Summary

Many teething beliefs and remedies are based on myths rather than scientific evidence. 

Babies go through many immune and developmental changes between 6 to 36 months, the same time when the first teeth erupt. It is therefore not surprising that teething is mistakenly linked with symptoms such as high fever, systemic illness, diarrhoea and sleep disturbances.

To ensure a child’s safety, parents should always consult health care professionals when a child is ill and before using teething treatments.