Teething and Fever: Why Parents Shouldn’t Worry About High Temperatures

Teething is an inevitable part of every child's early development, but it comes with an abundance of myths and misconceptions that can lead to confusion, unnecessary concern, and mismanagement. One of the most pervasive and misleading of these myths is the idea that teething causes fevers. Many parents and even some healthcare professionals continue to attribute fever and other symptoms like diarrhea or irritability to teething, potentially overlooking more serious underlying conditions.

In this article, we'll delve deep into the relationship between teething and other commonly believed myths, unraveling the facts to ensure that healthcare professionals are armed with evidence-based information when counseling parents.

Teething and Fever: Myth vs. Reality

The notion that teething causes fevers is widespread, but it lacks scientific backing. Numerous studies have examined the connection between teething and febrile responses, yet none have consistently found teething to be responsible for significant rises in body temperature.

What Does the Evidence Say?

One of the largest studies on this topic, published in Pediatrics (2000), examined the symptoms of 125 children during their teething phase. The study found that while children did experience mild increases in temperature, this was not enough to classify as a fever (which is typically defined as a temperature over 100.4°F or 38°C). Instead, teething was associated with minor symptoms like irritability, drooling, and gum discomfort.

More recently, a review published in the Journal of the American Academy of Pediatrics reaffirmed that teething does not cause high-grade fevers. This review highlighted that attributing fever to teething could lead to a missed diagnosis of infections or other illnesses. This is especially dangerous, as underlying conditions like viral or bacterial infections could require immediate medical attention.

In conclusion, teething can cause slight discomfort and maybe a minor temperature rise, but it does not cause true fever. Healthcare professionals should always advise parents to monitor their child’s symptoms carefully and seek medical evaluation for any significant fever or prolonged illness.

Other Teething Myths: Debunked

Fever isn’t the only myth associated with teething. Many misconceptions persist, despite being debunked by science. Let's explore some of the most common myths and separate fact from fiction.

Myth 1: Teething Causes Diarrhea

Another common belief is that teething leads to diarrhea. The idea behind this myth likely stems from the fact that teething babies often drool more, leading parents to think this excess saliva affects the digestive system. However, there is no conclusive scientific evidence linking teething to diarrhea.

A study published in the Archives of Diseases in Childhood in 2016 examined the incidence of gastrointestinal disturbances during teething and found no significant relationship between teething and diarrhea. While it's true that infants may put objects in their mouths to soothe their gums, increasing the risk of exposure to bacteria, this does not mean that teething itself is causing gastrointestinal symptoms.

If a baby experiences persistent diarrhea, healthcare providers should be alert to other causes, such as viral gastroenteritis, food intolerance, or infection, rather than attributing it to teething.

Myth 2: Teething Causes Ear Infections

Many parents and even some pediatricians believe that teething can cause ear infections, as babies tend to tug at their ears when teething. The assumption is that the discomfort from teething radiates to the ear due to shared nerve pathways in the face and jaw.

However, teething does not directly cause ear infections. Ear pulling is more likely a sign of teething-related discomfort, not an actual ear infection. Ear infections are usually caused by viral or bacterial agents that affect the middle ear, unrelated to teething.

When babies tug at their ears, healthcare professionals should carefully assess other symptoms such as fever, irritability, or fluid drainage, which may indicate a true ear infection rather than assuming teething is the culprit.

Myth 3: Teething Can Cause Severe Pain

While teething is certainly uncomfortable, and babies may show signs of irritability and gum tenderness, the belief that teething causes excruciating pain is exaggerated. Most babies tolerate teething with mild discomfort. It's important to remember that teething is a natural developmental process, and while some infants may experience more distress than others, it is generally not a cause for extreme pain.

Parents may notice their babies becoming fussier or having trouble sleeping, but severe crying, inconsolable behavior, or prolonged discomfort should prompt further medical investigation. This ensures that other causes of distress, such as illness or injury, are not missed.

Myth 4: Teething Toys and Gels Are Necessary for Pain Relief

Teething toys, gels, and other products are often marketed as essential for soothing teething pain. While some toys can help provide relief by offering a safe, chewable surface, the reliance on gels and teething tablets is not always necessary—and in some cases, it can be harmful.

The FDA has warned against the use of some over-the-counter teething gels that contain benzocaine, as they pose a risk of methemoglobinemia, a rare but serious condition that reduces the blood's ability to carry oxygen. Similarly, homeopathic teething tablets have been recalled in the past due to concerns over inconsistent levels of belladonna, a potentially toxic substance.

Healthcare professionals should advise parents to use simple, safe alternatives such as a clean, cool washcloth or refrigerated teething rings. These options offer relief without the risks associated with teething gels and tablets.

The Real Symptoms of Teething: What to Expect

While teething doesn't cause fever, diarrhea, or ear infections, it does come with a recognizable set of symptoms. Parents should be educated on what to expect during this stage of development and how to manage these symptoms effectively.

Here are the most common teething symptoms:

• Drooling: Increased saliva production is a hallmark of teething and can sometimes cause a rash around the mouth or on the chin.
• Irritability: Babies may become fussier during teething, especially at night when the discomfort may interfere with sleep.
• Gum Swelling: The gums around the erupting tooth may become slightly swollen and tender.
• Chewing on Objects: Babies often chew on anything they can get their hands on to relieve the pressure of the emerging tooth.
• Decreased Appetite: Some babies may eat less than usual due to gum discomfort.

While these symptoms are typical of teething, healthcare professionals should remind parents that if they notice more serious symptoms such as fever, diarrhea, or persistent irritability, they should seek medical advice to rule out other conditions.

Best Practices for Managing Teething Symptoms

When counseling parents on managing teething discomfort, healthcare professionals should emphasize safe, effective methods. Here are evidence-based strategies that can help soothe a teething baby:

1. Cold Compresses: Applying a cold, wet washcloth or a chilled (but not frozen) teething ring can help soothe swollen gums.
2. Gentle Gum Massage: Gently rubbing the baby's gums with a clean finger can help alleviate discomfort.
3. Teething Toys: Choose BPA-free teething toys that are designed to be chewed on safely. Avoid toys that are frozen solid, as they can be too hard and potentially harm the baby's gums.
4. Avoid Harmful Teething Products: Avoid using gels containing benzocaine or homeopathic teething tablets, as they may pose health risks.
5. Keep the Baby Comfortable: Ensure the baby stays hydrated, well-fed, and gets plenty of rest. A comforting environment can help reduce irritability.

When to Seek Medical Advice

Although teething is a normal part of child development, there are certain situations where healthcare providers should guide parents to seek medical attention:

• High Fever: Any fever over 100.4°F (38°C) should not be dismissed as teething-related and warrants further investigation.
• Persistent Symptoms: If irritability, discomfort, or any other symptoms persist beyond a few days, healthcare professionals should rule out other causes.
• Diarrhea or Vomiting: These are not common teething symptoms and should be evaluated to rule out gastrointestinal infections or other illnesses.

The Bottom Line: Teething Isn’t to Blame for Everything

Teething is often blamed for a wide range of symptoms, many of which are unrelated to the actual process of tooth eruption. Fever, diarrhea, ear infections, and severe pain are not typical symptoms of teething, and attributing these issues to teething may delay necessary medical care.

Healthcare professionals must dispel these myths and provide parents with accurate, evidence-based information. By doing so, they can help parents better understand and manage teething while ensuring that more serious conditions are not overlooked.