• Teething does not cause fever, upper respiratory infection, ear infection, or diarrhea.
  • Teething may cause fussiness.
  • Drooling is developmentally normal in infancy.

Eruption Hematoma


Anticipatory Guidance

  • Apply cold teething ring or cloth to gums.
  • Provide acetaminophen or ibuprofen if necessary.
  • Avoid teething gels—they are not effective and contain topical anesthetics (benzocaine) which can be dangerous in infancy. The FDA warned in 2018 that over-the-counter drug products containing benzocaine should not be used to treat infants and children younger than 2 years. Such products carry serious risks and provide little to no benefits for treating oral pain. Benzocaine can cause a condition in which the amount of oxygen carried through the blood is greatly reduced (methemoglobinemia) which can be life-threatening or lethal.
  • Remember tooth emergence may be preceded by a hematoma—no treatment is needed in primary dentition.
  • Recommend never to dip pacifier in honey or other sweetened food.


Wake M, Hesketh K, Lucas J. Teething and tooth eruption in infants: A cohort study. Pediatrics. 2000;106(6):1374-9.


U.S. Food and Drug Administration. Drug Safety Communications. Risk of serious and potentially fatal blood disorder prompts FDA action on oral over-the-counter benzocaine products used for teething and mouth pain and prescription local anesthetics. 5-23-2018. View site here.