Teething is one of those parenting experiences that involves a lot of uncertainty. Your baby is unsettled, drooling more than usual and chewing everything in reach, but you cannot see a tooth anywhere. The question most parents find themselves asking is a simple one: what am I actually looking for?
This guide covers what teething gums look like at each stage of the process, how to check safely, what normal teething looks like versus what warrants attention, and how to tell the difference between teething and something else entirely.
What Teething Gums Look Like: Stage by Stage
Teething does not happen overnight. The tooth moves through the gum over a period of days to weeks, and the gum changes appearance at each stage.
Early Stage: Before the Tooth Is Visible
In the days and sometimes weeks before a tooth breaks through, the gum directly above (or below, for lower teeth) the emerging tooth may look:
- Swollen and raised. The gum tissue over the tooth may look slightly puffier than surrounding gum tissue. It can look like a small dome or bump under the surface.
- Redder than surrounding tissue. The increased blood flow to the area as the tooth pushes upward causes localised redness.
- White or bluish beneath the surface. In some babies, you can see a faint white or yellowish line just beneath the gum where the tooth edge is pressing upward. This is one of the clearest early signs that a tooth is approaching the surface.
At this stage the tooth is not yet visible. You are looking at changes to the gum tissue itself rather than the tooth.
Active Breaking-Through Stage
When the tooth is actively cutting through the gum tissue:
- The gum may have a small white dot or ridge visible on the surface. This is the tip of the tooth beginning to emerge.
- The surrounding tissue can look irritated, with a bright red ring around the point of emergence.
- The area may appear shiny or taut.
- In some babies, a small amount of bleeding may be visible. A tiny spot of blood on a teether or your finger after feeling the gum is normal when a tooth is actively cutting through.
This is usually the most uncomfortable stage. The tooth edge cutting through the gum causes direct irritation to the tissue.
After the Tooth Has Broken Through
Once the tip of the tooth is visible through the gum:
- The acute discomfort usually reduces, though the gum around the base of the emerging tooth can remain sore as the tooth continues to rise.
- The white tip of the tooth becomes progressively more visible over days to weeks.
- The gum tissue around the emerging tooth may remain slightly swollen until the tooth is fully up.
How to Check Your Baby’s Gums Safely
Checking gums requires a clean finger and a cooperative baby, neither of which is always easy to arrange. A few practical tips:
When to Check
Choose a moment when your baby is calm and not already distressed. After a feed, when the baby is content, is usually better than mid-crying episode. Natural light or a torch held nearby helps you see more clearly.
How to Check
Wash your hands thoroughly. Gently lower the baby’s bottom lip with one finger to see the lower gum, and lift the upper lip to see the upper gum. Run a clean fingertip gently along the gum ridge to feel for any raised or hard areas that indicate a tooth just below the surface.
A tooth emerging from the lower front gum (lower central incisors, usually the first to appear) will feel like a hard ridge running along part of the gum line rather than the smooth, soft feel of the rest of the gum.
What You Are Feeling For
The difference between a gum with an emerging tooth and a gum without is tactile as much as visual. The gum over an emerging tooth feels harder and less giving than surrounding tissue. Running your finger along the gum and feeling a firm ridge beneath the surface, even before you can see anything, is often the first indication that a tooth is on its way.
Teething Gums vs Healthy Gums: How to Tell the Difference
Healthy Infant Gums
Healthy gums are:
- Pink and firm
- Smooth along the gum ridge
- Consistent in colour and texture across the full gum line
Babies’ gums naturally have a slightly ridged or bumpy texture in some areas due to the teeth positioned underneath, even before teething begins. This is normal and not the same as the localised swelling of active teething.
Teething Gums
Teething gums, in the area where a tooth is approaching, are:
- More swollen and raised than surrounding tissue
- Redder or more purple-red than the rest of the gum
- May feel harder beneath the surface when touched
- May have a visible white dot, line or ridge as the tooth approaches or breaks through
The key is localisation. Teething changes the appearance of the gum in a specific, small area directly over the emerging tooth. The rest of the gum looks normal.
Normal vs Concerning: What Warrants Medical Attention
Most teething symptoms are normal and self-limiting. Some signs warrant a call to your GP or health visitor.
Normal Teething Signs
- Increased drooling
- Chewing and mouthing objects more than usual
- Mild fussiness and unsettledness
- Slightly disturbed sleep around the time of active teething
- A small amount of blood when a tooth is actively cutting through
- A mild temperature increase (not a proper fever)
- Localised gum swelling over the emerging tooth
- A teething rash (red, chapped skin around the mouth and chin caused by drool)
Signs That Are Not Normal Teething
- A temperature of 38 degrees Celsius or above. Teething may cause a very slight temperature increase but a genuine fever is not caused by teething. It is worth investigating separately.
- Diarrhoea. Loose stools sometimes coincide with teething but diarrhoea is not caused by teething. If your baby has significant diarrhoea during a teething period, treat the diarrhoea as its own concern.
- A rash anywhere other than the face and neck. Teething rash stays in the areas where drool contacts skin. A widespread rash is not a teething symptom.
- Significant, persistent gum swelling over a large area. Teething swelling is localised. Widespread, significant gum swelling is unusual.
- A bluish, fluid-filled lump on the gum. This is called an eruption cyst (see below).
What Is an Eruption Cyst?
Some babies develop a smooth, bluish or purplish fluid-filled lump on the gum in the weeks before a tooth emerges. This is called an eruption cyst or eruption haematoma.
What It Looks Like
An eruption cyst looks like a small, raised blister on the gum. It may be bluish, purplish, or transparent depending on how much blood has accumulated in the space above the emerging tooth.
Is It Dangerous?
In most cases, no. Eruption cysts usually resolve on their own when the tooth breaks through the cyst and gum tissue, which typically happens without any intervention.
When to See a Dentist or GP
If the cyst is large, appears to be causing significant pain, is not resolving once the tooth should have come through, or shows signs of infection (increasing redness, heat, or discharge), see your dentist or GP. In rare cases, a small procedure may be needed to help the tooth emerge.
The Teething Timeline: What to Expect and When
Knowing when to expect teeth helps you interpret what you are seeing in the gum.
Lower Central Incisors
Usually the first teeth, typically emerging between 6 and 10 months. These are the two bottom front teeth.
Upper Central Incisors
Usually next, appearing between 8 and 12 months.
Upper Lateral Incisors
The teeth on either side of the upper front teeth, typically 9 to 13 months.
Lower Lateral Incisors
10 to 16 months.
First Molars
12 to 18 months. The first molars are larger teeth and many parents find this teething period more uncomfortable for the baby than the earlier ones.
Canines
The pointed teeth, upper and lower, typically 16 to 22 months.
Second Molars
The final baby teeth, typically 20 to 33 months. Most children have their full set of 20 baby teeth by around two and a half to three years.
How to Soothe Teething Gums
Chilled Teething Toys
A teething ring chilled (not frozen) in the fridge provides counter-pressure on the gum, which many babies find relieving. Frozen teething toys can be too cold for sensitive gum tissue and should be avoided.
Clean Finger Pressure
Gently rubbing the sore gum with a clean finger provides counter-pressure similar to a teether and also gives you the opportunity to assess what is happening.
Chilled Foods
For babies who have started solids, chilled pureed food, chilled cucumber sticks or a cold damp cloth to chew on can provide relief.
Teething Gels
Over-the-counter teething gels vary in their evidence base. Products containing lignocaine (a local anaesthetic) are no longer recommended for infants. Sugar-free gels without anaesthetic agents can provide mild relief. Check the age recommendation on any product before use.
Paracetamol or Ibuprofen
For genuine teething pain that is disturbing sleep or causing significant distress, age-appropriate infant paracetamol or ibuprofen is appropriate. Check the dose for your baby’s weight, not their age, and follow the packaging guidance.