From the Guidelines
Teething typically does not cause high fevers, and a temperature above 100.4°F (38°C) is generally not attributed to teething alone. While teething may cause a slight temperature elevation (up to 99°F or 37.2°C), it is essential to evaluate the child for potential infections or illnesses if a true fever is present 1. During teething, babies may experience irritability, drooling, gum swelling, and mild discomfort, which can be managed with gentle gum massage using a clean finger, cold teething rings (refrigerated, not frozen), or age-appropriate over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for babies over 6 months. Some key points to consider when managing teething symptoms include:
- Follow package dosing instructions based on your child's weight
- Monitor for signs of infection or illness, such as decreased feeding, lethargy, or persistent crying
- Contact your pediatrician promptly if your baby has a temperature above 100.4°F, especially with other concerning symptoms It is crucial to note that the timing of teething symptoms coincides with when babies lose maternal antibody protection and become more susceptible to infections, which explains why fevers and teething often seem related 1. Therefore, it is essential to prioritize the child's health and seek medical attention if a high fever is present.
From the Research
Teething and Fever
- Teething does not appear to cause high fever, according to a study published in the American Family Physician in 1989 2.
- A study published in the Archives of Disease in Childhood in 1992 found that while there was a higher incidence of fever on the day of tooth eruption, the danger of attributing fever to teething is emphasized, suggesting that other causes of fever should not be overlooked 3.
- Another study published in the same journal is not directly relevant to the question of whether teething can cause high fever, but rather discusses the treatment of fever in children 4.
- Two other studies, published in Nursing Standard in 2016 5 and Evidence-based Child Health in 2014 6, do not provide direct evidence on the relationship between teething and high fever.
Treatment of Fever
- The study published in Evidence-based Child Health in 2014 found that combined and alternating paracetamol and ibuprofen therapy may be more effective at reducing temperatures than monotherapy alone, but the evidence for improvements in measures of child discomfort remains inconclusive 6.
- The study published in Annals of Emergency Medicine in 2013 found that combination treatment with ibuprofen and acetaminophen is beneficial over either agent alone for sustained fever reduction in children older than 6 months 4.