Can teething cause fever in infants?

Teething and Fever in Infants

Teething does not cause significant fever (>38°C/100.4°F) in infants, and fever during teething should prompt evaluation for other causes. 1, 2, 3

Evidence on Teething and Fever

• While mild temperature elevation may occur during teething, clinically significant fever (≥38°C/100.4°F) is reported in only 15.2% of teething infants and should not be attributed to teething alone 4

• A prospective study examining mothers' reports found that although some infants had temperatures >37.5°C on the day of tooth eruption, attributing significant fever solely to teething is dangerous and can lead to missed diagnoses 1

• Research shows no statistically significant difference in body temperature between "tooth days" (days preceding tooth eruption) and "non-tooth days" in infants 3

• While many symptoms are temporally associated with teething, no symptom cluster can reliably predict tooth emergence, and fevers >102°F were not significantly associated with teething 2

Common Teething Symptoms vs. Concerning Symptoms

Symptoms commonly associated with teething:

• Increased biting and gum-rubbing 2
• Drooling 2, 5
• Irritability 2, 5
• Mild temperature elevation (but not high fever) 2
• Decreased appetite for solid foods 2

Symptoms NOT reliably associated with teething:

• Fever >38°C/102°F 2, 3
• Vomiting 2
• Significant sleep disturbance 2
• Cough 2

Clinical Implications and Management

• Fever in an infant should prompt evaluation for other causes, particularly infections like urinary tract infections, which are present in approximately 3-7% of febrile children aged 2 months to 2 years with no other identifiable source 6

• Fever is often the most common symptom in young infants with infections, and attributing it solely to teething can delay diagnosis of serious conditions 6

• Young children with fever without source should be evaluated for potential bacterial infections, as approximately 8-13% of young febrile infants have bacterial infections, predominantly urinary tract infections 6

• Self-medication to relieve teething symptoms is common practice among parents, but proper medical evaluation should be sought for significant fever 5

Important Considerations

• Parents commonly attribute a wide range of symptoms to teething, including fever, but research does not support these strong beliefs 3

• Before caregivers attribute any infant's signs or symptoms of potentially serious illness to teething, other possible causes must be ruled out 2

• Fever in infants, especially those under 3 months, requires careful evaluation as it may indicate serious bacterial infection 6

• The risk of missing a serious infection by attributing fever to teething outweighs any benefit of avoiding medical evaluation 1, 2