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A white dot appeared on seven-month-old Prisha’s lower gum, her first tooth! At the same time she became irritable, drooled constantly, put whatever she held into her mouth, woke two or three times at night, and her cheeks were slightly red. On the third day a 102°F fever and watery diarrhea began. Grandmother said, “Teeth are coming, this happens, don’t worry.” Her mother waited another day. The fever did not come down and the baby became dull; the pediatrician examined her: an ear infection and viral diarrhea, not teeth. With treatment and ORS she improved in two days. The doctor explained: “Mild irritability, drooling and a slight rise in temperature are normal while teething, but high fever, diarrhea and vomiting are not caused by teeth; another cause must be found.”
Teething (tooth eruption) means the baby’s first milk teeth (primary teeth) coming out through the gums. Usually the first tooth comes around 6 months (anytime between 4 and 15 months is normal), and all 20 milk teeth have come by 3 years. During teething some babies have gum discomfort, irritability, drooling and an urge to chew; some have almost nothing. In Ayurveda it is called dantodbheda (eruption of teeth), and the Kashyapa Samhita has a special Dantajanmika Adhyaya describing teething, its timing, types, the disorders that occur at this time and care. Kashyapa noted that during teething the child becomes more susceptible to all diseases; this matches the modern view: at this age the antibodies received from the mother decline and the child puts everything in the mouth, so infections increase.
Key Takeaways
- The first tooth usually comes at 6 months; between 4–15 months is normal; 20 teeth by 3 years.
- Mild irritability, drooling, urge to chew, mild temperature, are normal.
- Fever above 100.4°F (38°C), diarrhea, vomiting, are not from teeth; find another cause.
- Risky: numbing gels, teething necklaces, household pills; Ayurveda offers gentle, safe care.
- Ayurveda: Kashyapa’s dantodbheda care, gentle use of yashtimadhu and ghrita, bala chaturbhadra, infant abhyanga and the mother’s wholesome diet calm teething irritability and indigestion and reduce the disorders that often occur at this time.
Usual Order of Teething
- 6–10 months: the two lower front teeth (central incisors)
- 8–12 months: the two upper front teeth
- 9–16 months: the teeth beside them (lateral incisors), upper and lower
- 13–19 months: first molars
- 16–23 months: canine teeth
- 23–33 months: second molars
Every child is different; some are born with teeth (rarely, “natal teeth”, show the doctor), some get teeth after 1 year. Family history also plays a role.
Common Symptoms of Teething
- Irritability, more crying
- More drooling, a mild rash on the chin and neck
- Putting everything in the mouth, chewing, biting
- Red, swollen gums
- Rubbing ears or cheeks (with back molars)
- Disturbed sleep
- Slightly less appetite, a little fussiness while breastfeeding
- Slight rise in temperature, below 38°C (100.4°F)
Symptoms are usually more in an 8-day “window”, a few days before and after the tooth comes through the gum.
What Teething Does “Not” Cause: the Right Understanding
- High fever (above 38°C/100.4°F)
- Diarrhea, vomiting
- Runny nose, cough
- Rash all over the body
- Lethargy, stopping eating and drinking
- Seizures
If these symptoms are present, show the child to a pediatrician to look for infection, ear, throat, urine, stomach or another cause. Dismissing it as “teething” can delay the diagnosis of a serious infection. Of course, because the child puts everything in the mouth during teething, infections (including diarrhea) are more common, so hygiene is especially important.
Ayurvedic Understanding: Kashyapa’s Dantajanmika Adhyaya
The Kashyapa Samhita regards the eruption of teeth as an important stage of a child’s development and describes it in detail: at what age teeth come, which teeth are auspicious and healthy (even, white, dense, shining, with strong gums), and the disorders that occur in the child while teething, jwara (fever), atisara (diarrhea), kasa (cough), chhardi (vomiting), shiroroga, abhishyanda (eye inflammation) and others. Kashyapa called the child “susceptible to all diseases” at this time, which agrees with the modern understanding that infections are caught easily at this age. Hence the advice of special care at this time: nutrition, hygiene and gentle measures.
Teeth are considered the upadhatu of asthi dhatu, so the mother’s nutrition in pregnancy and the child’s rasa-asthi nourishment (calcium, vitamin D, sunlight) are important for the timing and quality of teeth. If teeth come very late, Ayurveda advises attention to asthi dhatu nourishment; in modern terms, causes such as rickets, thyroid problems and malnutrition are checked (if there is not a single tooth even at 18 months).
Samprapti (dantodbheda period): the process of tooth eruption → local pitta-vata (pain and burning in the gums) + the child’s natural kapha phase + putting everything in the mouth → susceptibility to infection → disorders such as jwara and atisara.
Principle of care: local shamana (gentle, cooling measures on the gums) → hygiene → maintaining nutrition and agni → treating any disorder that occurs (ORS in diarrhea, evaluation in fever).
Classical References
- Kashyapa Samhita, Sutra Sthana, Dantajanmika Adhyaya (chapter level).
- Ashtanga Hridaya, Uttara Tantra, Chapter 2, Balamaya Pratishedha (disorders from dantodbheda).
- Ashtanga Sangraha, Uttara Tantra, Bala Upacharaniya (chapter level).
- Sushruta Samhita, Sutra Sthana, Chapter 15, reference to asthi and upadhatu.
Safe Ways to Relieve
- Gentle massage of the gums with a clean finger, 1–2 minutes; pressure brings relief
- A cool (not ice) teething ring, chilled in the fridge (not the freezer, it becomes too hard), solid silicone or rubber, BPA-free; not liquid-filled (it can burst)
- A clean, wet, cool cotton cloth to chew (with supervision)
- Over 6 months (if solids have started): chilled mashed fruit, cool curd (in the daytime)
- In a feeder or mesh feeder, pieces of cool fruit to chew without choking
- Wipe the drool, keep the chin dry, a thin barrier (ghee, coconut oil or cream) to prevent rash
- Distraction, play, songs, rocking, taking the baby outside
- Extra cuddles, patience
- In severe discomfort, a fever and pain medicine according to age and weight as advised by the doctor (the doctor decides the dose)
Risky Things to Avoid
- Numbing (local anaesthetic) teething gels, risk of a rare but serious blood condition (methemoglobinemia) and swallowing difficulty in children under 2 years; many regulatory authorities warn against them
- Teething necklaces or bracelets (amber, wooden beads), risk of strangulation and choking; no scientific evidence of benefit
- Unregulated products such as “homeopathic teething tablets”, warnings that some were found with inconsistent amounts of toxic substances
- Household “baby pills”, many old pills contain substances like opium, extremely dangerous
- Honey, not for babies under 1 year (botulism)
- Alcohol or brandy on the gums, an old dangerous practice
- An ice cube directly, cold injury
- Frequent biscuits or rusks, sugar, tooth decay; choking on pieces
- Rubbing anything with sugar or jaggery on the gums
- Cutting or slitting the gums, never
Useful Gentle Ayurvedic Care (on the vaidya’s advice)
The right medicine, dose, anupana and timing are decided by the vaidya according to the person’s prakriti, age, other illnesses and current medicines.
- Yashtimadhu (licorice), cooling, sweet; traditionally for soothing the gums, do not give a whole stick to chew because of the choking risk; in the form the vaidya suggests, with supervision.
- Ghee / shatadhauta ghrita, a thin layer on drool rash on the chin; a negligible amount on the gums with a clean finger (tradition).
- Bala chaturbhadra churna, a traditional children’s formulation for indigestion, mild diarrhea and kapha during teething, the vaidya decides the child dose; in diarrhea along with ORS, not instead of it.
- Dantodbhedagadantaka rasa, a classical formulation for teething disorders; may contain mineral ingredients, only under an experienced vaidya’s strict supervision.
- For the breastfeeding mother, light, easily digestible, less spicy food; shatavari for stanya nourishment.
Traditionally there are practices such as a touch of silver or gold, and rubbing the gums with a honey-ghee mixture; honey is not for babies under 1 year, and small objects carry a choking risk. Follow tradition only together with modern safety rules.
Gradual Ayurvedic approach: If the doctor’s medicine or ORS for fever or diarrhoea during teething is ongoing, Ayurvedic care starts alongside it, without stopping anything. Gum massage with a clean finger, yashtimadhu in the form the vaidya suggests, ghee or shatadhauta ghrita on the chin, bala chaturbhadra in a child dose (for indigestion, mild diarrhoea, kapha), daily infant abhyanga, and light, easily digestible food for the breastfeeding mother. When irritability, sleep and digestion improve, pain medicine is no longer needed, and Ayurvedic care and hygiene in the dantodbheda period reduce the frequent infections and indigestion of this time. Fever above 38°C, diarrhoea, vomiting or lethargy are not from teeth; see the doctor first.
Tooth Care from the First Tooth
- Before teeth come: clean the gums twice a day with a clean, wet cotton cloth
- From the first tooth: a soft, small baby toothbrush; fluoride toothpaste the size of a grain of rice up to 3 years, the size of a pea at 3–6 years (as advised by the doctor or dentist); twice a day
- Do not put the baby to sleep with a milk bottle in the mouth, “bottle caries” (front teeth decay rapidly)
- Habit of drinking from a cup at 1 year, wean off the bottle
- Sugar, chocolate, sticky candy, juice, less; not frequently
- First dental visit, after the first tooth or at 1 year
- Cleaning a spoon or bottle in your own mouth and giving it to the baby passes the parents’ mouth bacteria to the baby; avoid it
- The Ayurvedic dantadhavana tradition, neem or babool datun for older children (after 7–8 years) and adults; a soft brush for young children
Nutrition for Strong Teeth
- The mother in pregnancy, calcium, vitamin D, protein
- Exclusive breastfeeding for 6 months; then varied food
- Calcium, milk and curd, ragi, sesame (powder), paneer
- Vitamin D, sunlight, supplements as advised by the doctor
- Chances to chew, soft, textured food according to age; for jaw and tooth development
Hygiene of Teethers and Toys
- Wash teethers and toys daily with soap and hot water; if they fall on the floor, wash again before giving
- Use teethers that can be boiled as the manufacturer says
- Throw away teethers with cracks or pieces coming off
- Keep objects smaller than 3 cm out of the baby’s reach, choking
- Do not let the baby chew pet toys, keys, remotes or mobiles
If the Baby Bites While Breastfeeding
Some teething babies bite while breastfeeding, which is painful for the mother. If the baby bites, calmly put a finger in the corner of the mouth to break the latch; do not pull hard. Give a cool teether to chew for a while before feeding, and make sure of a good latch. Most babies stop biting within a few days; there is no need to stop breastfeeding because teeth have come.
For Grandparents and Family
Many traditional practices are linked with teething; some are lovely (massage, cuddles, lullabies), while some are risky (honey, brandy, small amulets and beads, pills with opium). Follow even loving traditions only with safety rules, and never wait by calling fever or diarrhea “teething”.
Sleep and Daily Routine
- Continue a regular bedtime routine, bath, massage, lullaby
- If the baby wakes at night, comfort calmly; do not make a habit of feeding every time
- Oil massage in the daytime, vata shamana in Ayurveda, relaxation
- Less crowd and noise
The Parents’ Mind
Teething days, especially sleepless nights, exhaust parents. This phase passes; take turns caring for the baby so both get some rest. Do not assume every fussy spell or fever is “teeth”, and do not look for medicine for every tooth either; mostly cuddles, a cool teething ring and patience are enough.
By Season and Prakriti
In summer, rash from drool and sweat is more common; keep the chin dry, loose cotton clothes, enough fluids. In the monsoon, diarrhea and infections are more common; boil or wash toys and teethers, clean hands. In winter, it gets mixed up with colds; if there is fever or cough, see the doctor. In children of pitta prakriti, gums are redder, more irritability, cooling measures; in vata, restlessness, less sleep, massage, routine; in kapha, more drool, colds, hygiene, less cold and sweet food.
Common Myths
- “High fever and diarrhea are normal when teeth come”, wrong; find another cause.
- “An amber necklace reduces pain”, no evidence, choking risk.
- “Late teeth mean calcium deficiency”, often normal variation; if none even at 18 months, get checked.
- “Milk teeth will fall anyway, no care needed”, wrong; decay causes pain and infection and affects permanent teeth.
- “A bottle at night keeps the baby calm, it’s fine”, tooth decay.
Precautions
- Fever above 38°C, diarrhea, vomiting, lethargy, see the doctor; do not assume “teeth”.
- No numbing gels, teething necklaces, unregulated tablets or household pills.
- No honey for babies under 1 year.
- Small hard objects, a whole yashtimadhu stick, choking.
- Ayurvedic formulations with minerals only under an experienced vaidya’s supervision.
- No tooth at all by 18 months, get checked.
Do’s and Don’ts
Do: gum massage, cool teething ring, wipe drool, cuddles, hygiene, brushing from the first tooth, nutrition, see the doctor in fever or diarrhea.
Don’t: teething gels or necklaces, household pills, honey (before 1 year), bottle at night, rubbing sugary things, assuming every symptom is “teething”.
Case Studies
Case 1: Not “teething fever” but an ear infection
7 months; the first tooth was coming, along with a 102°F fever and diarrhoea; the family waited a day thinking it was “teeth”. The pediatrician found an ear infection and viral diarrhoea; treatment, ORS, zinc. Alongside, the vaidya gave rice water, bala chaturbhadra in a child dose, less spicy and cold food for the mother, and gum massage. Improvement in two days, medicine completed on time, and no infections or diarrhoea with the remaining teeth. (Results may vary from person to person.)
Case 2: Normal teething
9 months; upper teeth, irritability, drooling, waking at night, temperature 99.2°F; pain medicine was being considered. The vaidya gave gum massage with a finger, a cool (fridge-chilled) silicone teether, a thin layer of ghee on the chin, infant abhyanga in the daytime, and bala chaturbhadra in a child dose (for mild indigestion). No medicine was needed; the tooth came out in four or five days, the baby was calm, and later teeth were also easy with this care. (Results may vary from person to person.)
Case 3: Bottle caries
2.5 years; upper front teeth brown-black, pain; habit of sleeping with sweetened milk in a bottle at night. Treatment by a pediatric dentist, bottle weaned off. The vaidya gave gentle triphala rinses (as the child grew), less sugar and chocolate, calcium-rich food like sesame, ragi and milk, and brushing twice a day. The pain went, and no new decay for a year. This case shows the importance of care from the first tooth. (Results may vary from person to person.)
When to See a Doctor (Red Flags)
- Fever above 38°C (100.4°F)
- Diarrhea, vomiting, stopping eating and drinking
- Lethargy, constant crying, seizures
- Pus, swelling or a lump in the gums
- Not a single tooth by 18 months
- Brown-black teeth, pain
About Dr. Nikul Patel
Dr. Nikul Patel (BAMS) is an Ayurvedic physician at Lifecare Ayurveda and has been practising since 1999, that is, for 27 years. During children’s dantodbheda period he gives guidance on safe, gentle care, nutrition and hygiene with the understanding of the Kashyapa Samhita, and gives priority to the pediatrician’s evaluation for symptoms such as fever and diarrhea.
Frequently Asked Questions
When does a baby get the first tooth?
Usually at 6 months; anytime between 4–15 months is normal.
Does teething cause fever?
Temperature may rise slightly; fever above 38°C (100.4°F) is not from teeth, evaluation is needed.
Does teething cause diarrhea?
Not the teeth themselves; putting everything in the mouth causes infection, ORS and care are needed.
What is safe relief for teething pain?
Gum massage, a fridge-chilled teething ring, cuddles; the doctor’s medicine if needed.
What does Ayurveda call teething?
Dantodbheda, described in detail in the Dantajanmika Adhyaya of the Kashyapa Samhita.
People Also Ask
Are teething gels safe?
Numbing gels are considered risky for young children; not without the doctor’s advice.
Do amber necklaces work?
There is no evidence, and there is a risk of strangulation and choking.
When to start brushing?
From the first tooth, with a soft baby brush.
What if teeth come late?
Often normal; if none even at 18 months, see the doctor.
What is bottle caries?
Rapid decay of the front teeth from sleeping with a bottle in the mouth at night.
Conclusion
Teething is a joyful milestone of development, with some irritability and sleepless nights. Avoid risky gels, necklaces and pills, and do not ignore high fever or diarrhoea as “teething”. At this time Ayurveda is the main companion: following Kashyapa’s understanding of dantodbheda, gum massage, gentle yashtimadhu and ghrita, bala chaturbhadra, infant abhyanga, the mother’s wholesome diet and hygiene calm irritability, reduce the need for medicine and prevent the frequent disorders of this period. Every child’s results may differ.
Dr. Nikul Patel (B.A.M.S.)
307, 3rd Floor, Shalin Complex, Above Farki Lassi, Krishnabaug Char Rasta, Maninagar, Ahmedabad – 380008
Timings: 10:00 AM to 1:00 PM and 3:00 PM to 6:30 PM | Saturday–Sunday: Closed
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