Red flags & when to go in person for Teething (Guidance)

Audience: pediatric

Teething is a natural process where a baby's first teeth begin to emerge through the gums. This can cause mild discomfort, fussiness, and increased drooling. Most babies manage teething symptoms at home with gentle care and comfort measures. However, some signs may indicate a more serious problem requiring in-person medical evaluation. This guide helps parents and caregivers recognize red flags during teething and understand when to seek urgent care. Telemedicine can support education and basic guidance but cannot replace hands-on examination when symptoms are severe or unusual. Knowing the difference helps keep your child safe and comfortable during this important developmental stage.

Red flags — go in person / ER

• High fever above 38°C (100.4°F) lasting more than one day — seek in-person care promptly.
• Severe vomiting or diarrhea causing dehydration signs — such as dry mouth, no tears, or fewer wet diapers — requires urgent evaluation.
• Signs of gum infection like pus, severe redness, or swelling that worsens — see a healthcare provider in person.

What telemedicine can do

• Providing education about typical teething symptoms and comfort measures.
• Assessing general symptom descriptions and advising on home care.
• Helping decide when symptoms require urgent in-person evaluation.

What telemedicine cannot do

• Performing physical examination of the mouth or gums.
• Diagnosing infections or other medical conditions mimicking teething.
• Treating severe symptoms or complications that need hands-on care.

What is Teething?

Teething is the process where a baby's teeth start to break through the gums. It usually begins around 6 months of age but can vary. Common signs include mild gum swelling, irritability, and increased drooling. These symptoms often come and go and usually do not require medical treatment.

Common Teething Symptoms

Typical symptoms include:

These signs are usually mild and can be managed at home with comfort measures like gentle gum massage or teething rings.

When to Seek In-Person Care

Some symptoms are not typical of teething and may signal other health issues. You should seek in-person care if your child has:

These signs require prompt medical evaluation.

How Telemedicine Can Help

Telemedicine can provide:

However, telemedicine cannot perform physical exams or treat serious complications that require hands-on care.

Preparing for a Telemedicine Visit

Before your tele-visit, prepare:

This preparation helps the provider give the best advice possible.

After the Telemedicine Visit

Follow the care advice given, including:

Keep track of any changes and communicate with your healthcare provider as needed.

How to prepare for your tele-visit

• Note the start date and details of your child's symptoms.
• List any treatments or remedies already tried.
• Prepare a quiet, well-lit area for the video call.
• Have your child's medical history or records available if possible.
• Write down any questions or concerns to discuss during the visit.

After your tele-visit

• Follow recommended comfort and care advice from the provider.
• Monitor your child’s symptoms closely for any worsening.
• Seek in-person care immediately if red flags appear.
• Keep a record of symptom changes and any new concerns.
• Schedule follow-up telemedicine or in-person visits if advised.

FAQs

Is fever a normal part of teething?

Mild temperature increases can sometimes happen during teething, but a high fever (above 38°C or 100.4°F) is not typical. If your child has a high or persistent fever, contact a healthcare provider for evaluation.

Can I give my baby medication for teething pain?

Some over-the-counter pain relievers may be used safely for teething discomfort, but always follow dosing instructions and consult a healthcare provider before giving any medication to your baby.

Are teething toys safe?

Teething toys designed for babies are generally safe and can help soothe sore gums. Avoid toys with small parts or that can break easily. Clean teething toys regularly to prevent infections.

When should I worry about my baby’s teething?

If your baby shows signs like high fever, severe vomiting, refusal to eat or drink, or signs of infection in the gums, seek medical care promptly. These are not normal teething symptoms.

Sources

1. Teething — MedlinePlus, U.S. National Library of Medicine.
2. Teething in Children — Centers for Disease Control and Prevention (CDC).
3. Teething: Symptoms and Remedies — Mayo Clinic.
4. Teething and Your Baby — American Academy of Pediatrics (AAP).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or you are concerned about their health, seek immediate evaluation by a healthcare professional.