It Was Not Teething. He Had an Ear Infection.

Quick answer: Teething causes drooling, gum discomfort, chewing on things and mild irritability. It does not cause a high fever, diarrhoea, vomiting or a rash. Attributing those to teething delays the diagnosis of something that needs treating.

The call

Four days of a miserable baby, a temperature of 38.9, and a family who had been told repeatedly that it was teething.

A mother in RBS Bet phoned about her ten-month-old, Yehuda, who was pulling at his face, not feeding well and had been given teething gel and a homeopathic remedy without improvement.

She phoned a dentist rather than a doctor because everyone had told her it was his teeth.

What we found

He had two lower incisors partly through and swollen gum over an upper canine region — genuine teething activity, and enough to explain some fretfulness.

What it did not explain was the rest.

Temperature 38.9. He was pulling at his left ear repeatedly, not his mouth. He had not fed properly in two days and had had loose stools.

We sent him to his kupah doctor the same morning. He had an ear infection, was treated, and was a different child within 48 hours.

What teething actually causes, which is a shorter list than folklore suggests:

• Drooling, sometimes heavily, and a rash on the chin from constant wetness.
• Gum discomfort — swelling, tenderness, occasionally a bluish eruption cyst over the tooth, which is harmless and resolves.
• Chewing and biting on anything available.
• Mild irritability and some disturbed sleep, usually in the day or two around a tooth breaking through.
• A slight rise in temperature — a few tenths of a degree.

What teething does not cause:

• Fever above about 38 degrees. Studies tracking infants daily through teething find no meaningful temperature rise. A real fever is an infection.
• Diarrhoea or vomiting.
• A body rash.
• Prolonged loss of appetite or refusal to drink.
• Days of severe distress. Teething discomfort is short and tied to a specific tooth.

The reason this matters is timing. Teething runs from roughly six months to two and a half years — exactly the window when infants lose maternal antibodies and start acquiring common infections. Something is nearly always erupting, so anything can be attributed to it, and the attribution is often wrong.

Two dangerous products came up in the conversation:

Amber teething necklaces. No evidence of benefit, and a genuine strangulation and choking risk. They are worn by an infant, unsupervised, around the neck, at night. Several deaths have been reported internationally. There is no version of this trade-off that works.

Teething gels containing certain anaesthetic agents. Some have been associated with rare but serious adverse effects in infants, and regulators in several countries have restricted them. The gel he had been given was one of the widely sold varieties, and we advised stopping it.

What we did

Referred him to his doctor the same morning — that was the whole clinical value of the visit.

For the genuine teething, the measures that help and are safe:

• A chilled, not frozen, teething ring. Frozen items can damage gum tissue.
• A clean cold flannel to chew.
• Firm gum massage with a clean finger.
• Paracetamol at the correct weight-based dose if the child is genuinely uncomfortable.
• Barrier cream on the chin for drool rash.

We also checked his mouth for eruption cysts and reassured her about the bluish swelling over the canine.

The outcome

The infection resolved on treatment. The canine came through a fortnight later with no drama.

He came for a first dental check at twelve months.

What to do if this happens to you

1. Take a temperature. Above 38 is not teething and needs assessing.
2. See a doctor for fever, diarrhoea, vomiting, a rash or refusal to drink.
3. Do not use amber necklaces. No benefit, real strangulation risk.
4. Be cautious with anaesthetic teething gels and check what is currently recommended locally.
5. Chilled, not frozen, for teething rings and flannels.
6. Trust the pattern. Teething is brief and localised. Days of illness is something else.

Unsure whether it is teething? Ramat Beit Shemesh Urgent Dental Care will look, and refer you on if it is not. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh

This is a composite clinical story. It reflects a presentation we see regularly in Beit Shemesh and Ramat Beit Shemesh; the name and details are illustrative and are not those of a real patient.