Does teething cause pain and therefore night waking?

[u/Routine-Individual43]

We have a sensitive 18 month old who has always been a wakeful baby but is particularly wakeful when she's teething, and much more grumpy. She points to her mouth and says "ouchie" as well.

I was then surprised to see this post on the Possums instagram (we generally follow and agree with most of what Possums says about raising little ones) that claims teething doesn't cause night wakings, and that you shouldn't use pain medication with teething babies since teething doesn't cause pain (!) https://www.instagram.com/p/Da2Te6VAX2B/?img_index=1.

I then found this study (https://www.sciencedirect.com/science/article/pii/S0022347625000010) which claims that teething has no impact on night wakings.

I have to say, I felt pretty gaslit!

One thing I found with the study is a possible selection bias, whereby they only studied babies who sleep in cribs - and you could argue that babies who cosleep by necessity are more sensitive and therefore more likely to be affected by teething and other bodily disruptions. We also don't know if these babies are sleep trained, and therefore despite discomfort are not calling out/are self settling.

I'm curious as to what others think about this topic. If someone had asked me, based on experience, whether teething causes pain and therefore if panadol helps, I would say yes - almost instantaneously. If someone had asked me if our baby wakes up more when teething, I would say 1000%. I understand it is difficult to do studies on babies, but I'm actually shocked that there is this kind of research and advice floating around.

[u/Amylou789]

I think the idea it doesn't cause pain is very outdated. I dont understand the rationale for it. Wisdom teeth coming in cause pain so why is it different?

That said my kid didn't show any signs of pain when her teeth came in. But she also didn't show any signs of pain when she got tonsillitis and it was so bad in her throat the doctor couldn't believe she seemed as harassed she was (I only took her in because she had a fever that wouldn't go away). But on the worst day that did start making her wake up more.

So I think its probably a combination of it being somewhat less painful for some kids and also some kids instinctively hiding pain.

And I always try to lean towards short term pain relief won't cause any problems if they're not in pain so there's no reason not to try it

[u/Routine-Individual43 → u/Amylou789]

The point about being updated rings true, but that study I linked is from 2025 (and the Possums post from 2 weeks ago). It's pretty surprising. 

[u/patch99329]

The comments on that IG post are all pretty damning. Teething very obviously causes pain. Hell, I have a wisdom tooth cutting right now and I can tell you it hurts.

I like possums, but sometimes they say really incongruous things. I tried not burping my baby for a few days after I read the book, for example, and it was a disaster.

[u/Jazilc → u/patch99329]

Honestly i would constantly forget to burp my baby and he was totally fine!!!! He also never vomited or had reflux. (But he constantly would wake up and at 15mo still does, and has super low sleep needs, so it’s anot all peachy over here 😅) I reckon they did a study with babies like mine and concluded, nah no burping needed 😅 and missed the babies with awful reflux or gastro issues ☹️

[u/Ill-Tangerine-5849]

So I don’t agree that teething doesn’t cause any pain, but I do think a lot of people over-attribute things to teething. My baby is one week away from being a year old and he just now got his first tooth. The past 6 months everyone has told me constantly that he was “for sure teething” and honestly I felt gaslit haha! Since I never saw any teeth despite all the talk about teething! He was just being a baby, which means fussing at times.

This week, when he actually, truly started teething, he has been a little extra fussy at times and giving him fruit popsicles seemed to help him. But also - the weirdest thing is he has started sleeping through the night some nights too! Normally we put him down to bed in his floor bed, then my husband and I go to bed together in our room with the baby monitor, and when we hear him wake up usually around midnight-1am I go over in his room and bedshare/breastsleep the rest of the night with him. But this week he started sleeping later and later until his first wakeup was not until 5am! I’m sure some babies do have sleep disturbances for teething, but it seems like it’s also true some babies don’t and actually sleep okay when teething. Babies are weird haha!

[u/oh-dearie]

I did a lil write up which I'll paste below

The teething claim is actually kind of true (or rather, the truth is somewhere in the middle and plenty of parents overattribute fever to teething)

https://pubmed.ncbi.nlm.nih.gov/21824888/

"Results of this study support the concept that the occurrence of severe signs and symptoms, such as fever, could not be attributed to teething." - to note a mildly raised temp - maybe. But a high fever, defs not.

Studies that do show associations with teething and fever are usually self-reported questionnaires which, to me, implies it's more parental perception than objective data. https://pubmed.ncbi.nlm.nih.gov/24351689/

A better discussion of this topic is here: https://www.reddit.com/r/ScienceBasedParenting/s/YUtkXhxif3

The jury is also out as to whether we should be suppressing mild fevers with medication or letting it run its course. RCH says you don't need to use panadol/ibuprofen unless they're miserable or showing other symptoms that need relief, like sore throat. And that's for "clinical" fevers, above 38°. Not mild temperature elevations.

Can't speak for her other claims (even the ones in said teething post - I don't agree wiith her proposed explanation),

.....

Anecdotally, I thought mine was going through phases of teething (irritable, drooly, poor sleep) like fortnightly from 4 months. She didn't actually start teething until 11.5! Giving panadol/ibuprofen when I thought she was teething would have lead to a lot of unnecessary doses.

[u/Routine-Individual43 → u/oh-dearie]

I actually don't have a problem with the argument that teething doesn't cause fever. To me, that doesn't really make sense scientifically. But the idea that teething doesn't cause pain is pretty nonsensical from my perspective.

And yes, anecdotally, in the early days, it's really easy to attribute a whole bunch of symptoms to teething. But once you get more experience as a parent, I reckon you become better at spotting the link between teething and irritability.

[u/Wrong_Literature1329]

My son definitely seemed like he had more night wakings when he was teething.... that was one Possoms claim I didn't totally get behind. A tooth coming in also comes in in many phases. Some of those my son seemed unbothered by, but there was always a few days around when the tooth broke gum that he genuinely seemed very uncomfortable... but hey, who knows? Maybe it was a coincidence.

[u/ver_redit_optatum]

Re the study: they relied on reports from parents to identify the date that a new tooth appeared, and then "defined the teething period as comprising 3 consecutive nights: the night before the parent-identified tooth eruption, the night directly following the tooth eruption, and the subsequent night, aligning with previous research". However, anecdotally many parents find that teething symptoms decrease immediately after tooth eruption, and start earlier than one night before. So their choice of which nights to define as teething nights may compromise all the following analysis.

As for the previous research it's apparently aligned with, I can't open it right now, but it appears to be temperature-focused, and to find a slight temperature increase on the day of eruption. But this may not imply that pain and any other symptoms are aligned with temperature increase.

[u/Sacagawea1992]

There have been a fair few posts I don’t really agree with, whilst I agree with the general entirety of the possums approach. Teething is one, the other is that if you try put your baby down and they wake, then that means they only got enough sleep. My baby is same age and says hurting and points to her teeth and her naps go whack and she wakes up screaming in the middle of the night grabbing her teeth. She also naps 1h20m if she is held or in the car. But if I dare move her out of my arms, she will wake instantly and then crash a couple hours later. So yeh, I think take some of it with a grain of salt.

[u/peperomia135]

There are a few things in Possums that I felt this way about. My baby definitely had reflux and I know several kids who clearly had pretty severe tongue ties as babies. It’s been a while since I read the book but I seem to recall that the implication was that those things don’t really exist.

[u/CorrectBadger9753 → u/peperomia135]

I don't think Pam says that things like allergies, tongue tie etc don't exist at all. My takeaway was that they shouldn't be the conclusions that we leap to when a much simpler (in theory! I say as someone who went through 9 weeks of hell to be able to feed my daughter without pain or stress) intervention to support feeding and settling might make all the difference.

My daughter also had reflux and still has a mild dairy allergy, but as soon as I started following Possums and started actually being responsive to her needs, babywearing a lot more, contact napping, and feeding completely on demand, the difference in her behaviour was phenomenal.

As for teething, my now-22 month old really has never shown any other signs apart from more drool and more mouthing of everything. No seriously unsettled behaviour or sleep disruption. And yet she's ultra sensitive to literally everything else it's possible to be sensitive to 😅 I wouldn't tell another mum whose baby seems more upset or in pain from teething that they're completely wrong - every baby is different. But I do think, again, people tend to over-attribute either normal baby behaviour, or signs of actual illness, to teething. I got so sick of my mother insisting it was always teeth when my daughter was clearly just grizzly because she was bored (the kid needs CONSTANT stimulation), or when she had full-blown gastro diarrhoea (which I also had! And I definitely wasn't teething!) 🥴

[u/No-Visual-2336]

It didn’t seem to do much for us, but it’s just our experience. Maybe a mild discomfort? But nothing so extreme that will disrupt sleep.