One of the most common messages I receive from exhausted parents is:
“I think she’s teething.”
Often followed by:
“Her sleep has completely fallen apart.”
And honestly? Sometimes teething is part of the picture.
But not nearly as often as most people think.
In fact, if there is one thing I have learned after working with hundreds of families, it is that teething gets blamed for almost everything.
Short naps? Teething.
Hourly night wakes? Teething.
Early mornings? Teething.
Refusing bedtime? Teething.
Suddenly needing to be held to sleep? Definitely teething.
The truth is much more interesting.
Let’s look at what the research actually tells us, what genuine teething sleep disruption tends to look like, and how to tell the difference between teething and a sleep issue that just happens to arrive at the same time.
First, Does Teething Affect Sleep?
Yes. It can.
But probably not in the way most people imagine.
When a tooth moves through the gum, it creates local inflammation and pressure. For some babies this causes very little discomfort. For others, particularly during the first few teeth or larger teeth such as molars, it can be uncomfortable enough to affect sleep. Studies have found associations between teething and increased irritability, drooling, gum rubbing, reduced appetite and mild sleep disturbance. However, these symptoms are generally mild and temporary.
What is fascinating is that when researchers recently monitored hundreds of babies using objective sleep tracking technology, they found no significant differences in total sleep, night waking frequency or parental visits on teething nights compared with non-teething nights. Parents often perceived sleep to be worse during teething, but the sleep data itself did not support this belief.
In other words:
Parents frequently notice sleep problems when a baby is teething.
Research suggests the teeth may not always be the main reason.
Why Teething Gets Blamed for Everything
Teething tends to arrive at exactly the same time as some of the biggest changes in infant sleep.
Around 4-12 months, babies are:
• Becoming more aware of their surroundings
• Developing stronger sleep associations
• Learning object permanence
• Experiencing separation anxiety
• Dropping naps
• Increasing mobility
• Changing feeding patterns
This creates the perfect storm.
A baby who has always been rocked to sleep may suddenly start waking between sleep cycles.
A baby who previously accepted transfers may suddenly protest.
A baby who was sleeping long stretches may suddenly become aware that Mum or Dad is missing.
And because there is a tooth coming through at the same time, the teeth get all the blame.
The timing is often coincidence rather than cause.
What Genuine Teething Sleep Disruption Usually Looks Like
When teething really is contributing to sleep difficulties, the pattern is often quite specific.
You may notice:
• Increased chewing during the day
• Excessive drooling
• Red or swollen gums
• A visible tooth close to erupting
• Mild fussiness that continues during waking hours
• More difficulty settling than usual
• Brief periods of increased night waking
Most importantly, the sleep disruption is usually short-lived.
Many parents expect weeks of poor sleep because of teething.
In reality, discomfort is often greatest in the few days before a tooth breaks through the gum and shortly afterwards.
If sleep has been deteriorating steadily for three weeks, there is a good chance something else is contributing.
What Teething Does NOT Usually Cause
This is where many parents are surprised.
Research does not support teething as a cause of:
• High fever
• Persistent vomiting
• Severe diarrhoea
• Significant illness
• Major changes in sleep lasting weeks or months
• Hourly night waking for extended periods without improvement
If your baby develops a genuine fever, seems unwell, has persistent diarrhoea, or is experiencing severe symptoms, it is important not to assume it is “just teething.”
Teething and illness often happen at the same age.
One should never automatically be blamed for the other.
The Question I Always Ask Parents
When someone tells me:
“I think she’s waking because she’s teething.”
I ask:
“What happens when you comfort her?”
This answer tells us a lot.
If a baby wakes distressed, receives pain relief when appropriate, settles comfortably, and then returns to sleep for a reasonable stretch, discomfort may genuinely have been contributing.
However, if a baby wakes every sleep cycle, requires the exact same assistance each time, and immediately protests when that assistance is removed, we may be looking at a sleep association rather than pain.
Pain and sleep habits can look remarkably similar at 2am.
The pattern over several days often reveals which one is driving the problem.
Why Sleep Sometimes Gets Worse During Teething
Even when teething is not the primary cause, it can still make sleep feel harder.
Think of it this way:
A well-rested adult with a mild headache can usually cope.
A sleep-deprived adult with the same headache feels significantly worse.
Babies are no different.
If a baby already struggles to connect sleep cycles independently, even mild gum discomfort may make those transitions harder.
This is why teething often exposes existing sleep challenges rather than creating entirely new ones.
So What Should You Do?
Keep it simple.
Focus on the things you know help sleep:
• Consistent bedtime routine
• Appropriate wake windows
• Plenty of milk feeds and hydration
• Opportunities for independent sleep practice where appropriate
• Extra comfort and reassurance when needed
If your baby appears genuinely uncomfortable, follow your healthcare provider’s guidance regarding appropriate pain management.
But try not to assume every difficult night is caused by teeth.
Because if the real issue is overtiredness, sleep associations, schedule changes or developmental progress, waiting for the tooth to arrive may leave everyone frustrated and exhausted.
The Bottom Line
Teething is real.
Teething can be uncomfortable.
Teething may cause a few difficult nights.
But teething is rarely responsible for weeks of disrupted sleep on its own.
If sleep has completely unravelled, it is worth looking at the bigger picture.
Sometimes the tooth is the culprit.
Often it is simply the most visible thing happening while something else is driving the sleep difficulties.
And sometimes, just to make parenting extra interesting, it is a little bit of both.
If you’re currently in the thick of teething and wondering whether it’s the teeth, the schedule, overtiredness, sleep associations, or all of the above, take a breath.
Most sleep challenges have an explanation.
And more importantly, they have a solution.
If you feel that your little one’s sleep challenges may extend beyond teething, I’d love to help. Together, we can look at the bigger picture and create a plan to get your family back on the path to better sleep.
