NEW YORK (Reuters Health) — When a baby is biting, drooling, irritable or has a slight increase in fever, a parent may be correct if they think their infant is teething.

However, many other symptoms commonly associated with teething — such as high fevers, diarrhea or vomiting — cannot be blamed on the imminent emergence of a new tooth, according to results of one of the largest studies of its kind.

However, many other symptoms commonly associated with teething — such as high fevers, diarrhea or vomiting — cannot be blamed on the imminent emergence of a new tooth, according to results of one of the largest studies of its kind.

“It is a complete surprise,” said study co-author Dr. Jonathan Jacobs. “All of us think of teething as being associated with a huge constellation of symptoms.”

Furthermore, there was no cluster of signs that could help parents predict when a tooth was about to emerge. No particular symptom — such as biting, drooling or gum rubbing — was seen in more than 35% of infants during the teething time.

In the new study, parents employed by the Cleveland Clinic Foundation recorded data on 111 infants for about 8 months, starting at 4 months of age. During the study period, 475 teeth emerged in 89 children.

Five symptoms associated with teething occurred in an 8-day period, beginning 4 days before the tooth emerged, and lasting up to 3 days after the event.

Those symptoms included biting, drooling, gum-rubbing, irritability and sucking. The day a tooth erupted, or in the day or two before, infants also experience a decreased appetite for solids, wakefulness, ear-rubbing, facial rash, and a slightly elevated temperature.

Diarrhea was not found to be strongly associated with teething, and that will surprise many doctors, Jacobs noted. A poll conducted in Florida a few years ago showed that 35% of physicians thought teething and diarrhea were strongly correlated, he said.

The authors conclude that before attributing anything serious such as a high fever or diarrhea to teething, parents and doctors must rule out other possible causes.

This is the largest study of teething done to date in which parents recorded the symptoms over time, Jacobs said. In past studies, parents were asked to recall their child’s symptoms after a tooth erupted — a method that can be prone to error.

“I hope we made the case that many symptoms correlated with teething are not so. If children are having fevers and are very fussy, it’s important that parents and physicians make sure there is no serious illness,” Jacobs added.