Teething, like crawling and talking, can be an exciting sign of healthy development in children, but it also comes with a slew of unique symptoms, some of which may mask real health concerns. A new analysis, published in the journal Pediatrics, warns parents to watch for the differences between ordinary teething-related fevers and symptoms and signs of more serious problems that extend beyond the teething phase.

"If a child has a really high fever, or is in significant discomfort, or won't eat or drink anything for days, that's a red flag for concern," said Dr. Paul Casamassimo of the American Academy of Pediatric Dentistry's Pediatric Oral Health and Research and Policy Center in an interview with CNN. "By and large, symptoms are not a chronic thing. They come and go, and the job of the parent is to comfort the child and keep their finger on the pulse of their child. Is the child eating? Staying hydrated?"

It’s common for parents to confuse teething symptoms with symptoms of a more serious condition or illness, which is why Casamassimo emphasizes the importance of paying attention. By attributing fevers and infections to teething and not following up with a doctor, parents risk not properly treating a real ailment in their child.

Most babies begin teething between four and six months of age. It’s a crucial part of development that goes beyond just biting and chewing different foods for digestion; it is also exercise that builds the muscles involved in speech development. While it may be an exciting milestone for parents, it can also be difficult for the babies, some of whom experience more irritating and painful tooth growth than others.

Because not all babies share the same teething symptoms, parents should pay close attention during this time. Some babies may drool excessively, which can cause a rash on their chin and face, or experience gum swelling and sensitivity, aching, or problems sleeping. Other babies may tug on their faces and ears out of frustration, refuse to eat or drink because of the pain, or suffer a mild fever.

However, the study found that, though the baby’s body temperature may rise slightly, it should still remain below 101 degrees Fahrenheit. Casamassimo reassures parents the symptoms unique to their babies should not last more than three to five days. Infant painkillers may be used to ease the infant’s discomfort, but too much acetaminophen, the active ingredient in Tylenol, is a leading cause of liver disease.

Casamassimo warns that giving the baby a mild painkiller day after day to keep their fever and pain at bay is dangerous and should be followed by a visit with a pediatrician. Aside from a high fever, other worrying symptoms include persistent sores or blisters in the mouth, complete appetite loss, and diarrhea. Ultimately, the best way to handle teething is to become hyperaware of your baby’s behaviors and take careful note of signs of discomfort.

"Just comfort your child and get through it," Casamassimo said. "Every kid is going to have it in slightly different ways. Pay attention to the symptoms. Ameliorate the symptoms. If things get out of hand, contact you pediatrician."

Source: Massignan C, Cardoso M, and Bolan M, et al. Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Pediatrics. 2016.