worsen or are persistent. Teething may cause signs and symptoms in the mouth and gums, but does not cause problems elsewhere in the body. Pulling on the ears is another sign of pain; the pain in the mouth throbs throughout the baby's head so they pull their ears believing that it will provide relief. Mild rash can develop around the mouth due to skin irritation that is caused by excessive drooling or dribbling. Sequence of appearance The infant teeth tend to emerge in pairs – first one lower incisor emerges then the other lower incisor emerges before the next set begin to emerge. The general pattern of emergence is: Lower central incisors (2) at approximately 6 months Upper central incisors (2) at approximately 8 months Upper lateral incisors (2) at approximately 10 months Lower lateral incisors (2) at approximately 10 months First molars (4) at approximately 14 months Canines (4) at approximately 18 months Second molars (4) at approximately 2–3 years Milk teeth tend to emerge sooner in females than in males. The exact pattern and initial starting times of teething appear to be hereditary. When and how teeth appear in an infant has no bearing on the health of the child. Misdiagnosis as teething Teething has not been shown to cause fever or diarrhea; however, the belief that teething causes fever is extremely common among parents. Whilst there is some evidence that teething can cause an elevated temperature, it does not cause fever (medically defined as rectal temperature greater than . One small 1992 study found a significant rise in temperature on the day of eruption of the first tooth. Another study in 2000 found "mild temperature elevation" but not fever over . There is a risk that fever around the age of teething is dismissed as due to teething when it is actually due to illness, particularly infection by herpes viruses. "Coincidentally, primary tooth eruption begins at about the time that infants are losing maternal antibody protection against the herpes virus. Also, reports on teething difficulties have recorded symptoms which are remarkably consistent with primary oral herpetic infection such as fever, irritability, sleeplessness, and difficulty with eating." "Younger infants with higher residual levels of antibodies would experience milder infections and these would be more likely to go unrecognized or be dismissed as teething difficulty." Herpes virus infection may take the form of primary herpetic gingivostomatitis (HSV-1) or of