“What stage of teething hurts the most?”

The final stage.

That is really difficult to answer, but I would surmise that just before breaking through the gum would be the most painful. The only problem is telling when that is going to occur - till you see the tooth through the gum, who really knows when it will break through?!

The tooth hurts the most just before it pops through the gum. If several teeth are erupting at the same time, of course the pain is worse. Typically, the 2 bottom teeth come through first, then the two top teeth. After that, it's somewhat variable, but it's not unusual for 2, or all 4, molars to erupt at the same time. The canines, also, frequently erupt at the same time. Ibuprofen can help with the pain, as can chewing on firm "teething toys." The older practice of offering cold or frozen teething rings is no longer recommended due to possible frostbite to the gums. A drop of the essential oil clove, added to 1 tsp of a carrier oil such as olive or coconut, rubbed on the swollen gum, can help relieve some of the pain. Be sure to test it yourself, first, to be sure it's not too strong.

Shelley C. Springer, MD, MBA, MSc, JD, FAAP