Babies typically get their first teeth around six months of age, starting with the four front teeth, two on top and two on the bottom. From there, teeth continue to appear in a fairly predictable pattern over the next two years, until all 20 primary teeth are in place by around age 3.
The Order Teeth Come In
The two lower central incisors (the bottom front teeth) are almost always first, usually appearing between 6 and 10 months. The two upper central incisors follow shortly after. From there, teeth tend to erupt in pairs, working outward from the center of the mouth.
After the front four are in, the lateral incisors come next. These are the teeth immediately beside the front ones, giving your baby a wider smile somewhere between 9 and 16 months. Then there’s a gap in the pattern: the first molars, farther back in the mouth, typically show up before the canines (the pointed teeth between the incisors and molars). The canines fill in that empty space later, often between 16 and 23 months. The second molars, the very back teeth, are the last to arrive, usually after your child turns 2. Most children have a complete set of 20 primary teeth by 33 months.
This timeline varies quite a bit from child to child. Some babies sprout their first tooth at 4 months, while others don’t see one until closer to their first birthday. Both ends of that range are normal. The sequence matters more than the exact timing. If teeth arrive in the expected order, even on a delayed schedule, development is on track.
What Happens Inside the Gums
Baby teeth actually start forming long before birth, developing inside the jawbone while a baby is still in the womb. By the time you see a tooth break through, it has already gone through three distinct phases of movement. First, the tooth forms and slowly positions itself within the bone, with very little visible movement. Second, the body begins breaking down the bone and gum tissue above the tooth, creating a path for it to travel upward (or downward, for upper teeth). This is the phase that causes discomfort. Third, once the tooth pokes through the surface of the gum, it continues rising until it meets the opposing tooth and settles into its final position.
The process is gradual. A single tooth can take several days to fully emerge through the gum, and you’ll often see a bluish-white bump on the gum ridge before the tooth itself is visible.
Signs Your Baby Is Teething
The most reliable early sign is increased drooling, sometimes weeks before you see a tooth. Your baby’s gums may look red, swollen, and puffy in the area where a tooth is about to break through. Many babies become fussier than usual, have trouble sleeping, lose interest in eating, or constantly chew on their hands and anything else they can get into their mouths. These are all normal teething behaviors.
One important thing to know: teething does not cause fever, diarrhea, diaper rash, or a runny nose. This is a common misconception, and the American Academy of Pediatrics warns that blaming these symptoms on teething can delay care for an actual infection. A baby who is running a real fever (above 100.4°F) or has diarrhea likely has something else going on, even if the timing happens to overlap with a new tooth.
Safe Ways to Ease Teething Pain
The simplest and safest options are pressure and cold. A clean, chilled (not frozen) washcloth gives your baby something firm to gnaw on, and the cool temperature helps numb sore gums. Solid silicone teething rings work the same way. You can refrigerate them but should avoid freezing, since a rock-hard ring can bruise tender gums. Gently rubbing your baby’s gums with a clean finger also provides counter-pressure that many babies find soothing.
What you should avoid is more important than what you should try. The FDA warns against using any teething gels or creams containing numbing agents like benzocaine or lidocaine on infants and young children. These products offer little benefit and carry serious risks. Benzocaine can cause a rare but potentially fatal condition that reduces the blood’s ability to carry oxygen. Lidocaine solutions can lead to seizures, heart problems, and severe brain injury if too much is swallowed or absorbed. Homeopathic teething tablets have also drawn FDA warnings for inconsistent ingredient levels and adverse events. None of these products are considered safe for teething pain.
Caring for New Teeth
You can start cleaning your baby’s gums with a soft, damp cloth even before the first tooth arrives. Once that first tooth breaks through, switch to a soft-bristled infant toothbrush with a rice-grain-sized smear of fluoride toothpaste. This tiny amount is safe to swallow and helps protect enamel from the start.
Your child should see a dentist by their first birthday, or within six months of their first tooth appearing, whichever comes first. This initial visit is mostly about establishing a baseline, catching any early issues, and getting guidance on oral care routines that fit your child’s specific development. Primary teeth matter more than many parents realize: they hold space in the jaw for the permanent teeth that will eventually replace them, and decay in baby teeth can affect the adult teeth forming underneath.