Most babies get their first tooth between 6 and 12 months of age, with 6 months being the most common starting point. Some babies teethe as early as 4 months, and a small number are actually born with teeth already visible. On the other end of the spectrum, some perfectly healthy babies don’t see a first tooth until closer to their first birthday.
The Typical Teething Timeline
The lower front teeth (central incisors) almost always come in first, usually around 6 months. The upper front teeth follow shortly after. From there, teeth tend to fill in from front to back, with the full set of 20 primary teeth usually in place by age 3. But this timeline has wide variation. A baby who gets their first tooth at 4 months and one who gets it at 10 months are both within the normal range.
If your baby hasn’t developed any teeth by 9 months, it’s worth mentioning to your pediatrician. Delayed eruption can sometimes signal a nutritional deficiency or other developmental factor, though in many cases late teethers are simply on their own schedule.
Babies Born With Teeth
About 1 in every 289 newborns worldwide is born with one or more teeth already through the gums. These are called natal teeth, and they’re usually harmless. Most don’t need any treatment at all. A dentist will only recommend removing them if the teeth are very loose (posing a choking risk), have weak or underdeveloped structure, cause pain during breastfeeding, or injure the baby’s tongue.
Signs a Tooth Is Coming
Before a tooth actually breaks through, you’ll likely notice behavioral changes. Your baby may drool more than usual, gnaw or chew on anything within reach, and become noticeably fussier. The gum where the tooth is pushing through often looks red and swollen. Some babies develop a flushed cheek on the side where the tooth is erupting, rub or pull at their ear, or sleep more poorly than normal.
A slight rise in body temperature is common during teething, typically in the range of 98 to 100.3°F. This is not a true fever. Doctors define a fever as 100.4°F or higher. If your baby’s temperature reaches that threshold, something else is going on.
Teething Symptoms vs. Illness
Because teething often overlaps with the age when babies start picking up more infections, it’s easy to blame teething for symptoms it doesn’t actually cause. Teething does not cause high fevers, diarrhea, vomiting, persistent coughing, or cold-like symptoms with nasal or chest congestion. Those point to an underlying illness, not a tooth coming in.
Ear pulling is a good example of a symptom that could go either way. Babies sometimes tug at their ears when a tooth is erupting nearby, since the pain can radiate. But ear pulling combined with a high fever is more likely an ear infection than teething discomfort. If the ear pulling is persistent or your baby seems unusually distressed, that’s worth a call to your pediatrician.
Safe Ways to Ease Teething Pain
The American Academy of Pediatrics recommends two straightforward approaches: rubbing your baby’s gums with a clean finger, and offering a teething ring made of firm rubber to chew on. Chilling the teething ring in the refrigerator (not the freezer) can add extra relief. A cold, wet washcloth works well too.
What you should avoid is more important than what you should try. The FDA warns that numbing gels and creams containing benzocaine or lidocaine should not be used for teething pain in children. Benzocaine can cause a rare but serious condition that reduces the blood’s ability to carry oxygen. Lidocaine solutions can cause seizures, heart problems, and severe brain injury in infants if too much is applied or accidentally swallowed. Homeopathic teething tablets also fall under the FDA’s warning. These products offer little to no benefit and carry real risks.
Which Teeth Come In and When
After those first lower front teeth around 6 months, the general order looks like this:
- Upper central incisors (front teeth): 8 to 12 months
- Upper and lower lateral incisors (next to front teeth): 9 to 16 months
- First molars: 13 to 19 months
- Canines (the pointy ones): 16 to 23 months
- Second molars: 23 to 33 months
Each new tooth can bring a fresh round of fussiness and drooling. Many parents find that the molars, which have a larger surface area pushing through the gums, cause more discomfort than the front teeth did. By around age 3, most children have all 20 baby teeth in place, and you’ll get a break from teething until the permanent teeth start arriving years later.