Most babies get their first tooth between 6 and 12 months of age. The two bottom front teeth almost always come in first, followed by the four upper front teeth. From there, teeth continue filling in gradually, usually in pairs on each side of the jaw, until all 20 baby teeth are in place by around age 2½ to 3.
The Typical Order and Timeline
The bottom central incisors (the two front teeth on the lower jaw) are the first to break through, typically around 6 months. The top four front teeth come next. After that, teeth tend to arrive in a predictable pattern: lower teeth before upper teeth, and in matching pairs, one on the left and one on the right.
Here’s roughly what to expect:
- 6 to 10 months: Bottom two front teeth
- 8 to 12 months: Top four front teeth
- 9 to 16 months: Bottom lateral incisors (the teeth flanking the front two) and first molars
- 16 to 23 months: Canines (the pointed teeth)
- 23 to 33 months: Second molars
These ranges are broad because the variation between babies is enormous. Some babies sprout a tooth at 4 months; others don’t see one until their first birthday. Both are perfectly normal. The total set is 20 teeth: 10 on top, 10 on the bottom.
Babies Born With Teeth
In rare cases, babies are actually born with one or more teeth already visible. These are called natal teeth, and a 2023 analysis found they occur in about 1 in every 289 newborns. Most natal teeth don’t need any treatment. A dental specialist will only remove them if they’re very loose (posing a choking risk), have a weak structure, cause pain during breastfeeding, or injure the baby’s tongue.
When Late Teething Is a Concern
If your baby hasn’t gotten a single tooth by 18 months, it’s worth having a pediatric dentist take a look. In many cases, late teething simply runs in the family. If you or your partner were late teethers, your baby likely will be too.
Other factors that can delay teeth include premature birth, low birth weight, and nutritional shortfalls, particularly in vitamin D, vitamin A, vitamin C, or calcium. Certain medical conditions like hypothyroidism or growth hormone issues can also slow things down, as can prolonged use of some medications like steroids or antibiotics. None of these are common, but they’re the reason a dental evaluation at 18 months makes sense if nothing has appeared yet.
What Teething Actually Feels Like for Your Baby
Teething causes swollen, tender gums, and you’ll probably notice your baby drooling more and wanting to chew on everything. Mild fussiness and irritability are normal, especially in the days right before and after a tooth breaks through. Some babies handle it easily; others have a rough few days with each new tooth.
One important distinction: teething does not cause high fevers, diarrhea, or rashes. These are common myths. If your baby develops a fever over 100.4°F or has persistent diarrhea, something else is going on, and teething shouldn’t be blamed for it.
Safe Ways to Ease Teething Pain
The simplest relief is often the best. Gently rubbing or massaging your baby’s swollen gums with a clean finger can help. A firm rubber teething ring (not liquid-filled) gives them something safe to chew on. You can chill the ring in the refrigerator, but don’t freeze it. A frozen teether becomes hard enough to bruise tender gums.
What you should avoid is more important. The FDA has warned that teething gels and creams containing benzocaine or lidocaine are dangerous for infants. Benzocaine can cause a life-threatening condition where red blood cells lose their ability to carry oxygen effectively. Lidocaine solutions can cause seizures, heart problems, severe brain injury, and death in young children when too much is applied or accidentally swallowed. Homeopathic teething tablets carry similar warnings. The FDA has also received reports of strangulation and choking from teething jewelry, including amber teething necklaces. Stick with simple, non-medicated options.
Caring for Those First Teeth
Start brushing as soon as the first tooth appears. Use a soft-bristled infant toothbrush with a rice grain-sized smear of fluoride toothpaste, twice a day. That tiny amount is safe to swallow and provides enough fluoride to protect the enamel. You’ll keep using that rice grain amount until age 3, when you can increase to a pea-sized dab.
The American Dental Association recommends scheduling your child’s first dental visit after the first tooth comes in, and no later than their first birthday. This visit is mostly about establishing a baseline, checking that teeth are developing normally, and getting personalized advice on cleaning and fluoride. It also gets your baby used to the dental office before there’s ever a problem to fix.