Most babies get their first tooth around 6 months old, though the normal range stretches from 4 to 12 months. The lower front teeth almost always come in first, followed by the upper front teeth a few months later. By age 3, most children have all 20 of their primary teeth.
The Typical Teething Timeline
The two lower central incisors (the bottom front teeth) are usually the first to break through, arriving around 6 months. The upper central incisors follow shortly after. From there, teeth tend to fill in from front to back, with the lateral incisors (the teeth flanking the front two) coming next, then the first molars, canines, and finally the second molars.
Children are born with all 20 baby teeth already formed beneath their gums. The process of those teeth pushing through the gum tissue happens in a fairly predictable sequence, but the exact timing varies widely from child to child. Some babies sprout a tooth at 4 months, while others don’t see one until after their first birthday. Both ends of that range are normal. Genetics plays a large role: if you or your partner teethed early or late, your baby may follow the same pattern.
When Late Teething Is Worth Checking
If your baby hasn’t developed any teeth by 9 months, it’s worth mentioning to your pediatrician. Delayed eruption on its own is rarely a sign of a serious problem, but it can occasionally point to nutritional deficiencies or other developmental factors that are easy to address once identified. In many cases, the teeth are simply taking their time.
Babies Born With Teeth
About 1 in every 289 newborns arrives with one or more teeth already visible, called natal teeth. These are uncommon but not dangerous in most cases. A dental specialist will typically leave them alone unless they’re loose enough to pose a choking risk, have a weak or underdeveloped structure, cause pain during breastfeeding, or damage the baby’s tongue. If any of those situations apply, the teeth are removed.
Signs Your Baby Is Teething
Teething causes swollen, tender gums as the tooth pushes toward the surface. The most reliable signs are increased drooling, fussiness, and a strong urge to chew on things. Your baby may rub their face or ears on the side where the tooth is coming in, and they may be more restless at night.
One thing teething does not cause is high fever. A very slight rise in temperature can happen, but if your baby has a fever above 100.4°F (38°C), that’s more likely an unrelated illness. The same goes for diarrhea and rashes, which parents often attribute to teething but are typically caused by the infections babies tend to pick up around the same age they start teething.
Safe Ways to Ease Teething Pain
The simplest and most effective relief is pressure on the gums. Use a clean finger or a piece of wet gauze and rub your baby’s gums for about two minutes. You can do this as often as needed throughout the day. The counter-pressure from rubbing helps offset the pressure of the tooth pushing up from below.
Cold also helps. Chill a teething ring, pacifier, or wet washcloth in the refrigerator (not the freezer, which can make them hard enough to hurt). If your baby’s teething ring is the liquid-filled type, look for one filled with distilled water rather than gel, since new teeth can puncture the ring. For babies older than 1, you can offer a chilled piece of soft fruit like banana or berries in a small mesh feeder.
If your baby usually breastfeeds but refuses because of sore gums, try offering breast milk from a cup, spoon, or syringe for a short time until the worst of the discomfort passes.
Products to Avoid
Numbing gels and creams containing benzocaine or lidocaine are widely available, but the FDA warns against using them for teething pain in infants and young children. These products provide little to no benefit and carry serious risks. Benzocaine can trigger a condition that drastically reduces the blood’s ability to carry oxygen, which can be fatal. Lidocaine solutions can cause seizures, heart problems, and severe brain injury if too much is applied or accidentally swallowed.
Homeopathic teething tablets fall under the same warning. Despite their “natural” branding, the FDA has found these products can also be dangerous to children. If your baby seems to need pain relief beyond cold and pressure, infant acetaminophen or ibuprofen (for babies 6 months and older) are safer options to discuss with your pediatrician.
Caring for New Teeth
Start cleaning your baby’s teeth as soon as the first one appears. Use a soft-bristled infant toothbrush with a rice-grain-sized smear of fluoride toothpaste twice a day. Even though these teeth will eventually fall out, cavities in baby teeth can cause pain and affect the spacing of permanent teeth later on.
The American Academy of Pediatric Dentistry recommends scheduling your child’s first dental visit within six months of the first tooth appearing, or by their first birthday, whichever comes first. This initial visit is mostly about establishing a baseline, checking for early issues, and getting your child comfortable with the dentist’s office before any real work ever needs to happen.