Most babies get their first tooth around 6 months old, though anywhere from 4 to 12 months is normal. The two bottom front teeth usually appear first, followed by the two top front teeth. By age 3, most children have a full set of 20 primary teeth. Here’s what to expect at each stage, from that first tooth breaking through to the day it wiggles out.
When Each Tooth Appears
Baby teeth follow a fairly predictable pattern, though every child’s timeline varies by several months. The lower central incisors (bottom front teeth) lead the way at 6 to 10 months. The upper central incisors follow at 8 to 12 months. After that, the lateral incisors fill in on either side: 9 to 13 months on top, 10 to 16 months on the bottom.
The first molars, those broader teeth farther back in the mouth, arrive between 13 and 19 months on top and 14 to 18 months on the bottom. The pointed canine teeth come next, around 16 to 23 months. The second molars are last, showing up between 23 and 33 months. Once those final molars push through, your child has all 20 primary teeth.
Some babies are born with a tooth already visible, while others don’t see one until after their first birthday. Both ends of that spectrum are normal. If your baby has no teeth at all by 18 months, though, it’s worth having a pediatric dentist take a look.
What Teething Feels Like for Your Baby
The most common early signs are heavy drooling and a baby who wants to chew on everything. You’ll likely notice increased fussiness, crying, and trouble sleeping in the days before a tooth breaks through. Some babies run a mild temperature under 101°F during teething.
A true fever above 101°F, diarrhea, or a runny nose is not caused by teething. Those symptoms point to a virus or other illness, even if the timing lines up with a new tooth. It’s a common mix-up because babies teethe on and off for months, so infections and tooth eruptions often overlap by coincidence.
Safe Ways to Ease Teething Pain
A chilled (not frozen) teething ring or a clean, cold washcloth gives your baby something firm to press against swollen gums. Gently rubbing the gums with a clean finger also helps. These simple approaches are the safest options available.
Numbing gels and creams containing benzocaine or lidocaine should not be used on infants or young children. The FDA warns that benzocaine can cause a rare but life-threatening condition where the blood loses its ability to carry oxygen effectively. Lidocaine solutions carry risks of seizures, heart problems, and severe brain injury if too much is swallowed or absorbed. Homeopathic teething tablets have also drawn safety warnings. Amber teething necklaces pose choking and strangulation hazards, and the FDA has received reports of infant deaths linked to teething jewelry.
When Kids Start Losing Baby Teeth
Baby teeth fall out in roughly the same order they came in. The bottom front teeth loosen first, typically around age 6, though some children don’t start losing teeth until age 7. The top front teeth go next, followed by the lateral incisors, first molars, canines, and finally the second molars. Most children lose their last baby tooth between ages 11 and 13.
A loose tooth can take days or weeks to fall out on its own. Wiggling it gently with the tongue is fine, but forcing it out before it’s ready can damage the root or surrounding tissue. If a baby tooth hasn’t loosened at all and the permanent tooth is visibly coming in behind or beside it, a dentist can help.
When Teeth Are Late
Late teething is often genetic. If you or your partner were late teethers, your child likely will be too. Premature birth and low birth weight are also common reasons for a delayed timeline.
Nutritional deficiencies in vitamin D, vitamin A, vitamin C, or calcium can slow tooth development. Less commonly, conditions like hypothyroidism, growth hormone deficiencies, or a bone development disorder called rickets can interfere with eruption. A pediatric dentist can evaluate whether delayed teeth reflect a simple family pattern or something that needs attention, and 18 months with no teeth is the standard threshold for that evaluation.
Caring for Teeth From the Start
You can start brushing as soon as the first tooth appears. For children under 3, use a smear of fluoride toothpaste about the size of a grain of rice. From ages 3 to 6, increase to a pea-sized amount. Young children swallow most of their toothpaste, so keeping the quantity small matters. Brush twice a day, and until your child can reliably spit (usually around age 6), do the brushing yourself or closely supervise.
The American Academy of Pediatric Dentistry, the American Dental Association, and the American Academy of Pediatrics all recommend scheduling a child’s first dental visit before their first birthday, or within six months of the first tooth appearing. This early visit establishes a baseline, catches any developmental concerns, and gives you a chance to ask questions about fluoride, pacifier habits, and bottle use before they become bigger issues.