Most babies get their first tooth between 5 and 9 months old, typically one of the lower front teeth. From there, teeth continue arriving in a fairly predictable pattern until all 20 baby teeth are in place by around age 2 to 3. Permanent teeth then start replacing them around age 6, with the process stretching into the late teens or early twenties when wisdom teeth arrive.
Baby Teeth: 5 Months to 3 Years
The lower front teeth (central incisors) are almost always first, showing up between 5 and 9 months. The upper front teeth follow close behind at 8 to 12 months. From there, teeth generally fill in from front to back:
- Upper side teeth (lateral incisors): 10 to 12 months
- Lower side teeth (lateral incisors): 12 to 15 months
- First back teeth (first molars): 10 to 16 months
- Canines (the pointed teeth): 16 to 20 months
- Second back teeth (second molars): 20 to 30 months
These ranges vary widely from child to child. Some babies sprout a tooth at 4 months, while others don’t get one until closer to their first birthday. Both ends of that spectrum are normal. If your child hasn’t gotten any teeth by 9 months, it’s worth mentioning to your pediatrician, but delayed eruption on its own is rarely a sign of a serious problem.
Signs a Tooth Is Coming In
Before a tooth breaks through the gum, you’ll likely notice extra drooling and a baby who wants to chew on everything. Crankiness, trouble sleeping, and general irritability are common. Some babies run a mild temperature under 101°F.
High fevers above 101°F, diarrhea, and runny nose are not caused by teething. Those symptoms point to a virus or other illness that happens to coincide with the teething timeline, and they shouldn’t be dismissed as “just teething.”
When Baby Teeth Fall Out
Baby teeth leave in roughly the same order they arrived. The lower front teeth are first to go, typically between ages 6 and 7. The upper front teeth follow at 7 to 8. The rest of the schedule unfolds over several years:
- Side teeth (lateral incisors): 7 to 9 years
- Canines: 9 to 12 years
- First molars: 9 to 12 years
- Second molars: 9 to 13 years
Lower teeth tend to loosen a bit earlier than their upper counterparts. It’s common for kids to have a mix of baby and permanent teeth for several years, sometimes called the “mixed dentition” stage. This is completely normal and doesn’t mean anything is going wrong with alignment, though a dentist can flag concerns during routine visits.
Permanent Teeth: 6 Years to Early Twenties
Permanent teeth don’t simply replace baby teeth one for one. Children have 20 baby teeth, but adults end up with 28 to 32 permanent teeth. The extra teeth, including premolars and third molars, emerge in spaces that grow as the jaw develops.
The first permanent teeth to arrive are usually the lower central incisors and the “six-year molars,” which come in behind the last baby teeth rather than replacing them. Because no baby tooth falls out to make room, parents sometimes don’t realize these molars are permanent. They are, and they’re worth paying attention to with brushing since they’ll be in the mouth for life.
The last permanent teeth to arrive (not counting wisdom teeth) are the upper canines, which typically settle into place between ages 11 and 12. By around age 13, most children have a full set of 28 permanent teeth.
Wisdom Teeth
Wisdom teeth, the third set of molars, usually come in between ages 17 and 21. Not everyone gets all four, and many people don’t have enough room in their jaw for them to emerge properly. Impacted wisdom teeth that are trapped beneath the gum or growing at an angle are extremely common. Research published in the British Journal of General Practice found that roughly 80% of dental patients age 70 or younger eventually need at least one wisdom tooth removed.
Babies Born With Teeth
In rare cases, about 1 in 2,000 to 1 in 3,000 births, a baby is born with one or more teeth already visible. These are called natal teeth. They’re usually lower front teeth and are often wobbly because the root hasn’t fully formed. The main concern is that a loose natal tooth could come free and pose a choking risk during feeding. They can also irritate the baby’s tongue or make breastfeeding painful for the mother. A pediatric dentist will evaluate whether the tooth is stable enough to leave in place or whether removal is safer.
Caring for Teeth From the Start
Good oral care starts before the first tooth even appears. After feedings, wiping your baby’s gums with a damp gauze pad or soft cloth removes bacteria and gets them accustomed to having their mouth cleaned. Once the first tooth breaks through, switch to a small, soft toothbrush. Use fluoride toothpaste right away, but only a rice-grain-sized smear for children under 3.
Brush at least twice a day, using gentle circular motions along the gum line rather than scrubbing back and forth. Don’t skip the tongue. The American Academy of Pediatric Dentistry recommends scheduling a child’s first dental visit within six months of the first tooth appearing, or by their first birthday, whichever comes first. That early visit establishes a baseline and catches any issues while they’re still small.