When teeth are coming in, the gums swell and redden in the spot where the tooth is pushing through, and you’ll often see a small white ridge or point just beneath the surface before the tooth breaks free. This looks different depending on whether it’s a baby’s first tooth, a child’s permanent teeth replacing baby teeth, or wisdom teeth arriving in the late teens. Here’s what to expect at each stage.
What Baby Gums Look Like Before a Tooth Appears
Even before any swelling starts, you can spot where teeth will eventually emerge. Babies are born with lighter areas on their gums that mark where teeth sit underneath. These pale lines or ridges are the first hint of what’s to come, and they’re completely normal from birth.
As a tooth gets closer to the surface, that area of the gum changes noticeably. The tissue becomes puffy and red, sometimes with a visible bulge where the tooth is pressing upward. If you run a clean finger along the gum, you may feel a hard bump or a sharp ridge just below the surface. Right before the tooth cuts through, you’ll often see a tiny white spot at the center of the swollen area. That’s the tip of the tooth becoming visible through thinned-out gum tissue.
The lower front teeth usually arrive first, typically between 5 and 9 months of age. The upper front teeth follow at around 8 to 12 months. From there, the side teeth fill in between 10 and 15 months, the first molars at 10 to 16 months, the pointed canines (the “eye teeth”) at 16 to 20 months, and the second molars at 20 to 30 months. These ranges vary widely from child to child, so a baby who gets a first tooth at 4 months and one who doesn’t see anything until 12 months can both be perfectly on track. By around age 3, most children have all 20 baby teeth.
Eruption Cysts: The Bluish Bump
Sometimes instead of a white point, you’ll notice a bluish or clear bubble on the gum where a tooth is about to come in. This is called an eruption cyst, a small fluid-filled sac that forms over the crown of the tooth as it pushes toward the surface. It can look alarming, almost like a bruise on the gum, but it’s usually painless and harmless.
Eruption cysts are most common toward the back of the lower jaw, where the molars come in, though they can appear anywhere. In most cases, the cyst pops on its own when the tooth finally breaks through, and no treatment is needed. If the bump lasts longer than two weeks, bleeds, oozes pus, or seems to cause your child pain, it’s worth having a dentist take a look. Cysts that persist beyond a month may need a simple procedure to help the tooth come through.
How Molars Look Different From Front Teeth
When front teeth erupt, you see a thin white line or a single point emerging from a relatively narrow strip of gum. Molars are a different story. Because the chewing surface of a molar is broad and flat, the gum over an incoming molar looks more broadly swollen, sometimes across a wide area at the back of the mouth. You may notice the gum looks lumpy or textured rather than showing a single sharp edge.
The two-year molars (the second set of baby molars, arriving between 20 and 30 months) tend to cause the most dramatic gum swelling because they’re the largest baby teeth pushing through. The gum tissue may stay red and puffy for days or even a couple of weeks before the tooth fully emerges. Drooling and chewing on objects often increase during this time.
How Teeth Move Through Bone and Gum
What you see on the surface is the tail end of a process that starts deep in the jawbone. The developing tooth is surrounded by a sac of tissue that signals the bone above it to dissolve, clearing a path upward. At the same time, new bone forms beneath the tooth’s root, pushing it toward the surface. This coordinated cycle of bone dissolving above and forming below is what moves the tooth through the jaw.
Once the tooth reaches the gum tissue, the protective layer covering the enamel merges with the lining of the mouth. This is what allows the tooth to slide through the gum without creating an open wound. After the tooth appears, tiny fibers in the tissue surrounding the root continue to tighten and shorten, pulling the tooth upward until it reaches its final position in the bite. That’s why a tooth that just barely poked through may take additional weeks to fully emerge.
Permanent Teeth Replacing Baby Teeth
When permanent teeth come in during childhood (starting around age 6), the process looks different from infant teething. Ideally, the baby tooth gets progressively looser as the permanent tooth dissolves its root from below, and the new tooth slides right into the gap once the baby tooth falls out. You’ll see a jagged, slightly yellowish edge poking up from the gum where the baby tooth used to be. Permanent teeth are naturally more yellow than the bright white baby teeth around them, which is normal.
Sometimes, though, the permanent tooth doesn’t wait for the baby tooth to leave. It erupts behind or in front of the baby tooth while the baby tooth is still in place. This creates a double row that parents often call “shark teeth.” It’s surprisingly common and happens for a few reasons: the baby tooth’s root didn’t dissolve on schedule, the jaw doesn’t yet have enough space, or the permanent tooth simply took a slightly off-center path. In most cases the baby tooth loosens and falls out on its own within a few weeks, and the tongue naturally nudges the permanent tooth forward into position. If the baby tooth stays firmly rooted for more than a couple of months after the permanent tooth appears, a dentist can remove it to make room.
What Wisdom Teeth Look Like Coming In
Wisdom teeth, the third molars at the very back of the mouth, typically try to emerge in the late teens or early twenties. Because there’s often limited space at the back of the jaw, a wisdom tooth may only partially break through the gum. When this happens, you’ll see a flap of gum tissue (called an operculum) draped over part of the tooth. The visible portion of the tooth may appear as a small white or yellowish surface peeking out from beneath swollen, reddish gum.
That gum flap can trap food and bacteria, leading to a condition called pericoronitis, where the tissue around the partially erupted tooth becomes inflamed and sometimes infected. Signs include redness, swelling, pain when chewing, and occasionally pus or drainage around the flap. Pericoronitis is one of the most common reasons wisdom teeth end up needing removal, since the flap rarely resolves on its own if the tooth doesn’t have room to fully come in.
Teething Symptoms vs. Signs of Illness
Teething can cause fussiness, drooling, and a slight increase in body temperature, but it does not cause a true fever. Normal body temperature sits around 98.6°F (37°C), and a fever is defined as 100.4°F (38°C) or higher. Teething may raise temperature slightly but won’t push it to that 100.4°F threshold. If your baby’s temperature hits 100.4°F or above, that points to an infection rather than teething.
On the gums themselves, normal teething looks like localized redness and swelling in a specific spot where you can feel or see a tooth coming. What’s not normal is widespread bleeding gums, pus, a foul smell, or a rash spreading beyond the chin and cheeks. Excessive drool can irritate the skin around the mouth and chin, creating a red rash that looks worse than it is, but actual blisters or sores inside the mouth are more likely related to a viral infection than to teething.