The first teeth to appear are almost always the two bottom front teeth, known as the lower central incisors. They typically break through the gums around 6 months of age, though anywhere from 6 to 10 months is normal. From there, the remaining 18 baby teeth follow a fairly predictable pattern over the next two years.
The Eruption Sequence
After those two bottom front teeth arrive, the top front teeth (upper central incisors) come in next, usually a couple of months later. Then the teeth flanking the top front pair (upper lateral incisors) emerge, followed by the matching pair on the bottom. By around 12 to 16 months, most babies have their eight front teeth.
The first molars, the broader teeth toward the back of the mouth, tend to appear between 13 and 19 months. Then come the canines, the pointed teeth that fill the gap between the front teeth and the molars, typically between 16 and 23 months. The second molars, furthest back in the mouth, are usually the last to arrive, coming in between 23 and 33 months. By age 3, most children have a full set of 20 baby teeth.
When Teeth Are Early or Late
Some babies sprout their first tooth as early as 4 months, while others don’t see one until closer to their first birthday. Both ends of that range are perfectly normal. Genetics plays a big role: if you or your partner got teeth early, your baby may too.
If your child hasn’t developed any teeth by 9 months, it’s worth mentioning to your pediatrician. Delayed tooth formation can sometimes be linked to conditions like hypothyroidism or Down syndrome, though in many cases a late teether is simply on their own schedule. Your doctor can determine whether any testing is needed.
Teething Symptoms to Expect
You’ll likely notice teething before you see the tooth itself. Common signs include drooling, fussiness, swollen or red gums, disrupted sleep, and a strong urge to chew on anything within reach. Some babies rub their cheeks or pull at their ears on the side where a tooth is pushing through. Appetite changes are common too, especially a reluctance to eat when gums are tender.
One widely misunderstood symptom is temperature. Teething can push body temperature slightly above normal, into the 98 to 100.3°F range, but it does not cause a true fever. High fevers, diarrhea, vomiting, persistent coughing, and cold-like symptoms are not caused by teething. These point to an illness that happens to coincide with the teething timeline. Ear pulling can also signal an ear infection rather than a new tooth, so pay attention to whether it’s accompanied by fever or unusual crying.
Caring for the First Teeth
Cleaning should start the day that first tooth appears. Use a soft-bristled infant toothbrush with a rice-grain-sized smear of fluoride toothpaste. Brush at least twice a day: once after breakfast and once before bed. That tiny amount of fluoride is safe to swallow and helps protect enamel from the start. At age 3, you can increase to a pea-sized amount.
Before any teeth come in, you can wipe your baby’s gums with a clean, damp washcloth after feedings. This removes bacteria and gets your baby used to the routine of oral care.
The First Dental Visit
The American Academy of Pediatrics, the American Dental Association, and the American Academy of Pediatric Dentistry all recommend that every child have a dental visit by age 1. This first appointment is brief and low-key. The dentist checks for early signs of decay, evaluates how the teeth and jaw are developing, and gives you guidance on cleaning, diet, and fluoride. Establishing a “dental home” early means small problems get caught before they become painful ones.