The question of whether babies are born with all their teeth requires a distinction between presence and visibility. While you will not see a full set of teeth in a newborn’s mouth, the foundational structures for all the primary teeth are already in place beneath the gums. These first teeth, known as deciduous teeth, are fully formed. Dental development begins very early in fetal development, long before birth.
The Foundation: Teeth Development in the Womb
Tooth formation begins during the earliest stages of pregnancy. As early as six weeks of gestation, the initial structures, known as tooth buds, start to form within the developing jawbone. By the third trimester, all 20 of the primary teeth are fully formed as crowns beneath the gum line. This means that a baby is born with the entire first set of teeth already present, though they remain hidden from view.
The permanent teeth also begin their development during this time, with the buds for the adult molars present at birth. The process involves specialized cells creating the hard tissues of the tooth, with enamel and dentin forming around the tenth week of pregnancy. This internal formation lays the groundwork for future chewing and speech capabilities. The visible eruption later in life is the final stage of this prenatal preparation.
The Typical Eruption Timeline
A baby’s first tooth breaks through the gum line, a process called eruption, generally occurs between six and twelve months of age. This initial appearance is the lower central incisors, the two front teeth on the bottom jaw. The sequence usually follows a predictable pattern, with the corresponding upper central incisors appearing shortly thereafter.
The eruption continues in pairs, sequentially moving toward the back of the mouth, though the timing can vary from one child to the next. Lateral incisors generally emerge next, followed by the first molars and then the canine teeth. The final teeth to appear are typically the second molars, and most children will have their full set of 20 primary teeth by the time they reach two and a half to three years old. This entire first set plays an important role in preserving space for the eventual permanent teeth.
When Teeth Appear Too Early
Although most infants are born without visible teeth, exceptions occur where a tooth is already visible. Teeth present at the time of birth are known as natal teeth, while those that erupt within the first 30 days of life are called neonatal teeth. These occurrences are uncommon, with an estimated incidence ranging from 1 in 2,000 to 1 in 3,500 live births.
The teeth that appear early are most often the lower central incisors and are usually part of the normal primary dentition, not extra teeth. Natal and neonatal teeth can present challenges, such as interfering with breastfeeding or causing ulcers on the baby’s tongue due to friction. If a tooth is very loose or poses a risk of aspiration, a dentist may recommend its removal. If the tooth is stable and not causing issues, a dental professional may advise a conservative approach.
Early Oral Hygiene
Even before the first tooth erupts, establishing an oral hygiene routine is important. Parents can start by gently wiping the baby’s gums with a clean, damp washcloth or a soft silicone finger brush after feedings. This practice helps to remove any milk residue, preparing the baby for the later introduction of a toothbrush.
Once the first tooth appears, typically around six months, introduce a small, soft-bristled toothbrush and fluoride toothpaste. The amount of toothpaste should be no more than a smear, or the size of a single grain of rice, applied twice a day. Dental professionals recommend scheduling the baby’s first dental check-up by their first birthday or within six months of the first tooth emerging to monitor development and provide guidance on proper care.