A 20-month-old typically has around 12 to 16 teeth, though some toddlers may have a few more or fewer and still be perfectly on track. By this age, most children have all eight incisors (the front teeth) and are working on their first molars and canines, with the exact count depending on their individual pace of development.
Which Teeth Are In by 20 Months
Baby teeth follow a fairly predictable sequence, even though the timing varies from child to child. Here’s what most 20-month-olds have already cut or are actively cutting:
- Central incisors (4 teeth): The bottom two typically arrive between 6 and 10 months, the top two between 8 and 12 months. These are almost certainly in by 20 months.
- Lateral incisors (4 teeth): The upper pair comes in around 9 to 13 months, the lower pair around 10 to 16 months. Again, nearly all 20-month-olds have these.
- First molars (4 teeth): These larger back teeth appear between 11 and 19 months. Most toddlers have at least some of their first molars by 20 months, though a late eruption on the upper jaw (up to 19 months) is still normal.
- Canines (4 teeth): The pointed teeth between the incisors and molars come in around 16 to 22 months on top and 17 to 23 months on the bottom. At 20 months, some children already have their canines while others won’t see them for a couple more months.
That adds up to a possible 16 teeth if the first molars and canines have all come through. If your toddler is on the later end for canines or first molars, a count of 12 is completely normal. The full set of 20 baby teeth isn’t expected until around age 3, once the second molars arrive between 20 and 33 months.
Why Some Toddlers Have More or Fewer
Tooth eruption timing is largely genetic. If you or your partner were late teethers, your child may follow the same pattern. Other factors like nutrition and overall health can play a role, but in most cases a toddler who’s a few months behind the average schedule is simply following their own biological clock.
Delayed eruption is only considered a concern if a child hasn’t developed any teeth at all by 9 months of age. If your 20-month-old has at least several teeth and new ones keep gradually appearing, there’s typically nothing to worry about. When tooth formation is significantly delayed, a provider may ask about family dental history and look for other developmental signs, but dental X-rays or further testing are rarely needed.
What Teething Looks Like at This Age
At 20 months, your toddler may be cutting canines, finishing up first molars, or even starting on second molars (which can begin as early as 20 months on top and 23 months on the bottom). Molars and canines tend to cause more discomfort than the front teeth did because they’re larger and have broader surfaces pushing through the gums.
Common signs that a new tooth is on its way include swollen or red gums in the area where the tooth is emerging, increased drooling, fussiness, irritability, trouble sleeping, decreased appetite, and chewing or biting on objects more than usual. A slight bump in temperature can happen, but a true fever above 100.4°F (38°C) isn’t caused by teething. If your toddler has a higher fever, something else is going on.
What Comes Next
After the canines and first molars fill in, the only teeth left are the four second molars, which sit at the very back of the mouth. These typically arrive between 20 and 30 months on top and 23 and 31 months on the bottom, according to the American Academy of Pediatric Dentistry. Once all four second molars are in, your child will have a complete set of 20 baby teeth, usually by age 3. Those teeth stay in place until the permanent teeth begin replacing them, starting around age 6.
Caring for Your Toddler’s Teeth
The American Academy of Pediatric Dentistry recommends brushing twice a day with a tiny smear of fluoride toothpaste as soon as the first tooth appears. At 20 months, a smear (about the size of a grain of rice) on a soft, small toothbrush is the right amount. You don’t need a pea-sized drop until your child is closer to 3.
If your toddler hasn’t been to a dentist yet, it’s a good time to schedule a visit. Major dental organizations, including the AAPD, ADA, and AAP, recommend that all children have their first dental checkup during their first year of life. A visit now, even if it’s later than the official recommendation, gives a dentist the chance to check that teeth are coming in properly and catch any early signs of decay.