Most babies get their first tooth around 6 months old, though any time between 6 and 12 months is perfectly normal. Some babies cut a tooth as early as 4 months, while others don’t have one until after their first birthday. This wide range is normal and rarely signals a problem.
Which Teeth Come In First
The two bottom front teeth, called the lower central incisors, are almost always the first to appear. The two upper front teeth typically follow. After that, teeth generally work outward: the lateral incisors (the ones flanking the front teeth), then the first molars, canines, and finally the second molars. By age 3, most children have all 20 of their primary teeth.
This sequence can vary from child to child. Some babies get an upper tooth before any lower ones, and that’s not a concern. The order matters less than the general timeline.
Signs a Tooth Is Coming
Teething symptoms often start a few days before you can see or feel anything on the gums. The most common early signs are heavier drooling than usual and red, swollen gums where the tooth is pushing through. Your baby may also become fussy, have trouble sleeping, lose interest in food, or constantly chew on objects, fingers, or your shoulder.
One important misconception: teething does not cause fevers. It may nudge your baby’s temperature slightly above normal, but it won’t reach the threshold of a true fever (100.4°F or higher). If your baby has a fever at or above that mark, something else is going on, likely an infection, and it shouldn’t be dismissed as teething.
How to Soothe Teething Pain Safely
The simplest and safest options are physical. Gently rubbing or massaging your baby’s gums with a clean finger can relieve pressure. A firm rubber teething ring also works well. You can chill it in the refrigerator, but don’t freeze it. A frozen teether becomes hard enough to bruise already-tender gums.
Avoid topical numbing gels. The FDA has warned that products containing benzocaine or lidocaine offer little benefit for teething and carry serious risks. Benzocaine can cause a rare but potentially fatal condition where red blood cells lose much of their ability to carry oxygen. Lidocaine solutions can cause seizures, heart problems, and severe brain injury in young children if too much is applied or accidentally swallowed. Neither should be used for teething pain.
Babies Born With Teeth
About 1 in every 289 newborns arrives with one or more teeth already visible, known as natal teeth. These are usually lower front teeth and are often slightly underdeveloped compared to teeth that erupt on a normal timeline. In most cases, natal teeth can stay in place without any treatment. A doctor or dentist may recommend removal only if the tooth is very loose (posing a choking risk), causes pain during breastfeeding, or damages the baby’s tongue.
Natal teeth sometimes run in families with no underlying cause. In rarer cases, they’re linked to certain genetic conditions or endocrine issues like an overactive thyroid.
When Teeth Come In Late
If your baby hasn’t gotten a first tooth by about 10 months (40 weeks of age), pediatric dentists consider that on the later side of normal. Genetics play the biggest role. If you or your partner were late teethers, your baby likely will be too.
Premature babies are more likely to experience delayed tooth eruption, especially those born before 30 weeks or weighing under about 2.2 pounds at birth. The severity of illness in the newborn period, postnatal nutrition, and time spent on oral breathing tubes all influence timing. For preemies, dentists often use corrected age (adjusting for how early the baby arrived) rather than calendar age when evaluating whether teeth are on track.
Nutritional deficiencies, particularly low calcium or vitamin D, can also slow things down. In the absence of other health concerns, a baby who simply teethes late is rarely cause for alarm.
Caring for That First Tooth
Start brushing the day the first tooth appears. Use a soft-bristled infant toothbrush with a rice grain-sized smear of fluoride toothpaste, twice a day. That tiny amount provides cavity protection while being safe if swallowed. After 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 cloth after feedings. This gets them used to the routine and keeps bacteria in check.
The First Dental Visit
The American Academy of Pediatric Dentistry, the American Dental Association, and the American Academy of Pediatrics all recommend scheduling a child’s first dental visit before their first birthday. The visit is brief and mostly about checking that things are developing normally, identifying early risk factors for cavities, and giving you guidance on oral care at home. If your baby already has several teeth by then, the dentist can spot any issues with spacing or alignment early.