The first teeth to come in are almost always the two bottom front teeth, called the lower central incisors. They typically appear between 6 and 10 months of age, though the normal range for a first tooth stretches from 4 to 15 months. The upper front teeth usually follow about two months later. By age 2 to 3, your child will have a full set of 20 baby teeth.
The Full Eruption Sequence
Baby teeth follow a fairly predictable pattern, starting at the front of the mouth and working backward. Lower teeth tend to come in slightly before their upper counterparts. Here’s the typical order and timing:
- Lower central incisors (bottom front two): 6 to 10 months
- Upper central incisors (top front two): 8 to 12 months
- Upper lateral incisors (flanking the top front teeth): 9 to 13 months
- Lower lateral incisors (flanking the bottom front teeth): 10 to 16 months
- Upper first molars: 13 to 19 months
- Lower first molars: 14 to 18 months
- Upper canines (the pointed teeth): 16 to 22 months
- Lower canines: 17 to 23 months
- Lower second molars: 23 to 31 months
- Upper second molars: 25 to 33 months
Notice that the canines don’t come in right after the other front teeth. The first molars actually arrive before the canines, leaving a temporary gap in between. This is normal. Your child’s teeth are filling in a set of 20 total, and the process wraps up somewhere between their second and third birthday.
How to Tell a Tooth Is Coming In
The most reliable sign is a swollen or puffy spot on the gum where the tooth is pushing through. You might also notice more drooling than usual, though drooling can start as early as 3 or 4 months and doesn’t always mean a tooth is on the way. Babies who are teething tend to shove their fingers or fists into their mouths constantly, get fussy, and have trouble sleeping.
One important distinction: teething does not cause fevers, colds, rashes, or diarrhea. These are common misconceptions. If your baby develops a fever alongside what looks like teething, something else is going on.
When Teeth Come In Early or Late
Some babies are born with one or two teeth already visible. These natal teeth occur in roughly 1 out of every 289 newborns. They don’t always need treatment, but a dental specialist may remove them if they’re loose enough to pose a choking risk, have a weak structure, cause pain during breastfeeding, or damage the baby’s tongue.
On the other end of the spectrum, some babies take their time. The American Academy of Pediatrics recommends a visit to a pediatric dental professional if your child has no teeth by 9 months. Several factors can delay eruption: premature birth, low birth weight, nutritional deficiencies (particularly vitamin D), thyroid conditions, and certain genetic conditions like Down syndrome. In most cases, though, late teething is simply a variation of normal, and the teeth show up on their own.
Safe Ways to Ease Teething Pain
The FDA has issued clear warnings against using numbing gels or creams containing benzocaine or lidocaine on infants’ gums. Products like Orajel and Anbesol fall into this category. Benzocaine can cause a dangerous condition where red blood cells lose their ability to carry oxygen effectively. Lidocaine solutions can lead to seizures, heart problems, and even death in young children. Homeopathic teething tablets also carry safety concerns and should be avoided.
Amber teething necklaces are another product to skip. The FDA has received reports of strangulation and choking linked to teething jewelry.
What actually works is simpler. Rubbing your baby’s gums with a clean finger provides direct pressure that helps ease discomfort. A firm rubber teething ring gives them something safe to chew on. Don’t freeze the ring, though. A frozen teether is hard enough to bruise tender gums. Keep it cool in the refrigerator instead, and always supervise your child while they’re using it.
Caring for the First Teeth
You can start cleaning your baby’s mouth before any teeth appear by wiping the gums with a damp gauze pad or soft cloth after feedings, at least twice a day. Once that first tooth breaks through, switch to a small, soft-bristled toothbrush. Use a rice-grain-sized smear of fluoride toothpaste for children under 3.
Angle the bristles along the gum line and brush in gentle circular motions rather than scrubbing back and forth, which can irritate the gums. Cover all sides of each tooth, then finish by lightly brushing the tongue. The American Academy of Pediatrics recommends scheduling your child’s first dental visit by their first birthday or within six months of that first tooth appearing, whichever comes first.