Around 18 months, most toddlers are cutting their canine teeth, the pointy ones that sit between the front teeth and the molars. The upper canines typically come in between 16 and 22 months, while the lower canines follow a similar timeline, arriving between 17 and 23 months. Some 18-month-olds may also still be finishing up their first molars, which usually start pushing through between 13 and 19 months.
Which Teeth Appear and Where
By 18 months, your toddler likely already has eight front teeth (four on top, four on bottom) and may have some or all of their first molars, the broad flat teeth toward the back. The canines fill in the gaps between those two groups. Upper canines tend to arrive slightly before the lower ones, though every child’s timeline varies by several months in either direction.
The canines are sharper and more pointed than your child’s other teeth, which means they can be particularly uncomfortable as they cut through the gums. After the canines come in, the next teeth on the schedule are the second molars, which typically don’t appear until age 2 to 3. So once these canines are through, you’ll likely get a break from teething for a while.
By the time your child is about 3 years old, all 20 primary teeth are usually in place. At 18 months, most kids have roughly 12 to 16 of those 20 teeth, depending on their individual pace.
What Teething Looks Like at This Age
Teething symptoms at 18 months are similar to what you saw with earlier teeth, but toddlers can be more vocal about the discomfort. Common signs include red, swollen, or tender gums right where the tooth is about to break through, along with increased drooling and a strong urge to bite or chew on things. Many toddlers also become fussy, have trouble sleeping, or lose interest in food for a few days.
Symptoms typically last about 48 hours around the time each tooth actually pushes through the gum surface. You may occasionally notice a blue-grey bubble on the gum where a tooth is emerging. This is called an eruption cyst, and it usually resolves on its own once the tooth breaks through. The extra drool can also irritate the skin around your child’s mouth and chin, so keeping the area dry with a soft cloth helps prevent a rash.
Easing Your Toddler’s Discomfort
At 18 months, you have more options for relief than you did during early infancy. Gentle pressure on the gums works well: wash your hands and massage the sore spots with a fingertip or knuckle. Chilled (not frozen) teething cloths and soft rubber or plastic teething toys give your toddler something safe to chew on. A damp washcloth twisted up and placed in the freezer for a short time can feel especially soothing.
Cold water in a sippy cup serves double duty, hydrating your child while letting them chew on the soft spout. A warm bath before bed, a gentle massage, or low white noise can help settle a toddler who’s struggling to sleep through teething pain. If the discomfort is significant enough to disrupt sleep, a dose of acetaminophen at bedtime is considered safe for occasional use, though you’ll want to follow the dosing guidelines on the package for your child’s weight.
When Teeth Are Late
There’s a wide range of normal when it comes to tooth eruption. Some babies get their first tooth at 4 months, others not until well past their first birthday. However, if your child still has no teeth at all by 18 months, a pediatric dentist visit is a good idea. The dentist can do a thorough exam and take X-rays to check whether teeth are developing beneath the gums and rule out any underlying issues.
If your child has some teeth but seems behind the typical schedule, that’s less of a concern. The order teeth arrive matters more than the exact timing, and variations of several months are completely normal. The American Dental Association recommends a first dental visit by age 1 or within six months of the first tooth appearing, so if you haven’t scheduled that yet, 18 months is a fine time to get started.
Caring for New Teeth
Once those canines are in, your toddler’s bite is becoming more functional, and brushing becomes more important. Brush twice a day with a soft-bristled toothbrush sized for toddlers. For children under 3, use a smear of fluoride toothpaste about the size of a grain of rice. That small amount provides cavity protection while minimizing the fluoride your child swallows.
The canines and first molars create new contact points between teeth where food can get trapped, so brushing along the gumline and between teeth matters more now than it did when your child only had a few front teeth. Many toddlers resist brushing, so making it part of a consistent routine (and letting them hold their own toothbrush afterward) helps build the habit early.