The arrival of your baby’s first tooth is a milestone many parents watch for closely. While some babies sprout a tiny white tip on their gums as early as 3 months, most begin teething between 6 and 12 months. But here’s the truth: there’s no single “right” time for that first tooth to appear. In fact, it’s perfectly normal for some babies to show no teeth until 15 or even 18 months, while others surprise their parents with a full grin by their first birthday.
The lower central incisors—the two front teeth on the bottom gum—are usually the first to emerge. You might notice your baby drooling more, gnawing on their hands, or waking up more often at night. But not all babies act fussy. Some pop a tooth overnight with little to no discomfort.
Whether your baby is ahead of the curve or taking their time, this guide will help you understand when babies get their first tooth, what signs to look for, how to ease sore gums, and when it’s time to call the doctor. You’ll also learn about early and late teething, safe pain relief, and why oral care should start before the first tooth even appears.
When Most Babies Get Their First Tooth
While every child develops at their own pace, most babies get their first tooth around 6 months, though the full healthy range spans from 3 to 18 months. By 12 months, about 60% of infants have at least one tooth, and nearly all will have started teething by 15 months.
It’s important to remember that 6 months is just an average, not a deadline. Many babies don’t get their first tooth until 8, 10, or even 12 months—and this is completely normal. Just like crawling or walking, teething follows a wide but healthy spectrum.
Early Teething: Before 4 Months
Some babies begin showing signs of teething as early as 2.5 to 4 months. If your baby is drooling heavily, chewing on fists, or seems irritable at night, a tooth could be on its way.
Early teething often runs in families. Babies who start early may also follow a faster eruption pattern, sometimes getting all 20 baby teeth by 14 to 16 months.
A small number of babies are born with natal teeth—one or more teeth already visible at birth. These are usually the lower central incisors. If they interfere with breastfeeding or pose a choking risk, your pediatric dentist may recommend removal.
Late Teething: After 12 Months
It’s not uncommon for some babies to have no teeth by their first birthday. Healthy children often get their first tooth at 14, 16, or even 18 months. In most cases, this is simply due to genetics—no treatment or intervention is needed.
However, if your baby has no teeth by 18 months, it’s time to consult a pediatric dentist. Delayed teething beyond this point could signal underlying issues like:
– Nutritional deficiencies (e.g., vitamin D or calcium)
– Genetic conditions (e.g., Down syndrome)
– Hormonal imbalances (e.g., hypothyroidism)
But again, late teething is usually just part of your baby’s unique timeline—not a cause for alarm.
What Order Do Baby Teeth Come In?
Teeth usually erupt in a predictable pattern, though individual differences are common.
Lower Central Incisors (6–10 Months)
These are typically the first teeth to appear. Located at the front of the bottom gum, they help your baby bite into soft foods like mashed banana or avocado.
Watch for:
– Swollen, red gums in the lower front area
– Increased drooling
– Chewing on the bottom gum
They often come in together, but it’s normal for one to appear a few weeks before the other.
Upper Central Incisors (8–12 Months)
Next come the upper front teeth, which usually emerge between 8 and 12 months. When these break through, you may notice your baby biting during nursing or bottle-feeding.
At this stage, many parents report:
– Night wakings
– Mild fussiness
– Pulling at ears (due to shared nerve pathways)
These symptoms are usually short-lived and ease once the tooth fully erupts.
Common Signs Your Baby Is Teething
Teething affects babies differently. Some show no signs, while others seem uncomfortable for days.
Typical Symptoms
- Excessive drooling: Starts around 3–4 months
- Swollen, tender gums: Especially where the tooth is emerging
- Chewing on hands or toys: A natural way to relieve pressure
- Irritability: Often worse in the evening
- Sleep disruptions: Waking more frequently at night
- Mild temperature rise: Up to 100.4°F (38°C)—but not a true fever
- Facial rash: Caused by drool irritating the skin
- Ear or cheek pulling: Due to jaw nerve discomfort
Symptoms That Are NOT Caused by Teething
High fever, diarrhea, vomiting, or persistent crying are not normal teething symptoms. These may indicate:
– Ear infection
– Cold or flu
– Stomach virus
If your baby has a fever over 101°F (38.3°C), contact your pediatrician. Teething does not cause serious illness.
How to Soothe a Teething Baby
Most babies don’t need medication, but gentle relief can make a big difference.
Safe, Effective Remedies
- Cold washcloth: Chill a clean, damp cloth in the fridge (not freezer) and let your baby chew on it
- Chilled teething rings: Use solid silicone or rubber—avoid liquid-filled ones (risk of leakage)
- Frozen fruit in mesh feeders: Banana, apple, or pear—always supervise to prevent choking
- Gum massage: Rub sore gums gently with a clean finger
- Cold pacifier: Some parents briefly chill water-filled pacifiers for cooling relief
Medications (When Needed)
- Acetaminophen (Tylenol): Safe for babies under 6 months; dose by weight
- Ibuprofen (Motrin, Advil): For infants over 6 months; effective for severe discomfort
Use only when necessary and follow dosing instructions carefully. Never give aspirin to children.
Products to Avoid
- Benzocaine gels (Orajel, Anbesol): Risk of methemoglobinemia—a life-threatening blood disorder—FDA warns against use under age 2
- Amber teething necklaces: Choking and strangulation hazard—no scientific proof of effectiveness
- Homeopathic teething tablets with belladonna: FDA warns of seizure and breathing risks
- Teething biscuits: Often high in sugar and a choking hazard
Oral Care Before the First Tooth
Good dental habits start before the first tooth appears.
Clean Gums Daily
Even without teeth, wipe your baby’s gums with a soft, damp cloth after feedings. This removes milk residue and bacteria, reducing the risk of early decay.
Start this routine from birth to build a healthy habit.
Start Brushing at First Tooth
As soon as that first tooth appears:
– Use a soft-bristled infant toothbrush
– Apply a smear of fluoride toothpaste (size of a grain of rice)
– Brush twice daily—morning and night
Fluoride strengthens enamel and prevents cavities. Most bottled waters lack fluoride, so check your tap water or ask your pediatrician about supplements.
Never Bottle Feed at Bedtime
Putting your baby to bed with a bottle leads to early childhood caries, also known as “bottle rot.” Milk pools in the mouth overnight, feeding bacteria that destroy tooth enamel.
When to Schedule the First Dental Visit
Don’t wait for a problem. The American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) agree:
Schedule the first dental visit by age 1—or within 6 months of the first tooth erupting, whichever comes first.
This visit establishes a “dental home” and prevents future issues.
What to Expect at the First Visit
- Gentle exam of teeth and gums
- Check for decay or developmental concerns
- Guidance on brushing, fluoride, and diet
- Discussion of thumb-sucking or pacifier use
- Fluoride varnish application (if needed)
Fluoride varnish is a quick, painless coating that strengthens enamel and is recommended every 3–6 months based on risk.
Early visits reduce dental anxiety and set the stage for lifelong oral health.
The Full Baby Teeth Timeline (All 20 Teeth)
By age 3, most children have 20 primary teeth. Here’s the typical order:
| Tooth Type | Upper Jaw | Lower Jaw |
|---|---|---|
| Central Incisors | 8–12 mo | 6–10 mo |
| Lateral Incisors | 9–13 mo | 10–16 mo |
| First Molars | 13–19 mo | 14–18 mo |
| Canines | 16–22 mo | 17–23 mo |
| Second Molars | 25–33 mo | 23–31 mo |
Teeth usually come in pairs, but asymmetrical eruption is common and not a concern.
The last to emerge are the upper second molars, which may not appear until 33 months.
Why Baby Teeth Matter
Primary teeth are more than just placeholders. They help with:
– Chewing and nutrition
– Speech development
– Jaw and facial growth
– Holding space for permanent teeth
Losing a baby tooth too early—due to decay or trauma—can lead to crowding or misalignment of adult teeth, possibly requiring braces later.
When to Call the Doctor: Red Flags
Most teething is uneventful, but some signs need attention.
Seek help if your baby:
– Has no teeth by 18 months
– Has a fever over 101°F
– Has diarrhea, vomiting, or persistent crying
– Has swollen gums with pus (sign of infection)
– Has a discolored or chipped tooth after a fall
For dental trauma, contact your pediatric dentist. Never reimplant a knocked-out baby tooth—it could damage the permanent tooth underneath.
Final Tips for Parents
Teething is a natural phase, but it can be tough on babies—and parents.
Quick Reassurance
- Variability is normal: Early or late teething is usually genetic
- Symptoms vary: Some babies are fussy; others show no signs
- No intervention needed for healthy babies who teethe early or late
Pro Tips
- Chill a spoon and let your baby chew on the handle for cooling relief
- Use a teething mitt to protect clothes from drool
- Wipe drool frequently to prevent rash
- Stick to safe remedies—skip amber necklaces and numbing gels
Remember: Whether your baby’s first tooth arrives at 4 months or 15 months, it’s part of a normal, healthy journey. With gentle care, proper hygiene, and timely dental visits, you’re setting the foundation for a lifetime of strong, healthy smiles.