When your child's teeth come through: the full timeline
Most babies get their first tooth between about 6 and 10 months, usually at the bottom front. By about three, all twenty baby teeth are in. Between about 6 and 12, baby teeth give way to adult teeth. A few months either side, up to about a year, is usually normal; what's worth a check is a longer delay than that, or a tooth arriving well before its turn.
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When does the first tooth come through, and in what order?
Some babies start at around 4 to 5 months, and some not until after their first birthday. In the end there are 20 baby teeth: 10 on top and 10 on the bottom.
Every child has their own timing, and a few months either side of the chart, up to about a year, is usually normal.
| Teeth | Comes through | What you'll notice |
|---|---|---|
| Middle front teeth (4 incisors) | About 6 to 12 months | Usually the bottom two show first, then the top two. |
| Side front teeth (4 incisors) | About 9 to 16 months | They complete the front row, top and bottom. |
| First molars (4) | About 13 to 19 months | They come in before the canines, leaving a gap beside them for a while. |
| Canines (4) | About 16 to 23 months | They fill the gap between the front teeth and the molars. |
| Second molars (4) | About 23 to 33 months | The last of the baby teeth; with them, all 20 are in. |
The order tells you more than the date. If the teeth are coming in the right order, just a little late, that is usually your child's own timing. And notice that the first molars come in before the canines, so the gap that sits between them for a while is not a missing tooth: that is where the canine goes, and it is on its way.
When do baby teeth fall out and adult teeth come in?
Baby teeth usually start falling out at around 6 to 7, starting at the bottom front, and the swap is mostly done by about 12. Usually the tooth that came in first is the first to fall out. In the end there are 28 adult teeth, or 32 with the wisdom teeth, if they come through.
Every child has their own timing, and a few months either side of the chart, up to about a year, is usually normal.
| Teeth | Baby tooth falls out | Adult tooth comes in |
|---|---|---|
| First adult molar | Nothing falls out first: it comes in behind the baby molars | About 6 to 7 years |
| Middle front teeth (incisors) | About 6 to 7 years | About 6 to 8 years |
| Side front teeth (incisors) | About 7 to 8 years | About 7 to 9 years |
| Canines | About 9 to 12 years | About 9 to 12 years |
| Baby molars, replaced by small adult premolars | About 9 to 12 years | About 10 to 12 years |
| Second adult molar | Nothing falls out first | About 11 to 13 years |
| Wisdom teeth | Nothing falls out first | About 17 to 21 years, and in some people they never come through |
Between about 9 and 10, many children go through a quieter spell, and most canines and molars change over between about 10 and 12. And keep an eye on that first adult molar: it comes in at around 6 to 7, behind the last baby molar, without anything falling out first, so many parents take it for a baby tooth. It is permanent, and nothing else will grow in its place. What is normal with wobbly teeth and falling out, and when it is worth a check: Baby teeth: when to worry, and when not to.
Is it teething? What's normal, and what isn't
Teething shows in the mouth and the mood, not in the whole body. And it usually lasts a few days around the time the tooth breaks through, a little before and a little after. These are the normal signs:
- More drool than usual. The skin around the mouth and chin can turn red.
- Chewing on everything within reach. Pressure on the gums soothes them.
- Fussier and more tearful. Harder to settle, and calmer in your arms.
- Broken sleep. Waking more often on the nights a tooth is close to coming through.
- Slightly swollen, red gums where the next tooth is coming, and sometimes you can feel the tip of the tooth with your finger before you see it.
And these are not from teething
Teething does not make the whole body ill. If you see one of these, there is another cause, and the first person to talk to is your child's paediatrician:
- A real fever (not just feeling a little warm), or a raised temperature that lingers.
- Diarrhoea, or vomiting.
- Refusing food for a long time.
If they won't drink, their nappies are drier than usual, or they're unusually drowsy or floppy: go to the nearest hospital emergency department now. If your baby is under 3 months and has any fever: go to the nearest hospital emergency department now, not an appointment. If they have a seizure: call an ambulance on 911.
And when not to wait?
Slightly swollen gums where the next tooth is coming are normal. But these don't wait:
Nearest hospital emergency department now, not an appointment: difficulty breathing, swallowing or speaking, swelling that has reached the eye or below it, or the neck, or swelling or a fever while they're unusually drowsy or floppy or won't drink. If they're struggling to breathe, call an ambulance on 911 rather than driving them yourself.
Call us now: swelling in the cheek or under the jaw, or a fever with pain in a tooth that came through long ago. That is not teething. If the clinic is closed or you can't reach us, go to the nearest hospital emergency department.
Call today: a small bump on the gum around a tooth that came through long ago, without a fever, or pain in an older tooth that wakes them from sleep. If we're closed, call as soon as we open.
What to give and what to avoid until you get here: Toothache in children: what to give and what not to.
How to soothe them safely, and what not to do
What eases sore gums is pressure and cold. The rest is cuddles and patience.
- 1
A chilled teether, not a frozen oneKeep it in the fridge, not the freezer. A frozen one turns hard and can hurt their gums. And make it a single piece held in the hand, not something hung around the neck.
- 2
Rub their gums with a clean fingerWash your hands, then rub their gums with gentle pressure for a minute or two, or use a clean piece of gauze dampened with cold water.
- 3
Wipe the drool away as you goWith a soft cloth, so the skin around the mouth and neck does not get red and sore.
- 4
Keep bedtime on its routineThe same time and the same steps every night, with a wipe of the gums before sleep. And if they wake, a cuddle and calm first.
- 5
If nothing settles themAsk a pharmacist or a doctor: they decide whether your child needs a pain reliever suited to their age and weight. Never give anything from an adult's medicine.
And what not to do
- No numbing teething gel on the gums at home. It is not safe for babies and young children.
- No teething necklaces or bracelets around the neck, wrist or ankle, whatever they are made of: they are a strangulation and choking risk, and a bead can come loose and be breathed in or swallowed.
- Nothing frozen hard, and no ice straight on the gums.
- No honey or sugar on a dummy or teether. Sugar harms a tooth from the moment it appears, and honey is not given before a child's first birthday.
- No tablet held against the gums, and nothing rubbed on them that a doctor has not prescribed.
When should a delay worry you?
Most delays are normal, and simply your child's own timing. But some situations are worth a check rather than a wait:
- Around 18 months old, and not a single tooth yet. A check, with an x-ray if needed, shows whether the teeth are there under the gum and on their way.
- An adult tooth has come in on one side, and its partner on the other side still has not, about six months later. A little difference between the two sides is normal; a big one needs a look.
- Teeth coming in very differently from the chart above. In other words, a tooth arriving well before its turn, like the upper canine coming in while the baby molars beside it have not been replaced yet.
- A baby born with a tooth, or one that appears in the first month. It happens, and it needs an early look, because the tooth is sometimes loose or gets in the way of feeding.
In a small number of cases, a very long delay is linked to a child's growth or general health. A tooth that is missing altogether is usually inherited, not a sign of illness. Either way, an x-ray shows what is under the gum, and the paediatrician becomes part of the picture if needed.
And what happens at the check?
Keeping track of how the teeth come through is part of children's dentistry at the clinic. We count your child's teeth, see what has come through and in what order, and decide whether an x-ray is needed, or simply regular follow-up. And you leave knowing the next step.
What to do from today
- 1
Write down the date of the first toothAnd when each one after it came through, and in what order, even if it is just a photo on your phone. Those small details save a lot of time at the check.
- 2
Brush from the very first toothBefore any teeth come through: wipe the gums with clean gauze after feeds. From the first tooth: a small soft brush twice a day, with a smear of fluoride toothpaste the size of a grain of rice.
- 3
No bottle of milk or juice at bedtimeWhatever sits on the teeth all night decays them while they are still new. And juice isn't for babies under one at all. If your child falls asleep on a bottle, make it water, and if they are under six months, ask your paediatrician before giving water. The details: Bottle decay: how to protect your child's teeth.
- 4
An early first visitWithin six months of the first tooth, or before the first birthday, whichever comes first. Not to treat anything, but to see the teeth as they come through.
And your child's first visit with us, step by step
The details are on Children's dentistry. And to see the chart for your own child's age, try Your child's teething chart: pick their birth month and year, and see which baby teeth are probably through, which are due now and which are still to come.
Questions people ask
When do babies start teething?
For most babies, the first tooth shows up somewhere between about 6 and 10 months, usually at the bottom front. Some babies get their first tooth early, at around 4 to 5 months, and some not until after the first birthday, and usually that is just their timing. If your child is around 18 months old with no teeth at all, it is worth a check.
Can a baby start teething at 4 months?
Yes, it happens. Some babies start early, with the first tooth showing at around 4 to 5 months. Early teething is usually not a sign of illness. What changes is that you start brushing earlier, from the first tooth. And if a baby is born with a tooth, or one appears in the first month, that needs an early look.
How do I know if my baby is teething?
The signs show in the mouth and the mood: more drool, chewing on everything, fussiness, broken sleep, and slightly swollen, red gums where the next tooth is coming. Sometimes you can feel the tip of the tooth with your finger before you see it. And the rough patch usually lasts a few days around the time the tooth breaks through, not weeks on end.
How can I tell a teething fever from an infection?
Teething can raise a child's temperature only a little. A real fever, not just feeling a little warm, or diarrhoea, or refusing food, is not from teething: those need your paediatrician. If they won't drink, their nappies are dry, they're unusually drowsy or floppy, they're struggling to breathe, or they're under 3 months with any fever: go to the nearest hospital emergency department now, and for trouble breathing call an ambulance on 911.
How long does a teething fever last?
If teething raises the temperature at all, it is only slightly, and the whole rough patch usually lasts a few days around the time the tooth comes through. Any clear fever, or one that lingers or comes back, is not down to teething: your paediatrician will look for the cause. If they're unusually drowsy or floppy, or won't drink: go to the nearest hospital emergency department now. If they have a seizure: call an ambulance on 911.
How can I help my teething baby sleep?
Before bed: a chilled teether from the fridge, not the freezer, or a gentle rub of the gums with a clean finger. Keep the same bedtime routine every night, and if your baby wakes, a cuddle and calm first. Do not settle them to sleep with a bottle of milk or anything sweet, because it sits on the teeth all night. And if they still cannot sleep at all, a pharmacist or doctor decides whether they need a pain reliever suited to their age and weight.
What helps baby teeth come through?
Teeth come through in their own time, and no food, vitamin or home remedy speeds them up. A balanced diet for their age matters for their health as a whole, and any vitamin or supplement is decided by the paediatrician, not on your own. If you feel they are very late, a check, with an x-ray if needed, shows whether the teeth are there under the gum and on their way.
Your next step
A check-up for your child from the first tooth, not only when something hurts. Bring the dates you noted down, if you have them: they save a lot of time.
Pages that go with this one
This is general information, not a diagnosis. The decision is made at the examination.