Although it’s not comfortable, teething is a normal part of growing for babies and occurs when their baby teeth push through their gums.
Teething usually begins between four and seven months of age, although some babies experience the eruption of the teeth earlier or later.
Parents often are aware when the babies are teething because they tend to be more irritable, cry, refuse food and have trouble sleeping.
Knowing the baby teething timeline helps parents prepare for this process and to seek medical advice if needed.
When the babies start teething, their parents will notice, because teething pains often cause discomfort. Teething is associated with changes in appetite, sleep patterns, and behavior. To better be prepared for this process, parents can use a baby teeth chart, to get an idea of when the teeth arrive and in what order.
While most babies start teething between four and seven months old, parents should use the teething timetable as a guideline. Just like other milestones, some children may start teething much later, at the age of one. Other children may have the first tooth appear at month three. Both cases are considered normal. The teeth may erupt or fall out at different times compared with the standard guidelines, as well.
The primary and the permanent teeth
Your baby’s first teeth, also known as the primary or milk teeth, will start to erupt between six and 12 months of age. By age three, most children will have all 20 primary teeth: four incisors, two canines and four molars in the upper jaw and the same set on the lower jaw.
Compared with the permanent teeth, the primary teeth are whiter and tend to be shorter.
By age six or seven, these teeth start to be replaced with the permanent, adult teeth. There are 32 permanent adult teeth, which include eight incisors, four canines, eight premolars and twelve molars (including wisdom teeth). Baby girls usually get their teeth before the boys do. Incisors tend to erupt in pairs, while molars are more likely to erupt on one side before forming on the other side.
Signs and symptoms of teething
As the teeth grow and break through the gums, many babies may experience some of the following signs and symptoms:
- Increased irritability and crying.
- Rejecting foods.
- Biting and chewing everything, from mothers breast to heard items like toys and spoons.
- Swollen, tender gums.
- The baby rub their face more than usual or pull on their ear.
- Trouble sleeping.
The most obvious sign that confirms the teething is a noticeable tooth breaking the gum. These symptoms may last a few days right before the new tooth erupts and tend to decrease once the tooth breaks through the gum. Of course, the symptoms are experienced again when a new tooth comes out.
In some cases, teething may not cause any signs and symptoms at all.
Fever (especially over 101F), diarrhea, skin rashes, excessive coughing and congestion are not signs of teething. Parents should seek advice from their pediatrician if these symptoms occur.
The teething timeline
According to the American Dental Association, the following timeline can be used as guideline:
- The lower central incisors, which are the front two teeth of the lower jaw, erupt around six to 10 months and shed around age six to seven.
- The upper central incisors, which are the front two teeth of the upper jaw, tend to appear between eight to 12 months of age and shed around age six to seven.
- The upper lateral incisors, located next to the upper central incisors on each side, erupt around nine to 13 months of age and shed around age seven to eight.
- The lower lateral incisors, found at either side of lower central incisors, typically appear between 10 and 16 months and shed between seven to eight years of age.
- The upper first molars, located right behind the canines of the upper jaw, erupt between 13 to 19 months and shed between nine and 11 years of age.
- The lower first molars, found in the lower jaw behind the canines, appear between age 14 and 18 months and shed between ages nine and 11.
- The upper canines erupt between 16 and 22 months and the lower canines about one month later (between 17 and 23 months). Upper canines shed around age 10 to 12 and lower canines around nine to 12 years of age.
- The lower second molars erupt between 23 and 31 months and are shed by age 10 to 12.
- The upper second molars tend to appear between 25 and 33 months and shed around age 10 to 12.
As the primary teeth shed, they are replaced with permanent or adult teeth, which are stronger and bigger. By adolescence, all teeth are permanent teeth in most cases.
The third molars, also known as the wisdom teeth, erupt around age 17 to 21 months and many children do not develop all four. Dentists recommend removal of the third molars, especially if they cause pain, damage the other molars or if a person needs braces.
When to visit the doctor
The American Dental Association recommends that the first dental visit should be scheduled after the first tooth appears, but not later than the first birthday.
During the first visit, the dentist will examine your child’s jaw and the teeth to see if the teeth are formed properly. Parents should avoid booking medical appointments during naptime, so their child is rested and more likely to cooperate. Some dentists receive additional training and specialize in pediatric dentistry.
Any problems or concerns related to teething can also be discussed with the pediatrician during the routine visits. Pediatricians can also recommend teething remedies to better cope with the symptoms.
For example, freezing a wet cloth and allowing the baby to chew on it helps decrease gum inflammation. Cold foods, teething biscuits (starting at eight to 12 months) and non-freezable teething rings and toys can also help relieve some of the discomfort.
Similarly with other baby’s milestones, there is also a timeline for teething suggested by the American Dental Association. Parents should not worry if the baby’s teeth start to erupt a bit earlier or later. Every baby is unique and has his or her own way to experience teething. Any unusual symptoms or signs during teething should be discussed with a doctor.