Newborns typically have 20 baby teeth concealed below the gumline. Teething is the process of these teeth erupting through the gums.
During teething, a baby may feel pain and discomfort, and they can show this in various ways.
In this article, we give a general timeline for the eruption of baby teeth. We also describe signs of teething and provide tips on easing any pain and discomfort.
According to the American Dental Association (ADA), baby teeth tend to appear within the first 6–8 months of life.
The first teeth to erupt are usually the front teeth at the top or bottom of the mouth. Dentists refer to these teeth as the incisors. The rate and order in which the other teeth appear can differ from one baby to another.
The ADA provide the following timeline of the usual ages at which baby teeth emerge:
- lower central incisors (the bottom front two teeth): 6–10 months
- upper central incisors (the top front two teeth): 8–12 months
- upper lateral incisors (at either side of the central incisors): 9–13 months
- lower lateral incisors (at either side of the central incisors): 10–16 months
- upper first molars (behind the upper canines): 13–19 months
- lower first molars (behind the lower canines): 14–18 months
- upper canines: 16–22 months
- lower canines: 17–23 months
- lower second molars: 23–31 months
- upper second molars: 25–33 months
If there is no sign of any teeth appearing at about 6 or 7 months of age, this is usually no cause for concern, according to the American Academy of Pediatrics.
By the baby’s first birthday, they should see a dentist, whether or not they have teeth yet.
The enamel coating on baby teeth is thinner than that on adult teeth, and so it is more prone to cavities. For this reason, routine dental checkups are important for babies.
There are several indications that a baby is teething, including:
- increased irritability
- increased crying
- a rash around the mouth, neck, or chest, caused by drooling
- gnawing or biting on objects
- cheek rubbing
- ear pulling
- a slight elevation in temperature, but not a fever
At about 6 months of age, when teething usually begins, a baby’s immune system is starting to develop, and the antibodies received from the placenta are wearing off. During this time, babies start developing colds and other viral illnesses.
It can be easy to mistake symptoms of a minor cold — such as a fever, a runny nose, fussiness, or poor appetite — for symptoms of teething.
Also, many babies put things in their mouths, drool more, and bite or chew on objects when they are this age, whether or not they are teething.
A parent or caregiver can take some steps to ease discomfort during teething and prevent issues such as a rash developing on the face or neck.
A person might try:
- providing a rubber teething ring to satisfy the urge to bite or chew
- rubbing the gums for a few minutes at a time to help prevent cheek-rubbing and ear-pulling
- applying a barrier cream or moisturizing ointment to the cheeks to help prevent a rash
- keeping the area around the mouth, cheeks, and neck as clean and dry as possible to prevent skin irritation
- spending more time comforting the baby, for example by holding them for longer periods during the day
- providing a safe dosage of a pain medication suitable for infants
Some approaches to teething can be dangerous for babies. Parents and caregivers should avoid:
Freezable teething rings
These tend to become very hard in the freezer and can hurt a baby’s gums, causing more harm than good in the long term.
Topical pain relievers
People should avoid using topical pain relief medications, such as creams or gels, on infants’ gums.
These can be harmful if a parent or caregiver accidentally applies too much or the baby swallows an excessive amount.
It is especially important to avoid gels containing benzocaine, such as Orajel products, because the medication can cause side effects.
Products containing belladonna
The Food and Drug Administration (FDA) have warned people against using teething tablets that contain extracts of the Atropa belladonna plant, commonly called belladonna.
Their investigations indicate that some of these products contain potentially toxic levels of belladonna.
The FDA have received reports of babies experiencing serious health issues after taking teething products that contain belladonna.
In most cases, a baby will not need to see a doctor because of teething. Home care can often provide relief from pain and discomfort.
However, a parent or caregiver should contact a doctor anytime an infant has a fever higher than 101°F (38.3°C), with or without additional symptoms. It could indicate that the baby has an infection.
During teething, a baby may pass looser stools. However, if a parent or caregiver believes that a baby has diarrhea, they should contact a doctor. Diarrhea can lead to dehydration, especially if it is severe, long-lasting, or accompanied by vomiting.
A baby should visit a dentist by their first birthday, whether or not their teeth have started to come through. Also, routine dental care is important to prevent cavities in baby teeth.
Teething typically begins around 6 months of age. Some signs include irritability, drooling, and gnawing on objects, though not all babies experience the pain or discomfort that causes these behaviors.
A parent or caregiver can typically treat any associated discomfort at home. However, contact a doctor if an infant develops a fever, diarrhea, or other common cold or flu symptoms.
Even if their teeth have yet to appear, a baby should receive a dental checkup by their first birthday.