When Do Children's Teeth Come In? A Simple Timeline

"My friend's baby already has four teeth and mine has none. Is that normal?" The answer is usually yes. Teeth follow a fairly predictable order, but the timing varies a lot from child to child. Here is a simple guide, and when it's worth a check.

Baby teeth: from about 6 months to 3 years

Most babies get their first tooth at around 6 months, but anywhere from about 4 to 12 months is common. By around age 3, most children have all 20 baby teeth.

| Baby teeth | Usual age they appear | |---|---| | Lower front teeth (central incisors) | 6 to 10 months | | Upper front teeth (central incisors) | 8 to 12 months | | Teeth next to the front teeth (lateral incisors) | 9 to 16 months | | First baby molars | 13 to 19 months | | Canines ("eye teeth") | 16 to 23 months | | Second baby molars | 23 to 33 months |

Notice that the first molars often arrive before the canines. A temporary gap where the canine will go is normal.

Adult teeth: from about 6 years to the late teens

The changeover usually starts around age 6 and continues until about age 12 or 13. During this time your child will have a mix of baby and adult teeth.

| Adult teeth | Usual age they appear | |---|---| | First adult molars ("six-year molars") | Around 6 to 7 years | | Front teeth (incisors) | 6 to 8 years | | Canines and premolars | 9 to 12 years | | Second adult molars ("twelve-year molars") | Around 11 to 13 years | | Wisdom teeth (third molars) | Late teens or later, and sometimes never |

Two points parents often miss:

• The six-year molars don't replace any baby tooth. They come in quietly behind the last baby molar, so many families don't notice them. Their deep grooves make them prone to cavities, so ask your dentist about sealants.
• Adult front teeth sometimes come in behind the baby teeth, giving a "double row" look (often called shark teeth). If the baby tooth is loose, it often falls out by itself within a few weeks. If it is firm, or nothing changes after a couple of months, it's worth a check.

Wide normal ranges

These ages are averages, not deadlines. A difference of several months either way is very common, and girls' adult teeth often come in a little earlier than boys'. Family patterns matter too.

What matters most is the order and symmetry. Teeth on the left and right usually come in within a few months of each other.

Helping your child through eruption

• Teething babies: a clean, chilled (not frozen) teething ring or rubbing the gum with a clean finger often helps. Avoid numbing teething gels and amber necklaces. Fever is not a typical sign of teething, so check with your doctor if your baby is unwell.
• Start brushing with the first tooth, using a rice-grain smear of fluoride toothpaste.
• New adult molars at the back are hard to reach. Angle the brush into the back corners and check them yourself.
• Wobbly baby teeth can be left to come out naturally. Avoid pulling a tooth that isn't ready.

When is a delay worth checking?

It's a good idea to see a dentist if:

• your baby has no teeth by around 15 to 18 months;
• a tooth on one side has come in but the matching tooth on the other side still hasn't appeared after about six months;
• an adult tooth is coming in behind or in front of a baby tooth that isn't loose;
• a baby tooth was lost early through injury or decay (the space may need to be held);
• you notice swelling, pain or a bluish bump over an erupting tooth that doesn't settle.

Usually everything is normal. When it isn't, a simple exam, and sometimes an X-ray, shows what is happening under the gum.