Baby teething timeline: when teeth come in and how to help

When baby teeth come in

Most babies get their first tooth around 6 months of age. That's an average, not a deadline. Some babies get a tooth much earlier, and others are still waiting at their first birthday. Both are usually normal.

Teeth tend to come in pairs and in a fairly predictable order, starting at the front and working toward the back. By about age 3, most children have a full set of 20 baby teeth.

Don't worry if your baby's teeth don't follow this exact sequence. Some babies get a top tooth before a bottom one, or a molar a little early. Family patterns can play a role, too. If you got your teeth early or late, your baby may do the same.

After the baby teeth: what comes next

New teeth don't stop with toddlerhood. A second round starts in the early school years.

• First permanent molars usually come in around age 6, behind the last baby teeth. No baby tooth falls out to make room, so many parents don't notice them arriving. Some kids get sore gums and start chewing on things again.
• Loose teeth begin around the same time. Baby teeth usually fall out from about age 6 to 12, often starting with the bottom front teeth and roughly following the order they came in.

Those baby teeth have important jobs until they fall out, from chewing and speech to saving space for adult teeth. Our guide on why baby teeth matter explains why they're worth protecting.

Signs your baby is teething

Some babies sail through teething with barely a fuss. Others have a harder time, especially with the first teeth and the molars. Signs often start a few days before a tooth breaks through and ease once it's in.

• More drooling than usual, sometimes with a rash on the chin or cheeks from the wetness
• Chewing or gnawing on hands, toys, or anything within reach
• Swollen, tender, or slightly red gums where a tooth is coming in
• Fussiness or irritability, often worse in the evening
• Waking more at night or napping less
• Rubbing the cheek or tugging the ear on the side where a tooth is coming in
• Wanting to feed more for comfort, or less because sucking feels sore

What teething usually doesn't cause

It's tempting to blame teething for every rough day, but some symptoms point to something else. Teething isn't known to cause a high fever, diarrhea, vomiting, a rash across the body, or a runny nose that hangs on. A slightly warm forehead can happen, but a true fever deserves attention.

Safe ways to soothe sore gums

Gentle pressure and cold are the two best tools you have. Try one or more of these:

• A clean finger. Wash your hands and rub your baby's gums gently. Many babies find the pressure soothing.
• A chilled teething ring. Choose a firm, solid rubber or silicone teether and chill it in the refrigerator, not the freezer. Frozen teethers can get too hard for tender gums. Skip liquid-filled teethers, which can leak if they crack.
• A cold, damp washcloth. Wet a clean washcloth, twist it, and chill it. Let your baby chew on it while you watch.
• A dry chin. Gently wiping away drool through the day helps prevent the rash that often comes with it.
• Extra comfort. Cuddles, rocking, and a little extra patience go a long way on hard days.

What about pain relievers?

Talk with your pediatrician before giving any medicine for teething. Doses for babies depend on age and weight, and some products aren't meant for young infants. Your child's doctor can tell you what's safe and how much to give.

Teething products to avoid

Some products sold for teething can do more harm than good. The U.S. Food and Drug Administration (FDA) has issued safety warnings about several of them.

A few other things are best skipped, too:

• Homeopathic teething tablets and gels. The FDA has warned parents against these products as well.
• Hard or crumbly foods used as teethers. Frozen bagels, raw carrots, and similar foods can break into pieces small enough to choke on.
• Sweet coatings. Don't dip a pacifier or teether in sugar, syrup, or honey. Sugar feeds cavity-causing germs, and honey isn't safe for infants.
• Home remedies on the gums, such as rubbing alcohol. Even small amounts can be harmful to a baby.

If your baby finds comfort in a pacifier while teething, that's generally fine. Our guide to thumb sucking, pacifiers, and your child's bite explains when those habits start to matter for the teeth.

Caring for your baby's first teeth

Good habits can start before any teeth appear. Wiping your baby's gums with a soft, damp cloth after feedings keeps the mouth clean and makes brushing feel familiar later.

Once that first tooth breaks through, it's time to brush. The American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) recommend fluoride toothpaste from the very first tooth, using just a smear about the size of a grain of rice for children under 3. Brush gently twice a day with a soft, baby-sized toothbrush. Our age-by-age guide to brushing and flossing shows positions that make brushing a squirmy baby easier, and our guide to fluoride toothpaste for kids explains why such a small amount is used.

Try not to put your baby to bed with a bottle of milk, formula, or juice. Once teeth are in, those drinks can pool around them overnight and raise the risk of decay. Our guide to cavities in children describes the early warning signs.

The first tooth also starts the clock on your baby's first dental visit. The AAPD and ADA recommend it within six months of the first tooth, or by the first birthday, whichever comes first. At that visit, the dentist checks how teeth are coming in, looks for early signs of decay, and answers your teething questions. See what to expect on our infant and toddler dentistry page.

When to call the doctor or the dentist

Most teething is uncomfortable but harmless. Here's who to call when something seems off.

Call your pediatrician if your baby

• Has a fever or seems sick
• Has diarrhea, vomiting, or a rash beyond the drool area
• Isn't eating or drinking well, or has fewer wet diapers than usual
• Is unusually hard to comfort

Call your child's dentist if you notice

• A bluish or purple bump on the gum where a tooth is coming in. This is often a harmless fluid-filled swelling that clears up once the tooth breaks through, but it's worth having checked.
• White, brown, or dark spots on new teeth.
• A tooth that's chipped, loose, or pushed in after a fall. For a serious injury to the head or face, call 911 or go to the emergency room. Our pediatric dental emergencies page explains what to do next.
• Worries about timing, such as no teeth yet by the first birthday. Late teeth are often normal, and the first dental visit is the right time to ask.

Frequently asked questions