In short: The first tooth most often appears at 6-8 months, but the norm according to the WHO is from 4 to 15 months. The order of eruption is more predictable than the timing. Eruption may be accompanied by salivation and restlessness, but should not give a high temperature.
When to expect the first tooth
The average time for the appearance of the first tooth is 6-8 months, but each child has its own way. Teeth can appear as early as 4 months or come only at 12-15 months - both are normal.
Late eruption is most often explained by heredity. If one of the parents has teeth erupting late, most likely, the child will follow the same pattern.
Important: missing teeth at 12 months is not a reason to panic, but it is worth mentioning the pediatrician at a routine examination. Complete absence of teeth at 18 months requires consultation.
Eruption order: approximate scheme
There are 20 milk teeth. They erupt in approximately the following sequence:
- Lower central incisors – 6-10 months
- Upper central incisors – 8-12 months
- Upper lateral incisors – 9-13 months
- Lower lateral incisors – 10-16 months
- Upper first molars – 13-19 months
- Lower first molars – 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
The order may vary: sometimes the lateral incisors appear before the central ones, which looks like "vampire fangs" – this is normal, the teeth will take the correct position.
Symptoms of eruption: what is really connected
There are many myths around teething. Modern pediatric studies show that eruption can actually accompany eruption:
- Increased salivation – 3-4 days before the tooth appears and after
- Itching and discomfort in the gums – the child pulls everything into the mouth
- Anxiety and moodiness
- Mild fever (up to 37.5°C) within 1 day
- Sleep disturbance on teething days
Not associated with teething: high fever (above 38°C), diarrhea, cough, runny nose, vomiting, convulsions. If these symptoms are present, the reason is different, a consultation with a pediatrician is necessary.
What helps with eruption
Ways to relieve discomfort:
- Silicone or rubber teethers – cooled in the refrigerator (not freezer) to reduce swelling of the gums
- Clean Adult Fingers – Gum Massage Relieves Tension
- Refrigerated safety items: a damp cloth from the refrigerator
- Additional attention and contact – a capricious child needs intimacy first of all
What is NOT recommended: Dentinox, Kamistad, and other lidocaine-based gels – the FDA and AAP do not recommend them for children under 2 years of age due to the risk of unwanted effects. Homeopathic pills and amber beads do not have proven effectiveness, beads pose a risk of suffocation.
Caring for the first teeth
Baby teeth are important: they help chew, form speech, and make room for permanent teeth. Care from the first tooth:
- Brush the first teeth with a silicone fingertip or a soft brush without paste
- With the appearance of several teeth - switch to children's toothpaste with fluoride (the size of a grain of rice up to 3 years old)
- The first visit to the dentist is when the first tooth appears or before 1 year
- Do not put them to bed with a bottle of milk or juice – this causes "bottle tooth decay"
When to see a doctor
- Not a single tooth at 18 months
- Teeth grow very crooked or with obvious defects (stains, pits on the enamel)
- Fever above 38°C, diarrhea, vomiting – this is not from the teeth
- The child stopped eating and drinking against the background of "teething"
Frequently Asked Questions
Can ibuprofen be given for teething pain?
Yes, ibuprofen or paracetamol in age-related dosages are used for obvious pain discomfort. But this issue is resolved with a pediatrician, and not independently. Do not prescribe drugs without consulting a doctor.
Teething disrupts sleep – is it for a long time?
The effect of eruption on sleep is usually limited to 1-3 days immediately before and after the tooth appears. If sleep disorders last longer, most likely, the cause is different. Read more about frequent awakenings in the article why a child often wakes up at night.
Conclusion
Teething is a normal process that goes according to each child's own schedule. The first tooth is a reason to start care and make an appointment with a dentist, not a cause for concern. Drooling, chewing, and mild discomfort are part of the process. High fever and other serious symptoms are a reason for a pediatrician.
Bibliography
- American Academy of Pediatrics. (2022). Teething: 4 to 7 Months. HealthyChildren.org.
- McIntyre G.T., McIntyre G.M. (2002). Teething troubles? British Dental Journal, 192(5), 251–255.
- Lyttle C.S. et al. (2015). Revisiting the SIDS Back to Sleep campaign to address unintended consequences of supine sleeping: A clinical perspective. Pediatrics, 135(1), e253.
- FDA. (2023). Risk of serious harm from use of benzocaine teething products. FDA Consumer Updates.
- AAPD. (2023). Policy on Early Childhood Caries (ECC). American Academy of Pediatric Dentistry.
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If you have questions about your child's teeth, ask your pediatrician or pediatric dentist.
