Articles (EN)

Teeth in children: the order of eruption and what helps

2026-05-26 12:00 Development
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:
  1. Lower central incisors – 6-10 months
  2. Upper central incisors – 8-12 months
  3. Upper lateral incisors – 9-13 months
  4. Lower lateral incisors – 10-16 months
  5. Upper first molars – 13-19 months
  6. Lower first molars – 14-18 months
  7. Upper canines – 16–22 months
  8. Lower canines – 17-23 months
  9. Lower second molars – 23-31 months
  10. 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

  1. American Academy of Pediatrics. (2022). Teething: 4 to 7 Months. HealthyChildren.org.
  2. McIntyre G.T., McIntyre G.M. (2002). Teething troubles? British Dental Journal, 192(5), 251–255.
  3. 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.
  4. FDA. (2023). Risk of serious harm from use of benzocaine teething products. FDA Consumer Updates.
  5. 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.