When Do Children’s Teeth Erupt?

When Will My Baby Start Getting Teeth?

The initial growth period for primary (baby) teeth begins in the second trimester of pregnancy (around 16-20 weeks).  During this time, it is especially important for expectant mothers to eat a healthy, nutritious diet, since nutrients are needed for bone and soft tissue development.

Though there are some individual differences in the timing of tooth eruption, primary teeth usually begin to emerge when the infant is between six and eight months old.  Altogether, a set of twenty primary teeth will emerge by the age of three.

The American Academy of Pediatric Dentistry (AAPD) recommends a first “well-baby” dental visit around the age of twelve months (or six months after the first tooth emerges).  This visit acquaints the infant with the dental office, allows the pediatric dentist to monitor development, and provides a great opportunity for parents to ask questions.

Which teeth emerge first?

In general, teeth emerge in pairs, starting at the front of the infant’s mouth.  Between the ages of six and ten months, the two lower central incisors break through.  Remember that cavities may develop between two adjacent teeth, so flossing should begin at this point.

Next (and sometimes simultaneously), the two upper central incisors emerge – usually between the ages of eight and twelve months.  Teething can be quite an uncomfortable process for the infant.  Clean teething rings and cold damp cloths can help ease the irritation and discomfort.

Between the ages of nine and sixteen months the upper lateral incisors emerge – one on either side of the central incisors.  Around the same time, the lower lateral incisors emerge, meaning that the infant has four adjacent teeth on the lower and upper arches.  Pediatric dentists suggest that sippy cup usage should end when the toddler reaches the age of fourteen months. This minimizes the risk of “baby bottle tooth decay.”

Eight more teeth break through between the ages of thirteen and twenty three months.  On each arch, a cuspid or canine tooth will appear immediately adjacent to each lateral incisor.  Immediately behind (looking towards the back of the child’s mouth), first molars will emerge on either side of the canine teeth on both jaws.

Finally, a second set of molars emerges on each arch – usually beginning on the lower arch.  Most children have a complete set of twenty primary teeth before the age of thirty-three months.  The pediatric dentist generally applies dental sealant to the molars, to lock out food particles, bacteria, and enamel-attacking acids.

How can I reduce the risk of early caries (cavities)?

Primary teeth preserve space for permanent teeth and guide their later alignment.  In addition, primary teeth help with speech production, prevent the tongue from posturing abnormally, and play an important role in the chewing of food.  For these reasons, it is critically important to learn how to care for the child’s emerging teeth.

Here are some helpful tips:

1. Brush twice each day – The AAPD recommends a pea-sized amount of ADA approved toothpaste for children under two years old, and the same amount of an ADA approved toothpaste for children over this age.  The toothbrush should be soft-bristled and appropriate for infants.
2. Start flossing – Flossing an infant’s teeth can be difficult but the process should begin when two adjacent teeth emerge.  The pediatric dentist will happily demonstrate good flossing techniques.
3. Provide a balanced diet – Sugars and starches feed oral bacteria, which produce harmful acids and attack tooth enamel.  Ensure that the child is eating a balanced diet and work to reduce sugary and starchy snacks.
4. Set a good example – Children who see parents brushing and flossing are often more likely to follow suit.  Explain the importance of good oral care to the child; age-appropriate books often help with this.
5. Visit the dentist – The pediatric dentist monitors oral development, provides professional cleanings, applies topical to the teeth, and coats molars with sealants.  Biannual trips to the dental office can help to prevent a wide range of painful conditions later.

Eruption of Your Child’s Teeth

The eruption of primary teeth (also known as deciduous or baby teeth) follows a similar developmental timeline for most children.  A full set of primary teeth begins to grow beneath the gums during the fourth month of pregnancy. For this reason, a nourishing prenatal diet is of paramount importance to the infant’s teeth, gums, and bones.

Generally, the first primary tooth breaks through the gums between the ages of six months and one year.  By the age of three years old most children have a “full” set of twenty primary teeth.  The American Dental Association (ADA) encourages parents to make a “well-baby” appointment with a pediatric dentist approximately six months after the first tooth emerges.  Pediatric dentists communicate with parents and children about prevention strategies, emphasizing the importance of a sound, “no tears” daily home care plan.

Although primary teeth are deciduous, they facilitate speech production, proper jaw development, good chewing habits, and the proper spacing and alignment of adult teeth.  Caring properly for primary teeth helps defend against painful tooth decay, premature tooth loss, malnutrition, and childhood periodontal disease.

In what order do primary teeth emerge?

As a general rule-of-thumb, the first teeth to emerge are the central incisors (very front teeth) on the lower and upper jaws (6-12 months).  These (and any other primary teeth) can be cleaned gently with a soft, clean cloth to reduce the risk of bacterial infection.  The central incisors are the first teeth to be lost, usually between 6 and 7 years of age.

Next, the lateral incisors (immediately adjacent to the central incisors) emerge on the upper and lower jaws (9-16 months).  These teeth are lost next, usually between 7 and 8 years of age.  First molars, the large flat teeth towards the rear of the mouth, then emerge on the upper and lower jaws (13-19 months).  The eruption of molars can be painful.  Clean fingers, cool gauzes, and teething rings are all useful in soothing discomfort and soreness. First molars are generally lost between 9 and 11 years of age.

Canine (cuspid) teeth then tend to emerge on the upper and lower jaws (16-23 months).  Canine teeth can be found next to the lateral incisors and are lost during preadolescence (10-12 years old).  Finally, second molars complete the primary set on the lower and upper jaw (23-33 months). Second molars can be found at the very back of the mouth and are lost between the ages of 10 and 12 years old.

What else is known about primary teeth?

Though each child is unique, baby girls generally have a head start on baby boys when it comes to primary tooth eruption.  Lower teeth usually erupt before opposing upper teeth in both sexes.

Teeth usually erupt in pairs – meaning that there may be months with no new activity and months where two or more teeth emerge at once.  Due to smaller jaw size, primary teeth are smaller than permanent teeth, and appear to have a whiter tone.  Finally, an interesting mixture of primary and permanent teeth is the norm for most school-age children.