Teething/Teething Syndrome

What is teething syndrome?

Teething syndrome, or teething, is the natural process that babies and children go through as their teeth cut through their gums. Your baby is born with a full set of teeth below their gums. Sometime during your baby’s first year, these teeth will start to erupt, or break through, their gum line.

Teething can cause pain and discomfort in babies. The gums around their erupting teeth may be swollen and tender. While it can be hard to see your baby dealing with the effects of teething, it’s a normal part of your baby’s development. Before you know it, your baby will have a mouthful of healthy teeth.

When do babies start teething?

Primary teeth (baby teeth) usually start coming in between the ages of 6 and 12 months.

When do molars come in?

Your baby’s first molars start to come in between 13 and 19 months. All of your baby’s primary teeth will gradually come in until they have a full set in place by age 3. This typically includes 10 top teeth and 10 bottom teeth.

When do all of the primary teeth erupt and fall out?

This tooth eruption chart shows when your baby’s primary teeth (also called baby teeth or deciduous teeth) will erupt (come in) and fall out (shed). Remember that eruption times can vary from child to child, and this is a general guide.

You can see from the chart that your baby’s first teeth begin to break through their gums at about 6 months of age. Usually, the first two teeth to erupt are their two bottom central incisors (the two bottom front teeth).

Next, their top four front teeth emerge.

After that, other teeth slowly begin to fill in, usually in pairs — one on each side of their upper or lower jaw — until all 20 teeth (10 in their upper jaw and 10 in their lower jaw) have come in by the time your child is 2-and-a-half to 3 years old.

The complete set of primary teeth is in your child’s mouth from 2-and-a-half to 3 years of age to 6 to 7 years of age.

A general rule of thumb is that for every six months of life, approximately four teeth will erupt. Babies assigned female at birth (AFAB) generally precede babies assigned male at birth (AMAB) in tooth eruption. Lower teeth usually erupt before upper teeth. Teeth in both jaws usually erupt in pairs — one on the right and one on the left. Primary teeth are smaller in size and whiter in color than the permanent teeth that will follow.

Shortly after age 4, your child’s jaw and facial bones will begin to grow, creating spaces between their primary teeth. This is a natural growth process that provides the necessary space for their larger permanent teeth to emerge. Between the ages of 6 and 12, a mixture of both primary teeth and permanent teeth reside in your child’s mouth.

If baby teeth fall out after a couple of years, why is caring for them important?

While it’s true that primary teeth are only in your child’s mouth for a short period of time, they play a vital role in the following ways:

• They reserve space for their permanent counterparts.
• They give your child’s face a typical shape.
• They aid in the development of clear speech.
• They help attain good nutrition. (Missing or decayed teeth make it difficult to chew, causing children to reject foods.)
• They help give a healthy start to permanent teeth. (Decay and infection in baby teeth can cause dark spots to develop beneath their permanent teeth.)

When do all of the permanent teeth erupt?

The following chart shows when permanent teeth emerge.

In some children, the first permanent molars are the first to emerge; in others, the incisors are the first to emerge. By the age of 13, most of the 28 permanent teeth will be in place. One to four wisdom teeth, or third molars, emerge between the ages of 17 and 21, bringing the total number of permanent teeth up to 32. However, some people don’t have permanent teeth behind all of their baby teeth. This is a condition known as hypodontia.

What are the symptoms of teething?

Early baby teething symptoms include drooling more than usual and sore gums. Your baby’s gums may be red, swollen and tender where teeth are about to erupt. Other symptoms of teething in babies include:

• Fussiness.
• Irritability.
• Difficulty sleeping.
• Loss of appetite.
• Biting or chewing on objects.

Your baby may have a slight increase in temperature, but if they have a fever above 100.4 degrees F (38 degrees C), it’s not due to teething. Call your baby’s healthcare provider if they have a fever or any of the following symptoms:

• Diarrhea.
• Vomiting.
• Rash.

How can I help soothe my baby while they’re teething?

The best way to help soothe your teething baby is by gently rubbing their sore gums. You can use a clean finger, a cool spoon, a moist gauze pad or a washcloth. You may also want to offer your baby a clean teether to chew on. Make sure the teether consists of solid rubber. For your baby’s safety, avoid plastic objects and liquid-filled teething rings that could easily break. Also avoid frozen teething rings, as they’re too hard for your baby’s mouth.

The U.S. Food and Drug Administration warns against using teething necklaces or bracelets made of amber, silicone, marble or wood. These types of teethers pose strangulation and choking hazards. You should also avoid the use of numbing gels and creams that contain benzocaine, as well as homeopathic remedies.

If your baby is inconsolable, ask their provider about giving them a dose of acetaminophen (Tylenol®) or ibuprofen (Advil®).

When do I start brushing my baby’s teeth?

Even before your baby’s teeth appear, you can gently wipe down their gums with a gauze pad or washcloth after meals.

But as soon as their first tooth erupts, you should start gently brushing twice a day. You should use a small, soft-bristled toothbrush and a tiny bit of fluoride toothpaste (no bigger than a grain of rice). When your child develops two teeth that touch, start flossing in between them with dental floss.

You’ll need to brush and floss your baby’s teeth for a while. When your child is between the ages of 3 and 6, you should begin teaching them how to brush and floss their own teeth. You’ll want to supervise to make sure they’re brushing properly. At this age, they should start using a pea-sized amount of toothpaste each time they brush.

A note from Cleveland Clinic

Teething is a normal yet uncomfortable part of your baby’s growth and development. You may be upset to see your baby in pain, but remember that the signs of teething will eventually pass. Your baby will soon have a mouth full of healthy teeth. If you have any concerns about your baby’s teething, reach out to their healthcare provider.