Your three-month-old is fussy and drooling, and you are already wondering if those first tiny teeth are on their way. Or maybe your baby just celebrated their first birthday with a gummy smile and only one tooth in sight. Either scenario can leave parents with a lot of questions about what is normal. The good news is that while baby teeth do tend to erupt in a predictable order, there is a wide range of what is considered healthy when it comes to timing. Knowing the general pattern can help you feel prepared rather than anxious.
At Pine Tree Pediatric Dentistry in Portland, we work with families every day who have these exact questions. Dr. T and our team love walking parents through the stages of dental development and helping you know what to expect at each milestone. Scheduling regular dental cleanings from the start is one of the best ways to make sure your child’s smile is developing the way it should.
What Happens Before the First Tooth Erupts
It may surprise you to learn that your baby’s 20 primary teeth actually begin forming during pregnancy. By the time your little one is born, those teeth are already sitting beneath the gum line, waiting to make their appearance. Most infants start showing the first signs of teething between four and six months of age, though some babies arrive earlier and others take closer to a year. According to the American Academy of Pediatric Dentistry, the first dental appointment is recommended by the time the first tooth erupts or no later than age one.
Genetics play a real role in when teeth arrive. If you got your teeth early as a baby, there is a good chance your child will too. Nutrition during pregnancy and infancy can also influence how quickly teeth develop. The most important thing to remember is that a range of several months in either direction is completely normal, and our team is here to answer any questions along the way.
The Baby Teeth Eruption Timeline
Baby teeth typically come in during a series of distinct phases. While the exact timing varies from child to child, the order is remarkably consistent. Here is a general overview of what to expect at each stage.
| Tooth Type | Typical Eruption | What It Does |
|---|---|---|
| Central incisors, upper and lower | 6 to 12 months | The bottom front teeth usually appear first, followed closely by the top front teeth. These give babies that classic early smile. |
| Lateral incisors, upper and lower | 9 to 16 months | These fill in on either side of the front teeth, widening the smile and helping your baby bite into soft foods more easily. |
| First molars | 13 to 19 months | Because these are larger teeth with a wider surface area, many babies have a renewed bout of teething discomfort. The flat surface helps your child chew and grind food. |
| Canines, also called cuspids | 16 to 23 months | These pointed teeth fill the gaps between the incisors and first molars, giving your child more ability to grip and tear food. |
| Second molars | 23 to 33 months | The final four teeth to arrive sit at the very back of the mouth. By the time most children turn three, they have a complete set of 20 primary teeth. |
Teeth also tend to arrive in matched pairs, so the left and right of each type usually break through around the same time. You can learn more about when to bring your child to a pediatric dentist based on where they are in this timeline.
When Baby Teeth Start to Fall Out
Eruption is only the first half of the story. Most children begin losing primary teeth around age six, usually starting with the same lower central incisors that arrived first. The first permanent molars typically show up around the same time, appearing behind the baby molars rather than replacing them. Between roughly age six and thirteen, children move through what the American Academy of Pediatric Dentistry describes as mixed dentition, a stage when primary and permanent teeth share the mouth at the same time.
This is the stage where smiles often look uneven, with a mix of large permanent teeth, small primary teeth, and a few gaps in between. That is normal, and it usually evens out as the remaining permanent teeth settle into place. Most children have shed all 20 primary teeth by around age twelve or thirteen. You can read more about what to expect as your child’s teeth grow through each of these stages.
How to Soothe Teething Discomfort
Teething can be uncomfortable for babies, and parents often feel helpless watching their little one fuss. A few safe and simple approaches can make the process more manageable. Chilled (not frozen) teething rings, clean damp washcloths, or gentle gum massage with a clean finger can all provide some relief. If your baby seems particularly uncomfortable, talk to your pediatrician about whether an age-appropriate pain reliever might be appropriate.
| Safe to Try | Best to Avoid |
|---|---|
| Chilled, not frozen, teething rings | Teething tablets containing belladonna |
| A clean, damp washcloth to chew on | Benzocaine-based numbing gels |
| Gentle gum massage with a clean finger | Amber teething necklaces |
The products in that second column have all been flagged by the FDA due to safety concerns, and there is no clinical evidence supporting their effectiveness. If you have questions about specific products, our team is always happy to help guide you toward what is safe.
Caring for Those First Teeth
Once the first tooth appears, it is time to start brushing. Use a soft-bristled infant toothbrush and a smear of fluoride toothpaste no larger than a grain of rice. Brush gently twice a day, especially before bedtime, and avoid putting your baby down with a bottle of milk or juice, as this can lead to early childhood cavities in baby teeth. If your toddler resists brushing, stay calm, be encouraging, and stick with it. Consistent, gentle brushing from the start sets habits that carry through childhood.
Until your child reaches that last stage, plan on helping with brushing every day. A few minutes of hands-on help now prevents a great deal of treatment later.
Why Baby Teeth Matter More Than You Might Think
Some parents wonder why so much care goes into teeth that are just going to fall out. Baby teeth do far more than fill out a smile. They help children eat and develop proper chewing habits, support the jaw and facial muscles as they grow, play a direct role in speech development, and hold the space that permanent teeth will eventually fill. If a baby tooth is lost too early due to decay or injury, nearby teeth can shift into the gap, which is why we sometimes recommend space maintainers for children to protect that spot until the permanent tooth is ready. You can read more about what to expect at your child’s first dental visit and how our team makes that appointment easy and welcoming.
Frequently Asked Questions About Baby Teeth
Is it normal for a one-year-old to have no teeth yet?
It happens more often than parents expect, and in most cases it simply reflects the wide normal range for eruption timing. Genetics are usually the reason, and a delay of several months in either direction is not a cause for alarm on its own. That said, the American Academy of Pediatric Dentistry recommends a first dental visit by age one regardless of how many teeth are in, so a first birthday with a gummy smile is still a good reason to come see us.
Which baby teeth come in first?
The lower central incisors, meaning the two bottom front teeth, almost always arrive first, typically between six and twelve months. The upper central incisors follow shortly after. Teeth tend to erupt in matched pairs, so the left and right of each type usually break through around the same time. After the front teeth, the lateral incisors fill in beside them, followed by the first molars, the canines, and finally the second molars at the back of the mouth.
How can I tell if my baby is teething?
Increased drooling, more chewing on hands and toys, tender or slightly swollen gums, disrupted sleep, and general fussiness are the most common signs. You may also be able to feel a firm bump along the gum before anything is visible. Teething can make a baby uncomfortable, but it should not cause a high fever, a rash, or diarrhea. If your baby has those symptoms, call your pediatrician, because something else is likely going on.
How long does teething discomfort last for each tooth?
Eruption is gradual rather than sudden, so discomfort tends to come and go over several days as the tooth works its way through the gum. Symptoms usually ease once the edge of the tooth breaks the surface. Molars often cause more complaint than the front teeth because they are larger and have a broader surface pushing through. If your child seems miserable for weeks at a stretch, that is worth a conversation with us rather than something to wait out.
When do baby teeth start falling out?
Most children lose their first baby tooth around age six, usually one of the lower front teeth, and the first permanent molars come in behind the baby molars around the same age. From roughly age six to thirteen, children have a mix of primary and permanent teeth at once. Most have shed all twenty primary teeth by about age twelve or thirteen. Losing a tooth much earlier than age five is worth having us take a look at.
Schedule a Visit with Pine Tree Pediatric Dentistry
Every child’s dental timeline looks a little different, and that is completely normal. What matters most is that you have a trusted team to turn to with questions along the way. Dr. Tesha Waggoner, known to patients as Dr. T, completed her doctorate of dental medicine and her pediatric specialty training at OHSU, and she is a member of the American Academy of Pediatric Dentistry and the American Board of Pediatric Dentistry. Our office is built around keeping kids comfortable, from our in-office dogs Meyers and CJ to weighted blankets and low lighting for children who need a calmer environment. Learn more about our approach by visiting the Dr. Tesha Waggoner page.
If you have concerns about your child’s teething schedule, eruption delays, or are simply ready to schedule that first visit, we would love to hear from you. Contact our office today and we will get you set up with an appointment.
