Most babies cut their first tooth somewhere between about 6 and 12 months, though some are earlier and some later, and by age three most children have the full set of 20 baby teeth. Over that time teething comes and goes in waves rather than as one long stretch. Each wave can bring a few sore, drooly, unsettled days, but it should not make a baby properly sick.
Written by Dr James Tran, dentist at Lumi Dental.
The order baby teeth usually arrive
Standard eruption charts show the lower front teeth usually appearing first, at around 6 to 10 months, followed by the upper front teeth and the teeth beside them. The first molars typically arrive at about 13 to 19 months, the canines at about 16 to 23 months, and the second molars at about 23 to 33 months. Every child has their own timetable within these ranges. Later, these teeth make way for the adult set, which our article on when adult teeth come through describes.
Drool, gnawing and grizzling are the real signs
A prospective study that had parents record symptoms and temperatures every day for 125 babies (Macknin and colleagues, Pediatrics, 2000) found teething symptoms clustered in a window of about eight days, from four days before a tooth broke through to three days after. Biting, drooling, gum rubbing, sucking, irritability, wakefulness, ear rubbing, a rash on the face, eating less solid food and a mild rise in temperature were all linked to teething. No symptom or group of symptoms reliably predicted that a tooth was about to appear.
A high temperature points to something else
In the same study, congestion, loose or more frequent stools, cough, vomiting and higher fevers were not linked to teething. The Australian Dental Association likewise lists high fever among symptoms that are not due to teething, and Tresillian advises that a temperature of 38 degrees Celsius or more in a baby over three months, or 37.5 degrees in a baby under three months, needs a medical review. If your baby seems unwell, see a GP, or seek urgent care if they are very unwell, rather than waiting for a tooth to appear.
Comfort that is safe to use
Simple measures are what the Australian Dental Association suggests: attention and cuddles, teething rings or washcloths that are cold but not frozen, and rubbing the back of a cold spoon gently over the gums. Massaging the sore gum with a clean finger is another option many babies like.
If your baby is really distressed, the association notes pain relief such as paracetamol or ibuprofen may be used, and advises asking your dentist, doctor, nurse or pharmacist first.
Products worth leaving on the shelf
- Teething necklaces and bracelets. The Australian Dental Association warns that beaded necklaces or bracelets may be a choking hazard and are not likely to help with pain.
- Numbing teething gels. The association cautions that babies can swallow gel put on their gums, which can numb the throat and create a choking risk. Gels containing benzocaine have also been linked in published case reports to a rare but serious blood disorder called methaemoglobinaemia. Ask a pharmacist before using any teething gel.
Looking after the new teeth
Once a tooth shows, clean it twice a day with a small soft brush or a soft cloth. The Australian Dental Association advises starting toothpaste at 18 months; before then, water is enough. Settling to sleep with a bottle of milk or juice keeps sugars on the new teeth for long periods, a common route to early decay explained in our article on bottle related tooth decay.
The association suggests a first dental visit when the first teeth arrive, and our guide to a child's first dental visit describes what happens. If feeding has been a struggle from the start, our page on tongue tie in babies may also be useful.
Teething questions
How long does each tooth cause trouble?
In the Pediatrics study, symptoms clustered in the few days either side of the tooth breaking through. Babies often seem fine between teeth.
Can teething cause a blocked nose or diarrhoea?
The same study did not find a link between teething and congestion or loose stools. These symptoms usually have other causes, so treat them as you would at any other time.
For questions about your baby's first teeth, or to book that first visit, the dentists and OHTs at Lumi Dental in Melrose Park see families of all ages. Read about our general dental care or see current offers. This article is general information and not a substitute for personal medical or dental advice.
