Teething

What to Expect

Tooth development

Primary teeth are usually known as "baby teeth." Usually, the first primary tooth comes in (erupts) at about 6 months of age, although it can be as early as 3 months or as late as 1 year of age. In rare cases, a baby gets a first tooth after his or her first birthday. By age 3, most children have all 20 of their primary teeth.

Primary teeth usually erupt in a certain order:

1. The two bottom front teeth (central incisors)
2. The four upper front teeth (central and lateral incisors)
3. The two lower lateral incisors
4. The first molars
5. The four canines (located on either side next to the upper and lower lateral incisors)
6. The remaining molars on either side of the existing line of teeth

Secondary, or permanent, teeth usually begin replacing primary teeth around 6 years of age. Permanent teeth erupt in roughly the same sequence as primary teeth. Usually, a permanent tooth pushes the primary tooth out as it erupts.

See a picture of the secondary teeth.

Symptoms of teething

Many times you might not know that your baby has a new tooth coming in until you see it or hear it click against an object, such as a spoon. Some babies may show signs of discomfort from sore and sensitive gums, be cranky, drool, and have other mild symptoms. These symptoms usually begin about 3 to 5 days before a tooth erupts and go away as soon as the tooth breaks through the gum.

Mild symptoms that gradually improve usually are nothing to worry about and may even be related to a viral infection or other condition. Severe or ongoing symptoms should be closely watched and discussed with your doctor.

Common concerns

Do not hesitate to call your doctor any time you have concerns about your child's teething. It is also a good idea to talk to your doctor if your child has unusual tooth development, such as late eruption of the first tooth. Tooth development issues usually resolve on their own or are easily treated.

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Author:	Debby Golonka, MPH	Last Updated: August 15, 2007
Medical Review:	Adam Husney, MD - Family Medicine Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics Michael J. Sexton, MD - Pediatrics
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