Teething in Children: Which Teeth Come First and in What Order

Which teeth come first in babies? Most often, they are the lower central incisors — the two front teeth in the middle of the lower jaw. They usually begin to appear at around six months, although the timing can vary. Use the overall pattern of development as a guide rather than expecting a tooth to appear on a particular date.

When Do the First Teeth Appear?

The first tooth most often appears during the second half of a baby’s first year. The typical range is 6–10 months for the lower central incisors and 8–12 months for the upper central incisors.

Your baby’s first tooth may come through earlier or later than another child’s. This difference alone does not mean there is a problem. If you are concerned about the timing, a dentist can assess your child’s dental development.

Is It Normal for a Tooth to Appear Earlier or Later?

Yes, teething times vary between children. During an examination, the dentist considers your child’s age, gum health, the order in which teeth appear, and their overall development. For babies born prematurely, corrected age — age adjusted for their expected due date — may also be relevant.

Do not give vitamins or calcium supplements simply to “speed up” teething. First, speak to a healthcare professional to find out whether any treatment is needed.

Which Teeth Come First?

The lower central incisors are usually the first teeth you will notice. They are generally followed by the upper central incisors and the lateral incisors — the teeth beside the central ones.

This is a common pattern, but it is not the same for every child. If the upper teeth appear first, this alone does not indicate a problem.

Why Do Teeth Not Always Appear in Pairs?

Matching teeth on the right and left sides may come through at different times. One may already be visible above the gum while the other has yet to appear.

Do not press on the gums or try to help a tooth break through. If the difference concerns you, particularly if there is swelling or pain, arrange a dental check-up.

The Order in Which Baby Teeth Appear

The first molars — the back chewing teeth — usually appear after the incisors. The canines come next, followed by the second molars.

The table shows typical age ranges for the upper and lower jaws. These help you follow your child’s development, but they are not an exact timetable for every child.

Stages of Teething in Children

Teeth appear gradually, and there may be breaks between periods of teething. If no new teeth appear for a while after the first incisors, this does not necessarily mean development is delayed.

When the first molars come through, there may still be gaps between them and the incisors. The canines will later fill these spaces.

The second molars are usually the last to appear. By the age of two to three years, most children have a complete set of 20 baby teeth.

Approximate Timing of Baby Tooth Eruption

Signs of Teething in Children

Before a tooth appears, the gum in that area may become red, slightly swollen, and tender. You may also notice:

• more drooling than usual;

• a desire to chew toys or a teether;

• mild irritability;

• unsettled sleep;

• discomfort when the gums are touched.

A lower incisor beginning to emerge. Photo: Daniel Schwen / Wikimedia Commons, CC BY-SA 4.0.

Some children’s teeth appear with very little noticeable discomfort. Others may seem uncomfortable for a few days. However, drooling or changes in sleep cannot reliably tell you exactly when a tooth will come through.

Do not automatically put a temperature of 38°C or above, diarrhoea, vomiting, or unusual lethargy down to teething. Contact your child’s doctor to find out the cause. If your child has difficulty breathing, seek emergency medical help.

How to Safely Ease Teething Discomfort

If your child’s gums are tender, start with simple measures:

• gently massage the gums with a clean finger;

• offer a firm rubber teether without liquid inside;

• cool the teether in the refrigerator, but do not freeze it;

• supervise your child while they use it;

• gently pat away saliva to reduce irritation around the mouth.

If the discomfort is significant, your child seems unwell, or you are considering pain medicine, speak to their doctor. The medicine and dose should be appropriate for your child’s age, weight, and health.

What Should You Avoid?

Do not use products containing benzocaine or lidocaine to relieve teething pain. They can cause serious side effects, particularly if a child swallows the product or receives too much.

Amber necklaces and other “teething jewellery” are also unsafe. A child may choke on the beads or become entangled in the cord.

Avoid frozen teethers. Freezing makes them too hard and may injure sensitive gums.

Late Teething: When to Arrange a Dental Check-Up

If your child has no teeth by 12 months, arrange a dental examination. This does not necessarily mean something is wrong, but their development should be assessed individually.

See a dentist sooner if you notice severe swelling, pus, unexplained bleeding, or significant pain. Also discuss any substantial difference in the timing of matching teeth on the right and left sides.

During a dental consultation, the dentist will examine your child’s gums and teeth, ask about their development, and explain whether any further investigations are needed.

How to Care for the First Teeth

Start brushing as soon as the first tooth appears. Use a baby toothbrush with soft bristles and fluoride toothpaste. For children under three, use a thin smear, about the size of a grain of rice. For children aged three to six, use a pea-sized amount.

Brush twice a day: before bed and at one other convenient time. An adult should put the toothpaste on the brush. Once your child can spit, encourage them to spit out the toothpaste after brushing, but there is no need to rinse with water.

Parents need to brush young children’s teeth. Your child can practise using the toothbrush, but you should help them clean all tooth surfaces thoroughly.

We recommend booking the first dental check-up after the first tooth appears, and no later than your child’s first birthday. You can read about preparing for the appointment in our article, “When to Take Your Child to the Dentist for the First Time”.

If you notice spots, small holes, or other changes in the enamel, arrange a dental examination. The dentist will identify the cause and explain whether your child needs treatment for tooth decay.

Sources

1. American Dental Association. Primary Tooth Development.

2. NHS. Baby teething symptoms.

3. NHS. Looking after your baby’s teeth.

4. U.S. Food and Drug Administration. Safely Soothing Teething Pain in Infants and Children.

5. American Academy of Pediatric Dentistry. Early Childhood Caries: Classifications, Consequences, and Preventive Strategies.