The eruption of baby teeth is part of your child’s normal development. In fact, by the time your baby is 3 years old, it’ll have 20 teeth! Needless to say, they will get most of their primary (“baby”) teeth during the first couple of years.
Typically, a baby is born with “buds” on the gums. These are areas in which these 20 teeth will eventually erupt and develop. However, there are some cases where this process doesn’t go as planned. It’s possible that your baby’s teeth don’t erupt correctly, or you may notice a significant delay.
Once you know what to look for, it’s important to contact your pediatrician or pediatric dentist if you have any concerns.
Order of Tooth Development
There are five different types of teeth your baby will develop during the first three years. The order your baby gets their teeth is as follows.
- central incisors (front teeth)
- lateral incisors (between the central incisors and canines)
- first molars
- canines (teeth beside the front molars)
- second molars
Generally, babies get their bottom front teeth (central incisors) first. Sometimes teeth erupt slightly out of order. According to the American Academy of Pediatrics (AAP), this is usually not a cause for concern.
When it comes to teething, every baby is different. Some babies might teethe as early as 4 to 7 months, while others get their first teeth closer to 9 months, or sometimes not until they turn one year old. Occasionally, a baby may be born with one or more teeth. Genetics can play a large role. If you or your partner got your baby teeth early, chances are that your child will.
Despite differences in eruptions, there is a general timeline to keep in mind. Your baby will get their lower teeth in each category first before teeth of a different category on the same gum line. The following timeline indicates approximately when most babies get their primary teeth.
6-10 months bottom central incisors
8-12 months top central incisors
9-13 months top lateral incisors
10-16 months bottom lateral incisors
13-19 months first molars in top of the mouth
14-18 months first molars on the bottom
16-22 months top canines
17-23 months bottom canines
23-31 months second molars on bottom of the mouth
25-33 months second molars on top
One way to keep track of tooth eruptions is to look for new teeth every four months after your baby starts getting them. For example, if the bottom central incisors come in at six months, then you should expect to see the top incisors come in about four months later.
How to Tell if Something Is Wrong
Spacing and disease prevention are perhaps more important than the precise order your baby’s teeth come in. Since baby teeth are smaller than permanent teeth, there should be plenty of space between them to allow for room in the future. Children tend to get their permanent teeth at around six years of age, starting with the bottom central incisors. If you are concerned that your baby’s teeth are coming in too close together, you should discuss this with a pediatric dentist.
Another issue is tooth decay. Unfortunately, baby teeth are at a higher risk of decay. This can lead to complications, such as:
- early tooth loss
- cellulitis (an infection that occurs and spreads underneath the skin)
- gingivitis (gum disease)
- yellow or brown spots on teeth
- feeding difficulties
- dental cavities
- poor self-esteem
Teething problems tend to occur most often in babies born prematurely, as well as those who don’t have adequate healthcare access. Professionals recommend contacting a dentist if your baby hasn’t experienced any tooth eruptions by 18 months of age. All babies should start seeing a dentist soon after their 1st birthday.
Why is caring for baby teeth important?
While it’s true that primary teeth are only in the mouth for a short period, they play a vital role in the following ways:
- They reserve space for their permanent counterparts.
- They give the face its normal appearance.
- 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 the permanent teeth (decay and infection in baby teeth can cause dark spots on the permanent teeth to develop beneath them).
Managing the teething process
Babies’ immune systems start to change when they are around six months old. Along with the tendency to put things in their mouths, this makes them more prone to illnesses. Symptoms of common childhood illnesses such as changes in sleep and eating patterns, fussiness, rash, drooling, runny nose, and diarrhea are often linked to teething when that might not be the cause. If your child has these symptoms, speak to your child’s doctor about other possible causes, such as bacterial, viral, or middle ear infections.
Teething takes about 8 days, which includes 4 days before and 3 days after the tooth comes through the gum. (You may see a blue-grey bubble on the gum where the tooth is about to appear. This is called an eruption cyst and will usually go away without treatment.) During this time, it can be tough to keep children comfortable.
Some tips include:
- Massage – gently massage the gum with clean fingers or a soft, wet cloth.
- Chilled (not frozen) teething rings or rusks – pressure from a cold object can relieve discomfort from teething. Do not sterilize plastic teething rings in boiling water or dishwater, unless specified by the manufacturer. Be sure to check the product information before buying teething rings. Avoid the ones that use a plastic softener.
- Unsweetened teething rusks or sugar-free biscuits can be given to infants over 6 months who have started eating solids.
- Pain-relieving medications – paracetamol works well for children. Ibuprofen may also help, but it is not as well tolerated by children.
- Dry the drool – the skin around the mouth, particularly the chin area, can become irritated. Gently wipe this away with a soft cloth throughout the day.
Some treatments should be used with caution or not at all. These include:
- Teething necklaces – amber is believed by some people to release healing oil on contact with warm skin. The oil is thought to be soothing or help to reduce pain. Although amber teething strings or necklaces are designed to be worn around the neck, wrist, or ankle, they have been incorrectly used to chew on. Parents are asked to consider other less risky ways of providing relief from teething.
- Teething gels – common teething gels contain 8.7–9.0% of the ingredient choline salicylate. Salicylate is related to aspirin. The use of aspirin for children younger than 16 is not recommended because, in some children, it has been known to cause Reye’s syndrome – a rare but potentially lethal condition that can cause liver and brain damage. Although there has not been a reported case of Reye’s syndrome associated with using teething gels, the general advice is that it is a risk not worth taking when other things are available.
Teething gels containing benzocaine are also not recommended for use in children. Research also suggests that teething gels may not relieve teething pain; rather, the act of massaging it into the gum is what helps.
Some parents may feel that caring for baby (primary) teeth isn’t as important as caring for adult (permanent) teeth simply because baby teeth fall out. However, baby teeth are very important. They allow children to chew food and speak properly and reserve the spaces in the gums for future adult teeth.
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