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Getting teeth isn't one of those milestones a baby reaches all at once. Transforming that gummy grin into a mouthful of gleaming teeth is a rite of passage that takes a few years. By the time your little one is 3, he'll have a mouthful of chompers that he can practice brushing himself, a basic step on the road to self-care. (He won't yet have the skills to do a good job, though, so be sure to lend a hand until he's at least 6 years old.)
When do babies start teething?
Most babies sprout their first tooth sometime between 6 and 10 months old.
Teeth begin developing when your child is still in the womb. While you were pregnant, your baby developed tooth buds, the foundation for baby teeth (also called milk teeth). Very rarely, a baby is born with a tooth or two, or grows a tooth in the first few weeks of life.
If your baby develops teeth early, you may see the first one (usually a bottom middle tooth) as soon as 3 months. In other cases, you may have to wait until he's at least a year old.
Most babies get new teeth in this order: the bottom two middle ones first, then the top two middle ones, then the ones along the sides.
The last teeth to appear are the second molars, found in the very back of the mouth on the top and bottom. They'll probably start coming in when your child is between 23 and 31 months old. Shortly after that, your child should have a full set of 20 baby teeth.
For more details, check out the video below or our baby teething timeline slideshow.
What are the signs of teething?
Some babies breeze through teething, but many feel some discomfort. You may notice signs and symptoms of teething such as:
- Drooling (which can lead to a facial rash)
- Swollen, sensitive gums
- Irritability or fussiness
- Gnawing or biting
- Refusing to eat
- Sleep problems
- Rubbing face and ears
Though many parents swear that teething causes a fever, vomiting, or diarrhea, there's no good scientific evidence that it does. If your baby has more than a very slight increase in temperature (higher than 100.4 degrees F) or any other worrisome symptoms, give his doctor a call.
Teething remedies to help your baby
Here are some things you can give your baby to make him more comfortable during the teething process:
Something to chew on. Offer a teething ring or a wet washcloth cooled in the refrigerator. Don't store teethers in the freezer because frozen teethers can get hard enough to damage a baby's gums.
Also, don't use teething necklaces because they're choking and strangulation hazards.
Cold food. If your baby is eating solids, yogurt or chilled applesauce may provide relief. If your baby is old enough to eat finger foods, a frozen banana or bagel may be soothing. As always, be aware of food choking hazards.
Gum massage. Wash your hands, then gently but firmly rub your baby's gums with your finger. This can be a welcome counter pressure to what your baby feels from his emerging teeth.
Pain reliever. If nothing else helps and your baby is at least 6 months old, his doctor may suggest acetaminophen or ibuprofen to ease the pain and inflammation. See our dosage charts for acetaminophen and ibuprofen, but be sure to double check the correct dose with your baby's doctor before giving any pain reliever to a child younger than 2.
Never give your baby aspirin (or rub it on his gums). Aspirin can lead to a rare but potentially life-threatening condition called Reye's syndrome.
Also, don't use over-the-counter teething medications, like gels and creams, on children younger than 2. The American Academy of Pediatric Dentistry, the U.S. Food and Drug Administration (FDA), and other experts warn that topical numbing medications containing benzocaine can cause methemoglobinemia, a rare but serious condition in which the amount of oxygen in the blood drops dangerously low.
The FDA also recommends against using homeopathic teething tablets and gels because of reported side effects, such as seizures and breathing problems, in infants and children.
How to brush your baby's teeth
Once your baby's teeth start to come in, it's up to you to keep them clean. As soon as his teeth appear, brush them twice a day (like once in the morning then again right before bed).
Use a baby-size toothbrush with a smear of toothpaste. Ask his doctor or dentist if you should use fluoridated toothpaste. If your child doesn't like the taste of one kind of toothpaste, try another flavor.
You don't have to brush in a certain direction. Just try to get out any food particles.
Once your baby has multiple teeth, it can be hard to reach all the tooth surfaces with a toothbrush. That means it's time to begin flossing! Those colorful flossing sticks designed especially for kids can make it easier for everyone.
At about 18 months, your child may be ready to start learning to brush his own teeth. You'll still have to help because he won't have the dexterity to maneuver a toothbrush successfully.
When your baby turns 2 years old, start to use a little bit more toothpaste – an amount about the size of a pea.
Other ways to care for your baby's teeth
Take steps to avoid bottle-related tooth decay
Don't let your baby fall asleep with a bottle (unless it's filled with water). The sugars in formula and breast milk can lead to baby-bottle tooth decay if they're in contact with his teeth all night.
Another way to prevent this condition and lower the risk of cavities is to switch your baby from a bottle to a cup as soon as he's coordinated enough to manage it, usually sometime around his first birthday.
You may want to avoid letting your child get into the habit of carrying around a sippy cup of juice or milk because prolonged exposure to sugar can damage teeth, just like when using a bottle. If you do give your baby a sippy cup, fill it with only water.
Ask about a fluoride supplement
The 6-month checkup is a good time to ask your child's doctor whether your baby needs a fluoride supplement. (These cavity-preventing drops are necessary only if the water supply in your area isn't fluoridated.) Also ask the doctor to examine your child's teeth.
See the dentist
Dentists recommend scheduling your baby's first dental appointment around his first birthday or within six months after his first tooth erupts, whichever comes first.
Set limits on treats
Limit the amount of sweets your child eats. When he does have a sugary treat (at a birthday party, for example), be sure to brush his teeth soon after he eats.
What to do if your baby doesn't have teeth yet
If you still don't see any sign of a tooth by his 18-month checkup, tell your child's doctor or dentist. (Premature babies may take a few months longer to get their teeth.)
Also, if your child has all the signs of teething – heavy drooling, swollen gums – but also shows signs of severe pain (crying inconsolably, for example), call his doctor. Teething shouldn't be an excruciating ordeal for a baby.
When do children begin losing teeth?
Baby teeth don't begin to fall out until your child's permanent teeth are ready to come in, beginning around age 6.
Where to go next
Watch a video showing how to care for your baby's teeth and gums.
See your child's teething and tooth loss timeline.
Find out how other parents soothe teething symptoms.