When Do Babies Start Teething?

At what age do babies start teething? Find out more about how your baby's teething affects physical development and what signs and symptoms to watch for. 

Think you love your baby's gummy grin now? Wait until cute little chompers make an appearance. The process of getting that first row of tiny teeth, however, isn't much fun—for your baby or for you.

Teething, like crawling, walking and talking, is an important milestone that shows your child is on the right track developmentally, says Tanny Josen, D.D.S., a pediatric dentist at Kid Island Dental in Long Island, New York. Although appearance is the first thing many think of when teeth are mentioned, your baby's pearly whites will be essential for much more.

Type of Development: Physical and Language

Your baby's teeth will help allow her to eat a well-rounded diet. Without them, she could be stuck eating pureed everything, forever. Tooth eruption means your child is acquiring the ability to tear into meat, bite into a plum, and chew beans, so teething has an indirect effect on her gaining weight, strengthening immunity, and improving bone and brain development.

Another perk: Your baby's teeth will help her emerging language skills. "As babies acquire teeth and can increasingly bite and chew more textured foods, they are exercising and building the underlying oral-motor musculature for speech development of the jaw, cheeks, tongue, and lips," says Sherry Artemenko, a speech-language pathologist and founder of Play on Words. Plus, your child will need to use her teeth for developing later sounds like /f/, /th/ or /sh/, she adds.

When to Expect Teething to Begin

"Most babies' teeth begin to erupt between the ages of 4 to 6 months, though for some it may be earlier or later," Dr. Josen says. And no matter what Grandma says, when your child's first tooth pops in, it has nothing to do with smarts. "The age the baby cuts his or her first tooth depends on family history of teething and nothing more," says Jill Lasky, D.D.S., a pediatric dentist at Lasky Pediatric Dental Group in Los Angeles. So, if you got your teeth early, your child probably will too. Same thing if you were late.

Typically, the two bottom front teeth (central incisors) are the first to erupt, followed by the four upper front teeth (central and lateral incisors). But variations in the order may occur and don't warrant any concern, Dr. Josen says. Your child should have a full set of primary (baby) teeth by the time he's almost three.

Some toddlers won't get their first tooth until 18 months, and that can be normal, but a child who doesn't have any teeth by 18 months should see their dentist to confirm the presence of teeth in the mouth, says Carrie M. Brown, M.D., a pediatrician in Little Rock, Arkansas. In rare cases, some medical conditions prevent the body from forming teeth.

Teething Symptoms and Milestones 

How do you know when a baby is teething? Not all will have teething symptoms, but for those who do, the arrival of their pearly whites can cause a whole lot of misery. "Symptoms a child may have when teething are drooling, which can cause a rash on the chin or face; gum swelling and sensitivity; irritability; biting; or sleep problems," Dr. Josen says.

A low-grade fever (less than 101 degrees F., taken rectally) is also common, and may be due to gum inflammation. But if it's accompanied by a runny nose, a bout of diarrhea, or other strange symptoms, call your pediatrician. Dr. Lasky says teething doesn't cause these symptoms. "Instead, the tiny open wounds in the gums that result from the teeth erupting makes it more likely for the baby to catch a little bug," she explains. (In the case of diarrhea, it could be due to a change in diet: Teething babies are typically trying various solid foods for the first time.)

You can do quite a few things to help your teething baby. Cold will help numb the gums naturally. "I recommend chilling—not freezing—a wet washcloth or a toy that you feel comfortable having your baby chew on," Dr. Lasky says. Make sure the toy is age-appropriate, BPA-free, and nontoxic. If you choose to use a washcloth, chill a few in a plastic food-storage bag so they'll be on hand when your child needs one.

Rubbing his gums with a clean finger or giving him cold food (like applesauce or pureed fruit) or drinks may also reduce the pain. If nothing is helping, check with your pediatrician, who may recommend that you use an over-the-counter pain reliever for babies, like acetaminophen or ibuprofen. Aspirin is off-limits for children because it is associated with Reye's syndrome, a rare but serious and life-threatening condition.

A couple of pain relief methods you shouldn't turn to are teethers (also known as teething rings) and topical teething gels. "The teeth could puncture the teether and your baby could ingest the substance inside," Dr. Lasky says. The FDA warns against using over-the-counter topical numbing preparations because they can be toxic to babies. Symptoms of teething usually disappear when the tooth breaks through the gum.

Learn when your baby's teeth may appear, and what to do if they cause discomfort coming in.

Red Flags to Watch Out For

Premature and low-birthweight babies may experience delays in when their first tooth erupts. If your baby isn't showing any signs of sprouting a tooth by his first birthday, discuss it with the pediatrician. If your child seems ill and you suspect she's teething, inspect her gums. If they're swollen and you can feel at least one tooth-size lump, teething's in progress. Contact your pediatrician if any of the following symptoms are also present:

  • high fever, diarrhea, or vomiting
  • the gums are red or blue instead of pink (this usually indicates an eruption cyst, a swelling of the gums above an erupting tooth; although most cysts are benign, it's best to have them checked)
  • the gums have lesions or bumps

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