What This Tooth Eruption Guide Covers
This guide explains the typical timeline for baby teeth and permanent teeth so you can track your child's dental development. It covers eruption order, teething signs, and when to seek professional evaluation.
Tooth eruption refers to the process of a tooth breaking through the gum tissue and becoming visible in the mouth. Humans develop two sets of teeth. The first set, called primary teeth or baby teeth, includes 20 teeth. The second set, called permanent or adult teeth, includes 32 teeth, counting the four wisdom teeth. [3]
This guide is for parents, caregivers, and anyone who wants a clear reference for when teeth typically appear. Keep in mind that every child develops at their own pace. The ages listed below are averages, not deadlines. If you have concerns about your child's teeth, a pediatric dentist can evaluate whether development is on track.
Tooth Eruption Timelines: Baby Teeth and Permanent Teeth
Baby teeth follow a general pattern, starting with the front teeth and moving toward the back of the mouth. Permanent teeth follow a similar pattern but also include additional molars that do not replace any baby tooth.
Baby Teeth Eruption Chart (Primary Teeth)
Most babies get their first tooth around 6 months of age, though a systematic review and meta-analysis found that eruption timing varies across populations. [1] The lower central incisors, the two bottom front teeth, are usually the first to appear. After that, the upper central incisors typically follow between 8 and 12 months.
Here is the general order and approximate age range for all 20 primary teeth:
By roughly age 2.5 to 3, most children have all 20 baby teeth. [4] These teeth serve important roles. They help children chew food, speak clearly, and hold space in the jaw for the permanent teeth that will replace them later.
- Lower central incisors (bottom front two): 6 to 10 months
- Upper central incisors (top front two): 8 to 12 months
- Upper lateral incisors (next to top front teeth): 9 to 13 months
- Lower lateral incisors (next to bottom front teeth): 10 to 16 months
- Upper first molars: 13 to 19 months
- Lower first molars: 14 to 18 months
- Upper canines (cuspids): 16 to 22 months
- Lower canines: 17 to 23 months
- Lower second molars: 23 to 31 months
- Upper second molars: 25 to 33 months
Permanent Teeth Eruption Chart (Adult Teeth)
Permanent teeth start coming in around age 6. The first permanent teeth to arrive are typically the first molars, sometimes called "six-year molars." These erupt behind the last baby teeth and do not replace any primary tooth. At roughly the same time, the lower central incisors begin to loosen and fall out as their permanent replacements push through. [3]
Here is the general order and approximate age range for the 28 permanent teeth (excluding wisdom teeth). This sequence is based on the American Dental Association (ADA) eruption chart. [6]
Wisdom teeth, also called third molars, may erupt between ages 17 and 25. Not everyone develops all four wisdom teeth, and some people never develop any. A dentist can use X-rays to monitor their position.
- First molars: 6 to 7 years
- Lower central incisors: 6 to 7 years
- Upper central incisors: 7 to 8 years
- Lower lateral incisors: 7 to 8 years
- Upper lateral incisors: 8 to 9 years
- Lower canines: 9 to 10 years
- Upper first premolars (bicuspids): 10 to 11 years
- Lower first premolars: 10 to 12 years
- Upper second premolars: 10 to 12 years
- Upper canines: 11 to 12 years
- Lower second premolars: 11 to 12 years
- Second molars: 12 to 13 years
Why Eruption Timing Varies
No two children follow the exact same eruption schedule. A difference of several months from these averages is considered normal. A 2024 systematic review examining global populations confirmed that eruption chronology varies by geography, sex, and nutritional status. [1] Girls tend to get their teeth slightly earlier than boys.
Genetics play a significant role. If a parent got their teeth early or late, their child may follow a similar pattern. Premature birth and low birth weight can also delay eruption by a few months. These variations alone typically do not require treatment.
Keep in mind that published eruption charts, including the one in this guide, represent averages across large groups of children. The exact order can also differ slightly from child to child. For example, the upper canines and lower second premolars often erupt around the same age, and the order in which they appear may vary. [6] Minor differences in sequence are usually not a concern.
What Parents Should Know About Teething and Tooth Loss
Teething is the process of baby teeth pushing through the gums, and it can cause mild discomfort that is manageable at home.
Common Signs of Teething
When a baby tooth is about to break through, you may notice several signs. These are normal parts of development and usually pass within a few days for each tooth. [4]
Some parents notice a mild rise in temperature during teething. However, true fever (above 100.4°F or 38°C) is not caused by teething. If your child has a high fever, contact your pediatrician to rule out other causes.
- Increased drooling: Saliva production rises before and during tooth eruption.
- Swollen or tender gums: The gum tissue may look red or puffy where the tooth is coming in.
- Irritability or fussiness: Mild discomfort can make babies cranky, especially at night.
- Chewing on objects: Babies may put fingers, toys, or teething rings in their mouths for counter-pressure relief.
- Changes in eating or sleeping: Some babies temporarily refuse food or wake more often.
Safe Ways to Ease Teething Discomfort
The American Academy of Pediatric Dentistry recommends simple comfort measures for teething. [4] A clean, chilled (not frozen) teething ring or washcloth can soothe sore gums. Gently rubbing the gums with a clean finger also helps.
Avoid teething gels that contain benzocaine for children under age 2. The U.S. Food and Drug Administration has warned about the risk of a rare but serious condition called methemoglobinemia linked to benzocaine. If your child seems to be in significant pain, ask your pediatrician about an appropriate dose of acetaminophen or ibuprofen based on the child's weight and age.
When Baby Teeth Fall Out
Baby teeth typically begin falling out around age 6, starting with the lower front teeth. This process continues until about age 12. The roots of baby teeth gradually dissolve, a process called resorption, as the permanent tooth beneath pushes upward.
Encourage your child to wiggle a loose tooth gently with their tongue. Pulling a tooth before it is ready can damage the gum tissue. If a baby tooth has not fallen out and the permanent tooth is already erupting next to it, a dentist can evaluate whether the baby tooth needs to be removed.
When to Schedule the First Dental Visit
The American Academy of Pediatric Dentistry recommends a child's first dental visit by age 1, or within 6 months of the first tooth appearing, whichever comes first. [4] Early visits allow the dentist to check eruption patterns, screen for early cavities, and advise on oral hygiene and diet.
Baby teeth are vulnerable to decay as soon as they appear. Cleaning your baby's gums with a soft, damp cloth before teeth erupt helps establish a routine. Once teeth appear, use a rice-grain-sized smear of fluoride toothpaste on a soft-bristled infant toothbrush. [5]
What to Expect at a Pediatric Dental Visit
A pediatric dental visit for eruption concerns is quick, gentle, and focused on making your child comfortable. Here is what typically happens, step by step.
The dentist or hygienist will start by reviewing your child's health history and asking about any concerns you have noticed, such as teeth that seem delayed or out of order. They will then examine your child's mouth, gums, and jaw. For very young children, this may be done with the child sitting in your lap.
If the child is old enough, the dentist may take X-rays (radiographs) to see permanent teeth developing below the gum line. These images show whether teeth are forming normally, growing in the right direction, and have enough space to erupt. The dentist will also check for cavities, gum health, and bite alignment.
At the end of the visit, the dentist will explain their findings, discuss any concerns, and recommend a timeline for follow-up. Most routine pediatric dental visits take about 30 to 45 minutes. If additional treatment such as a space maintainer is needed, the dentist will explain the options and schedule a separate appointment.
Cost Factors for Pediatric Dental Visits
Routine pediatric dental exams are often covered by dental insurance, but out-of-pocket costs vary by location, provider, and case complexity.
A standard pediatric dental exam without insurance typically costs between $50 and $200. X-rays, if needed, may add $25 to $150 depending on the type and number of images taken. Fluoride treatments and dental sealants, which are common preventive services for children, usually range from $20 to $60 each. Costs vary by location, provider, and case complexity.
Many dental insurance plans and state Medicaid programs cover preventive visits for children at little or no cost. Check with your insurance carrier or your state's Medicaid office to understand your specific benefits. Some pediatric dental offices also offer payment plans for families without insurance.
When to See a Pediatric Dentist About Eruption Concerns
Most eruption variations are normal, but certain signs warrant evaluation by a pediatric dentist who has additional training in children's dental development.
Schedule an evaluation if you notice any of the following:
A general dentist can handle routine cleanings and cavity fillings for children. However, a pediatric dentist is specifically trained to diagnose and manage developmental dental issues. They complete two to three additional years of residency training beyond dental school, focusing on infant, child, and adolescent oral health. [4] If your general dentist notices an eruption concern, they may refer you to a pediatric dentist for further evaluation.
Conditions such as ectopic eruption (a tooth growing in the wrong direction), ankylosis (a tooth fused to the bone), or supernumerary teeth (extra teeth) require specialized diagnosis. A pediatric dentist can use clinical exams and imaging to identify these conditions early and plan appropriate treatment.
- No teeth by 18 months: While late eruption alone may not signal a problem, the absence of any teeth by 18 months should be evaluated. [4]
- Teeth erupting significantly out of sequence: For example, molars appearing before front teeth.
- A permanent tooth erupting behind a baby tooth: Sometimes called "shark teeth," this is common but may need intervention if the baby tooth does not loosen on its own.
- Missing or extra teeth: X-rays can confirm whether permanent teeth are developing beneath the gums.
- Pain, swelling, or discoloration: These could indicate infection, trauma, or other issues unrelated to normal eruption.
- Crowding or spacing concerns: A pediatric dentist can assess whether early orthodontic evaluation is appropriate.
Find a Pediatric Dentist Near You
If you have questions about your child's tooth eruption timeline or want to schedule a first dental visit, a pediatric dentist can provide a thorough evaluation and personalized guidance. Use the the pediatric-dentistry page on My Specialty Dentist to search for a qualified pediatric dentist in your area and book an appointment.
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