Baby Teeth Eruption Chart: What Comes First & When to Worry About Delays

Written by the ChildBloom Pediatric Panel, FAAP | Medically reviewed | Last updated July 2025

As a pediatrician, I understand how concerning these moments can be for parents. My goal is to provide you with evidence-based guidance that helps you make informed decisions for your child, while also knowing exactly when to seek medical attention. This guide draws on current AAP recommendations and clinical experience to give you the clarity you need.

Every baby’s teething journey is different, but it follows a predictable pattern. Understanding this pattern will help you know what to expect, when to expect it, and when a delay might warrant a conversation with your pediatrician.

Part 1: The Eruption Chart

The primary (baby) dentition consists of 20 teeth: 10 in the upper jaw (maxilla) and 10 in the lower jaw (mandible). They erupt in a predictable sequence, though the exact timing varies.

KEY PATTERNS:

• Lower teeth typically erupt before upper teeth (especially the central incisors).
• Teeth erupt in pairs (left and right sides of the same jaw).
• Incisors come first, then first molars, then canines, then second molars.
• The process is usually complete by age 2.5-3 years.

THE NORMAL RANGE:

• First tooth: 3-14 months (most commonly 6-10 months)
• Full dentition (all 20 teeth): 24-36 months

Part 2: The Biology of Tooth Eruption

2.1 How Teeth Erupt

Each tooth develops within the jawbone in a structure called a dental follicle. As the tooth crown forms and matures, the follicle produces enzymes that break down the bone and gum tissue above it, creating a path for the tooth to emerge.

The process:

1. The tooth crown is fully formed beneath the gum (this happens before birth for primary teeth).
2. The root begins to form, pushing the crown upward.
3. The gum tissue above the tooth thins and the tooth “erupts” through the surface.
4. The root continues to form after eruption and is typically complete 1-2 years after the tooth appears.

2.2 Why Some Babies Teethe Earlier or Later

• Genetics: The strongest predictor. If you teething early, your baby likely will too.
• Sex: Girls tend to teethe slightly earlier than boys.
• Birth weight: Lower birth weight babies may teethe later.
• Nutrition: Vitamin D deficiency can delay eruption.
• Prematurity: Use adjusted age for teething milestones.
• Individual variation: Some babies are simply early or late.

Part 3: When Delayed Eruption Is a Concern

3.1 The Timeline for Concern

• No teeth by 12 months: Mention it to your pediatrician. In most cases, this is normal variation.
• No teeth by 15 months: This warrants evaluation. Your pediatrician may check vitamin D levels.
• No teeth by 18 months: This requires evaluation by a pediatric dentist.

3.2 Causes of Delayed Eruption

Vitamin D deficiency:

• Vitamin D is essential for calcium absorption and bone/tooth mineralization.
• Severe deficiency can cause rickets and delayed tooth eruption.
• Risk factors: exclusively breastfed babies without supplementation, dark-skinned babies in northern latitudes.
• The AAP recommends 400 IU of vitamin D daily for all breastfed babies from birth.

Hypothyroidism:

• Congenital hypothyroidism can cause delayed tooth eruption along with other developmental delays.
• This is screened for in all newborns (the “heel prick” test).

Genetic conditions:

• Rare genetic conditions (cleidocranial dysplasia, Down syndrome, ectodermal dysplasia) can cause delayed or absent teeth.
• These conditions have other characteristic features usually apparent at birth.

3.3 Early Eruption (Natal and Neonatal Teeth)

Some babies are born with teeth (natal teeth, approximately 1 in 2,000-3,000 births) or develop teeth in the first month of life. These are usually extra teeth, poorly formed with weak roots, and may need to be removed if loose or causing feeding problems.

Part 4: What to Do If Teething Is Delayed

4.1 Steps to Take

1. Mention it to your pediatrician at the 12-month visit (or earlier if concerned).
2. Ensure your baby is receiving adequate vitamin D (400 IU/day for breastfed babies).
3. If the pediatrician is concerned, they may order blood tests or dental X-rays.
4. If teeth are present beneath the gums and developing normally, this is reassuring — they will come in.

4.2 What NOT to Do

• Do NOT try to “help” the teeth erupt by massaging aggressively or applying substances.
• Do NOT give extra vitamin D beyond the recommended dose.
• Do NOT panic. In the vast majority of cases, late teething is simply normal variation.

When to Call the Doctor

• No teeth by 12 months (mention at the visit)
• No teeth by 15 months (warrants evaluation)
• No teeth by 18 months (requires dental evaluation)
• Baby is not receiving vitamin D supplementation (if breastfed)
• Other signs of developmental delay alongside late teething

For age-appropriate teethers for each eruption phase, see Best Silicone Teethers by Teething Stage.

Related Articles

• When to Start Brushing Baby Teeth: Fluoride Rules by Age
• Teething Fever: Can Teething Really Cause a Fever?
• The Pediatrician’s Guide to Baby Teething

MEDICAL DISCLAIMER: This article is for informational purposes only and does not constitute medical advice. Always consult your pediatrician or pediatric dentist for guidance on your child’s specific needs.

Related: Best Safe Teething Relief Products: Pediatrician-Approved Picks

Related: Top 5 Baby Toothbrushes & Finger Brushes for First Teeth: Pediatrician-Reviewed

Related: Best Silicone Teethers by Teething Stage: A Pediatrician’s Guide

Reference: American Academy of Pediatrics (AAP)

Key Facts About Baby Teeth

Every parent should understand baby teeth. This guide covers what you need to know, based on current pediatric evidence.

Related Resources

Explore more pediatrician-reviewed guidance from ChildBloom:

• Teething Rash on Chin & Cheeks: Drool Dermatitis or Allergy?
• When to Start Brushing Baby Teeth: Fluoride Rules by Age

Authoritative External Sources

• AAP Teething

Frequently Asked Questions

Related Articles

• Parent Guide: Baby Teething Guide
• Teething Fever: Can Teething Really Cause Fever?
• Amber Teething Necklaces: Are They Safe?
• When to Start Brushing Baby Teeth
• Teething Rash on Chin & Cheeks
• Best Silicone Teethers by Stage
• Best Baby Toothbrushes & Finger Brushes
• Best Safe Teething Relief Products

📖 More from the Health & Safety Hub: your A-Z pediatrician guide to baby health, common illnesses, fevers, rashes, allergies, safety

Safety Considerations and Red Flags

Parents should be aware of the following safety considerations when managing their child’s health at home:

• Never ignore persistent or worsening symptoms
• Keep emergency numbers (pediatrician, poison control, emergency services) readily accessible
• Follow medication dosing instructions precisely — never estimate or use household spoons
• Trust your gut: if you feel something is seriously wrong, seek medical attention immediately

Understanding the Teething Process

Teething is a natural developmental process that typically begins around 6 months of age, though the range can vary from 3 to 12 months. The lower central incisors usually emerge first, followed by the upper central incisors. By age 3, most children have their full set of 20 primary teeth.

Signs and Symptoms

Common teething signs include increased drooling, gum swelling and tenderness, chewing on hands or objects, irritability, disrupted sleep, and decreased appetite for solid foods. Low-grade temperature elevation (under 100.4°F) can occur due to gum inflammation, but true fever is not caused by teething. If your baby has a fever above 100.4°F, look for another cause.

Safe Teething Relief Options

Safe teething relief includes chilled (not frozen) teething rings, clean wet washcloths placed in the refrigerator for 30 minutes, gentle gum massage with a clean finger, and age-appropriate pain relievers like acetaminophen after 3 months or ibuprofen after 6 months (always confirm dosing with your pediatrician). Avoid teething gels containing benzocaine, which can cause a rare but serious condition called methemoglobinemia in infants.

Supporting Your Baby Through Teething

Teething Toys and Tools

Choose teethers made from food-grade silicone, natural rubber, or solid wood (unpainted). Avoid liquid-filled teethers that can leak if punctured, and avoid frozen teethers that can be too hard and damage delicate gums. Refrigerator-chilled (not frozen) teethers provide soothing relief. Soft silicone teething brushes can double as gum massagers. Always clean teethers according to manufacturer instructions to prevent bacterial buildup.

Oral Hygiene During Teething

Begin oral care before the first tooth erupts by wiping your baby’s gums with a clean, damp washcloth after feeds. Once teeth appear, use a soft-bristled, age-appropriate toothbrush with a rice-grain-sized smear of fluoride toothpaste. Brush twice daily, especially before bedtime. Avoid putting your baby to bed with a bottle of milk or juice (bottle mouth syndrome), which can cause severe tooth decay.

Teething and Feeding

How Teething Affects Eating

Teething can temporarily affect your baby’s appetite. Some babies nurse or bottle-feed more for comfort, while others pull away due to gum sensitivity. Offer chilled teething toys before feeds to numb the gums. For babies eating solids, offer cool, soft foods like yogurt, chilled pureed fruit, or refrigerated teething biscuits. Your baby may prefer certain textures during teething — follow their lead and do not worry if solids intake drops temporarily.

Teething and Sleep Disruptions

Teething discomfort can cause sleep disruptions, especially when multiple teeth are erupting at once. Maintain your usual sleep routine as much as possible, as consistency is comforting. Offer extra comfort and soothing during the night, but try to avoid creating new sleep associations that will persist after the teething phase passes. If sleep disruptions continue for more than a week or two without a clear teething cause, look for other factors.

The Bottom Line

Baby Teeth Eruption Chart is a common concern for parents, and most of the time it resolves with simple home care and patience. As a pediatrician, I encourage parents to trust their instincts, stay informed with evidence-based resources, and maintain open communication with their healthcare provider. You know your child best — if something does not feel right, speak up. Every question you ask is valid, and every concern you raise helps us provide better care for your little one.