Baby's First Tooth: Everything You Need to Know

There it is — a tiny white edge peeking through the gum. Baby's first tooth is a milestone that often brings equal parts joy and worry.

For most babies, the first tooth appears around 6 months, but there's a wide range of normal. Some babies cut their first tooth as early as 3 months, others wait until their first birthday.

Here's everything you need to know about teething, pain relief, and starting a brushing routine.

When does baby's first tooth come in?

Most babies get their first tooth between 4 and 7 months. According to dental health guidelines, the average is around 6 months, but there's a broad range of normal.

The typical order is:

1. Lower central incisors (6–10 months) — the two middle bottom teeth come first
2. Upper central incisors (8–12 months) — the four middle top teeth
3. Lateral incisors (9–13 months) — the teeth next to the front ones
4. First molars (13–19 months) — toward the back
5. Canines (16–22 months) — the pointed teeth
6. Second molars (25–33 months) — the last baby teeth at the back

By around age 3, all 20 baby teeth should be in place.

Teething symptoms

Most babies feel discomfort as teeth push through the gums. Common signs include:

• Drooling — more saliva than usual, often in large amounts
• Need to chew — baby puts everything in their mouth and gnaws intensely
• Irritability — fussier than usual, especially late in the day
• Swollen gums — red, puffy area where the tooth is coming in
• Disrupted sleep — waking more frequently at night
• Reduced appetite — may not want to eat as usual
• Rubbing their ear — on the same side as the incoming tooth

What is NOT teething?

Teething does not cause a fever above 100.4°F (38°C), diarrhea, or serious illness. These symptoms have another cause and should be evaluated by a doctor.

According to the American Dental Association, it's a common misconception that teething causes fever. A slight temperature increase (under 100.4°F) can occur, but high fever is not related to teeth.

6 ways to relieve teething pain

1. Teething rings — chilled, not frozen

A cold teething ring is the most effective relief for most babies. Put it in the refrigerator (not the freezer) so it's pleasantly cool.

Avoid frozen teethers — they can damage the gums. Choose rings without liquid filling, as these can leak.

2. Gum massage

Wash your hands thoroughly and gently massage the gums with a clean finger. The mild pressure can be soothing.

You can also use a soft silicone finger brush designed for gum massage, available at pharmacies and baby stores.

3. Cold foods (from 6 months)

Babies who have started solid foods may enjoy:

• Cold cucumber sticks (supervised)
• Chilled fruit in a mesh feeder
• Chilled yogurt (from 10 months)
• Frozen banana pieces in a mesh feeder

4. Dry drool regularly

All that drooling can cause a rash around the mouth and chin. Gently dab with a soft cloth, and consider applying a thin barrier cream for protection.

A drool bib saves many outfit changes.

5. Pain relievers (when needed)

For significant discomfort, you can give infant acetaminophen (Tylenol) dosed by your baby's weight and age. Always follow the package instructions or your pharmacist's recommendations.

Ibuprofen (Advil/Motrin) can be used from 6 months. Check with your pharmacist or doctor for the correct dose.

6. Extra comfort and closeness

Teething is uncomfortable, and baby needs extra care. More nursing, being carried, and cuddles are entirely appropriate. You are not "spoiling" your baby by comforting them.

Start brushing from the first tooth

Tooth brushing should start the day the first tooth appears. According to the AAP and WHO guidelines, you should brush twice daily from day one.

What you'll need

• Toothbrush: A small, soft baby brush with a short head
• Fluoride toothpaste: From the first tooth — use a rice-grain-sized amount
• Finger brush: Can work in the early days for babies who don't like the brush

How to brush baby's teeth

1. Lay baby in your lap with their head toward you
2. Use a rice-grain-sized amount of fluoride toothpaste
3. Gently brush all tooth surfaces — front, back, and chewing surface
4. Use soft, small circular motions
5. Let baby spit out the excess, but don't rinse — the fluoride needs to work

Fluoride — how much?

AAP/WHO-aligned guidelines recommend:

First dental visit

The AAP recommends a first dental visit by age 1, or within 6 months of the first tooth appearing. Don't wait for a reminder — contact your dentist earlier if:

• You have concerns about baby's teeth
• There are signs of discoloration or damage
• The child has high cavity risk (lots of sugar, poor brushing routine)

Baby teeth and cavities

Baby teeth can get cavities — and it happens more often than many people think. Even though they'll eventually fall out, baby teeth are important: they hold space for permanent teeth and are essential for chewing and speech.

How to prevent cavities in your baby:

• Brush morning and evening with fluoride toothpaste
• Avoid sugary drinks in a bottle or sippy cup, especially at bedtime
• Don't dip the pacifier in honey or sugar
• Limit sugar intake between meals
• Don't share spoons — cavity-causing bacteria can be transferred from parent to child

Common questions

Can baby teeth come in without symptoms?

Yes, some babies cut teeth with no noticeable discomfort. You might only discover the tooth when you see or feel it.

Is it normal for teeth to come in in a "wrong" order?

Yes. The order described above is the most common, but it's completely normal for teeth to arrive in a slightly different sequence. It has no impact on baby's development.

Does breastfeeding affect dental health?

Breast milk itself doesn't cause cavities. However, prolonged nighttime nursing (especially after baby teeth have come in) combined with no brushing can increase the risk. Brush teeth after the last feeding of the evening.

When should baby stop using a bottle?

Pediatric dentists recommend transitioning from bottle to cup around 12 months. Long-term bottle use, especially with sweet drinks, increases the risk of cavities on the front teeth.

What do I do if baby knocks out a tooth?

Contact your dentist immediately. Keep the tooth moist (in milk or saliva) and see the dentist as quickly as possible. Baby teeth can sometimes be reinserted.

Good dental health starts from day one

Baby's first tooth is the beginning of a dental health journey that lasts a lifetime. By establishing good routines from day one, you're laying the foundation for healthy teeth and positive dental visits.

Remember: twice daily with fluoride toothpaste, limited sugar, and regular contact with your dentist.

Read more

• Baby teeth and dental health 0–3 years
• Baby milestones tracker

Sources

1. American Academy of Pediatrics — Dental Health
2. American Dental Association — Baby Teeth
3. WHO — Oral Health Guidelines