Parents want to do what is best for their kids, and they also want to know what to expect so that they can know what the best course of action is. With something like tooth development in childhood, it’s important to keep in mind that there is a wide range of variability in what is normal. It’s generally not a concern for very long, and these kinds of questions can always be answered by your local family dentist if you do have questions. With that in mind, we thought it important to compile a small list of some of the most important FAQs that we get and to provide a general timeline of childhood development when it comes to overall mouth health. By knowing what to look out for, you’ll be better equipped to provide your child with the best care you can.

3–6 Months: Teething Begins

Babies will generally start the process of teething anywhere from 3 to 6 months, though it is not uncommon for this process to start after the first year. Babies are actually born with 20 primary teeth, also known as baby teeth. The process of teething is essentially the act of these teeth erupting through the gum line, which explains the general pain and fussiness that tends to accompany teething. At around 3 months, it is common for babies to begin the process of exploratory biting as well as experience physiological changes that lead to increased saliva production. On average, the first teeth will begin to erupt around the 6 month mark. It is generally going to be more common for girls to get their first tooth earlier than boys.

9–12 Months: First Dental Exam

It is generally recommended that you set a general exam 6 months after your child’s first tooth comes in. Regardless, the first dentist visit needs to be scheduled by at least their first birthday. It is also important to start brushing after their first tooth comes in, and you should begin flossing after they experience their first two teeth that are together. 

2–3 Years: All Baby Teeth Come In

While most babies will get their bottom front incisors first, this is only what is most common. From that point, it is generally the front incisors that follow. The rest of the development generally follows this trend of teeth emerging in pairs on the bottom, then corresponding teeth emerging in pairs on the top. Between age 2 and 3 however, most children will have had all 20 of their baby teeth fully come in. Around age 4 your child’s face and jaw will begin to expand, making more room on the gum line and in their mouth for their permanent teeth. 

6–7 Years: First Adult Teeth

The process of secondary (adult) teeth coming in follows a similar pattern to the baby teeth. Generally it is the bottom and then top front teeth that will fall out first, in a process known as shedding. Most children will begin this process between the ages of 6 and 7, but some children may begin gaining their secondary teeth earlier or later. Teeth can be expected to fall out in the order they came in, but this is not a hard and fast rule. Just like the secondary molars are the last teeth that come in, they are also the last primary teeth to fall out. This in-between period can be called “mixed dentition.” The actual care for this transition will vary, but if the primary tooth falls out before the secondary tooth comes in a space maintainer may be needed to be inserted by a dentist to avoid malformed spacing. , It is important to let baby teeth fall out on their own and wait until they are good and loose before doing anything (this can sometimes take up to a month or two).

9–13 Years: All Baby Teeth are Replaced

While the first baby tooth may fall out between 5 and 7, the process generally completes somewhere between the ages of 9 and 12. The child will generally get their primary molars first. These are not replacing baby teeth at all, though sometimes incisors are the ones that come in first. As a primary tooth falls out, it’s secondary tooth equivalent should erupt behind it. At some point between ages 12 and 13, children will begin to gain their permanent secondary molars. For some children, this will take until late teenage years.

17–21 Years: Wisdom Teeth Come In

Finally, the wisdom teeth, or third primary molars, will form between 17 and 21 years of age. These require inspections and even removal in most cases. 

What Can I Do to Help My Teething Child?

Your baby will likely make it known that they are teething and uncomfortable. Gums may appear swollen, and drool will become more common. During this time, the baby’s metabolic energy can slightly raise core temperature, but any actual fevers are most likely to be limited to illness (which is why it is important to discuss general health with a pediatrician and best mouth care practices with a dentist when you are unsure). You can offer your baby frozen rings, but opt for those that use a solid core as opposed to a liquid core, as they can represent a health risk if they burst. You can also massage their gums yourself—just make sure that you clean your hands first.

When it comes to offering pain-relief, it is best to stay away from benzocaine products (which are numbing agents) or those based on atropine derived from belladonna. Both of these can present a risk for infants. What you can offer is acetaminophen to kids of all ages, and for babies over 6 months ibuprofen may be a better solution. Talk to your pediatrician to find out exactly how many milligrams you should give your child based on their current weight. Teething biscuits can also be an option, but make sure it is one that fits their nutrition profile and that you keep an eye out for choking. Teething necklaces may have the same products as frozen rings, but the string around their necks can also present a hazard. Since a frozen ring would offer a similar level of relief, it’s better to offer relief without the danger and opt for the rings instead. 

Hopefully you now have a better idea of exactly what to expect when your child begins teething, and how to treat some of the situations that arise out of this development!

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