Teething is one of those milestones that parents look forward to and then immediately wish would hurry up and finish. Drool, grizzling, chewing on everything in reach. It is a normal developmental process, but it can be hard to know what is typical and what warrants a phone call to the dentist.
This guide covers the teething timeline, what to expect, how to provide relief, and when professional advice is worth seeking.
The teething timeline
Every child is different, but the general pattern of tooth eruption follows a predictable sequence.
6 to 10 months: The lower central incisors (bottom front teeth) are usually first. Some babies get these as early as 4 months. Others do not see a tooth until after 12 months. Both ends of the range are normal.
8 to 12 months: The upper central incisors (top front teeth) follow.
9 to 16 months: Upper and lower lateral incisors (the teeth either side of the front two) come through.
13 to 19 months: First molars appear. These are larger teeth and can cause more discomfort than the incisors.
16 to 23 months: Canines (the pointed teeth) fill the gaps between incisors and molars.
23 to 33 months: Second molars come through at the back of the mouth. These are often the most uncomfortable.
By age 3, most children have a full set of 20 primary (baby) teeth.
If your child has not had any teeth appear by 18 months, it is worth mentioning at a dental or medical appointment. Delayed eruption is rarely a concern, but it is worth ruling out uncommon conditions.
What teething looks like
Teething symptoms vary widely between children. Some barely seem to notice a new tooth arriving. Others have several days of discomfort with each one.
Common signs:
- Drooling more than usual
- Putting fingers, fists, or objects in the mouth
- Red or swollen gums where the tooth is coming through
- Irritability or fussiness, particularly at sleep time
- Slight change in eating habits (refusing the breast or bottle, or wanting to feed more for comfort)
- A mild rash around the mouth or chin from excess drool
What teething does not usually cause:
A fever above 38 degrees Celsius, diarrhoea, or severe illness. Research published in the journal Pediatrics has found that teething may cause a slight temperature elevation, but not true fever. If your child is unwell, see your GP. Do not attribute it to teething without ruling out other causes.
Safe teething relief
There are several evidence-supported ways to ease teething discomfort.
Chilled teething rings. Refrigerate (do not freeze) a solid teething ring. The cool temperature provides relief. Avoid liquid-filled rings, which can break.
Gentle gum massage. Wash your hands and gently rub the sore area of the gum with a clean finger. Firm, gentle pressure can provide relief.
Cold washcloth. Dampen a clean face washer, chill it in the fridge, and let your child chew on it.
Age-appropriate pain relief. Infant paracetamol or ibuprofen, given according to the dosage instructions for your child's weight and age, can help on particularly difficult days. Consult your pharmacist or GP for the right product and dose.
What to avoid:
Teething gels containing benzocaine or lignocaine carry risks for young children, including a rare but serious condition called methaemoglobinaemia. The TGA and many dental organisations recommend against their use in children under 2. Safer alternatives are almost always sufficient.
Amber teething necklaces have no scientific evidence supporting their effectiveness and present a choking and strangulation risk. The Australian Competition and Consumer Commission (ACCC) has issued warnings about these products.
Homeopathic teething tablets have been subject to safety recalls. There is no reliable evidence they work.
When to see a dentist during teething
The Australian Dental Association recommends a child's first dental visit by age 1, or within 6 months of the first tooth erupting.
This first visit is brief and low-key. At Ivy Dental, it typically involves a quick visual check of the emerging teeth and gums, a conversation with parents about cleaning, diet, and fluoride, and a chance for your child to become familiar with the dental environment without any treatment.
Beyond this routine first visit, contact your dentist if:
A tooth erupts with visible discolouration. Brown, yellow, or white spots on a newly erupted tooth may indicate enamel hypoplasia (underdeveloped enamel) and should be assessed early.
The gums appear very swollen, dark red, or have a blue-purple blister. An eruption cyst (a fluid-filled bump over an emerging tooth) is usually harmless and resolves on its own. But if it persists or seems infected, have it checked.
Teeth come through in an unusual position or order. Minor variations are common and rarely a problem. Significant irregularities are worth a professional opinion.
Your child is in pain that is not relieved by standard measures. Persistent pain may have a cause other than teething.
A tooth is chipped or injured. Toddler dental injuries from falls are common once children are mobile. A chipped or knocked baby tooth should be assessed.
Caring for new teeth from day one
Start cleaning teeth as soon as they appear.
First teeth (up to 18 months): Wipe the teeth with a clean, damp face washer or a soft infant toothbrush. No toothpaste is needed at this stage, though a small smear of low-fluoride children's toothpaste can be introduced from around 6 months if you are in a fluoridated water area. Brisbane's water is fluoridated.
18 months to 6 years: Use a pea-sized amount of low-fluoride (children's) toothpaste. Brush twice daily. An adult should do the brushing until the child has the dexterity to do it well, typically around age 6 to 8.
Diet matters early. Prolonged bottle feeding with milk or juice, particularly at bedtime, is a common cause of early childhood decay. Once teeth are present, avoid putting your child to bed with a bottle. Water is the only safe bedtime drink.
Book your child's first dental visit
We welcome young families at our Everton Park and Nundah locations. First visits are short, gentle, and designed to set your child up for a positive relationship with dental care.
Call (07) 3266 7120 or book online. Open 7 days. Learn more about our kids dentistry services and approach to young patients. See our check-up cost page for pricing information.
