Meta Description: When do babies start teething? Get a month-by-month teething timeline, learn the common (and surprising) symptoms, and find safe, effective remedies for every stage.
The first glimpse of a tiny, pearly white bud pushing through your baby’s gum is a milestone met with equal parts excitement and sympathy. But long before that tooth appears, the journey of teething begins—and it can be a confusing, fussy road for both baby and parent. Is this drool a sign of a tooth, or just normal baby development? Is that low-grade fever from teething or an oncoming cold? You find yourself playing detective, trying to decode your baby’s discomfort without a clear manual.
It’s easy to feel overwhelmed. Advice from well-meaning friends and family often conflicts, and the vast amount of information online can be contradictory. You want to know what’s normal, what to expect next, and how to provide genuine relief without relying on guesswork or unproven remedies.
Take a deep breath. This guide is your evidence-based, pediatrician-informed map through the teething timeline. We’ll walk through the typical order of tooth eruption, month by month, and detail the real symptoms that accompany each phase. You’ll learn how to tell the difference between teething discomfort and signs of illness, and build a toolkit of safe, effective soothing strategies. Let’s navigate this milestone together, with confidence and calm.
Understanding the Teething Process: It’s More Than Just Teeth
Teething, or odontiasis, is the natural process of a baby’s primary (baby) teeth moving through the jawbone and breaking through the gum line. It’s not a one-day event but a process that unfolds in stages, often causing discomfort during the active “eruption” phase when the tooth is putting pressure on the gum.
The 20 Primary Teeth: A Full Set
Your baby is born with a full set of 20 primary teeth hidden beneath their gums. These teeth typically erupt in pairs and follow a general pattern, though the timeline can vary widely from child to child. Some babies get their first tooth at 4 months, others not until after their first birthday. Both can be perfectly normal. The order of eruption is often more predictable than the exact timing.
Key Takeaway: Variation is normal. Focus on the sequence and your baby’s unique symptoms rather than comparing their timeline to others.
The Teething Timeline and Order: A Month-by-Month Guide
While every baby is different, this timeline provides a general framework for what to expect and when.
Stage 1: The Early Months (0-3 Months – Pre-Teething)
- What’s Happening: Teeth are developing deep within the jaw. You won’t see anything, but some babies may start early teething behaviors.
- Common Signs: Increased drooling, mouthing objects, and general fussiness can begin as early as 2-3 months, as the teeth start their long journey upward.
Stage 2: The First Arrivals (4-7 Months – The Incisors)
This is when the first teeth most commonly make their debut.
- Typical Order:
- Bottom Central Incisors (4-7 months): The two front bottom teeth are almost always the first to appear. They often come in as a pair.
- Top Central Incisors (6-8 months): The two front top teeth come next.
- Top Lateral Incisors (9-11 months): The teeth on either side of the top front teeth.
- Bottom Lateral Incisors (10-12 months): The teeth on either side of the bottom front teeth.
- What to Expect: The initial teeth can be the most surprising for baby and parent. Symptoms are often pronounced. You may see a visible bulge in the gum, which may look bluish or red (an “eruption cyst”—usually harmless).
Stage 3: The Back Teeth Emerge (12-18 Months – The Molars)
This stage can be challenging, as the larger, broad-surfaced molars work their way through.
- Typical Order:
- First Molars (12-16 months): These wide teeth erupt in the back of the mouth, often without the fanfare of the front teeth but sometimes with more significant discomfort due to their size.
- What to Expect: Increased fussiness, disrupted sleep, and a strong urge to chew on hard, substantial objects. You may notice your baby rubbing their cheek or ear, as the pain from the back gums can radiate.
Stage 4: The Canines (Eye Teeth) (16-22 Months)
- Typical Order:
- Canines (16-22 months): These pointy teeth fill the gap between the incisors and molars. Their sharp points can cause noticeable localized gum swelling and tenderness.
- What to Expect: A return of heavy drooling and chewing. Babies may be irritable and have temporary changes in eating habits, avoiding foods that require biting.
Stage 5: The Final Set (24-33 Months – The Second Molars)
- Typical Order:
- Second Molars (20-33 months): The last teeth to come in, all the way in the back of the mouth. This completes the full set of 20 primary teeth.
- What to Expect: Similar to the first molars, this can be a tough phase due to the size and location of the teeth. Your toddler may be more vocal about their pain and able to tell you their mouth hurts.
Decoding the Symptoms: What’s Normal, What’s Not?
Teething symptoms usually begin 3-5 days before the tooth erupts and subside once the tooth breaks through the gum line. Symptoms may come and go in waves.
The Most Common (and Proven) Teething Symptoms:
- Excessive Drooling: The body’s response to gum irritation. This can lead to facial rashes.
- Gnawing and Chewing: Pressure from biting on objects counteracts the pressure from the tooth emerging.
- Fussiness and Irritability: Especially in the evening when distractions are fewer.
- Swollen, Tender Gums: The area may look red, puffy, and feel firm or bulgy.
- Ear Pulling or Cheek Rubbing: The nerves in the gums share pathways with those in the ears and cheeks. (Note: This can also be a sign of an ear infection, so monitor closely).
- Mild Rise in Body Temperature: Crucially, this is a low-grade elevation, not a true fever. The inflammation in the gums can cause a slight temperature increase, typically staying below 100.4°F (38°C).
Symptoms Often Attributed to Teething That Require a Second Look:
This is critical for parent awareness. The American Academy of Pediatrics (AAP) clearly states the following are NOT typical signs of teething and may indicate illness:
- High Fever (100.4°F / 38°C or above): A true fever points to an infection (viral or bacterial), not teething.
- Diarrhea: While excess saliva might slightly loosen stools, significant diarrhea is a sign of gastrointestinal illness.
- Vomiting
- Widespread Body Rash
- Lethargy or Extreme Fussiness That Can’t Be Soothed
If your baby experiences any of these more severe symptoms, contact your pediatrician to rule out conditions like an ear infection, urinary tract infection, or other childhood illness. It’s a common and dangerous assumption to blame a high fever on teething.
Your Soothing Toolkit: Safe and Effective Teething Remedies
When your baby is uncomfortable, having a range of strategies is key. Here’s a breakdown of what works, from simple to more involved.
1. Counter-Pressure and Chewing (The First Line of Defense)
- Chilled (Not Frozen) Teething Toys: A silicone or rubber teether chilled in the refrigerator provides firm pressure and cool relief. Avoid freezing, as it can make the toy too hard and damage gums.
- Clean, Cold Washcloth: Dampen a clean washcloth, twist it, and chill it. Let your baby gnaw on the textured fabric.
- Finger Massage: With clean hands, gently rub your baby’s gums with a clean finger. The pressure is often immediately soothing.
2. Cold and Numbness
- Chilled Foods: For babies already on solids, offer chilled purees or yogurt. For older babies with chewing skills, large, cold pieces of cucumber or banana in a silicone feeder mesh bag are safe and effective.
- Breast Milk or Formula Popsicles: Pour milk into an ice cube tray or specialized popsicle mold for a comforting, cold treat.
3. Pain Relief Medication (When Needed)
- Acetaminophen (Tylenol) or Ibuprofen (Advil/Motrin for babies 6+ months): For times of significant discomfort, especially at bedtime, these medications can be appropriate. Always consult your pediatrician for the correct weight-based dosage and use only as directed. Do not use medication for prolonged periods without medical advice.
4. What to Avoid: Safety First
- Amber Teething Necklaces: The AAP strongly warns against these due to serious risks of strangulation and choking, with no proven benefit.
- Topical Numbing Gels/Benzocaine: The FDA advises against OTC gels for children under 2 due to the risk of a rare but serious condition called methemoglobinemia.
- Homeopathic Teething Tablets: The FDA has found inconsistent amounts of belladonna (a toxic substance) in some and warns against their use.
- Alcohol: Never rub whiskey or other alcohol on a baby’s gums.
Troubleshooting the Tough Spots: Advanced Teething Scenarios
What if my baby’s teeth are coming in out of order?
This is very common and rarely a cause for concern. The general sequence is a guide, not a rule. As long as all teeth eventually come in and your pediatrician or dentist isn’t worried, you shouldn’t be either. The most important thing is that teeth are healthy, not the order they arrive in.
My baby is 10 months old with no teeth. Should I panic?
No. While most babies have a tooth by 9-12 months, some perfectly healthy children don’t get their first tooth until 15 or even 18 months. If your baby’s gums are healthy and they are meeting other developmental milestones, it’s likely just their unique timeline. Mention it at your next well-visit for reassurance.
Teething is destroying sleep. How can we survive?
This is a huge pain point. Stick to your calming bedtime routine. Offer a chilled teether and some gum massage right before bed. If discomfort is clearly waking them, a dose of pain reliever (as advised by your doctor) 30 minutes before bedtime can help them get over the hump and into a restful sleep. Consistency and extra comfort are key during these phases.
How do I care for the new teeth?
Start brushing as soon as the first tooth appears! Use a tiny smear of fluoride toothpaste (no larger than a grain of rice) on a soft infant toothbrush twice a day. This prevents decay and establishes a lifelong habit.
A Final Word of Reassurance
Teething is a season—a challenging but temporary one. While the fussiness and sleepless nights can feel endless in the moment, each tooth that emerges is a step toward your child’s growth and independence. You are not just soothing discomfort; you are guiding them through a fundamental developmental stage with love and patience.
Trust your instincts. You know your baby best. Use this timeline as a map, but follow their unique cues. Provide comfort, lean on safe remedies, and never hesitate to call your pediatrician when something feels off. You and your baby will get through this smile by (eventually toothy) smile.
For more on differentiating between teething and illness, see our guide on is it a cold or teething how to tell.
Your Top 5 Teething Timeline Questions, Answered!
1. Can teething cause a fever of 102°F?
No. This is a critical distinction. Teething may cause a slight elevation in body temperature, but it does not cause a true, high fever (100.4°F / 38°C or above). A high fever is a sign of infection or illness. If your baby has a fever that high, you should contact your pediatrician to determine the cause—don’t assume it’s just teething.
2. What’s the hardest tooth for a baby to cut?
Many parents and pediatricians report that the first molars (around 12-16 months) and the second molars (around 2-3 years) are often the most difficult. Their large, flat surface area creates more gum inflammation and pressure as they push through, which can lead to more pronounced discomfort, sleep disruption, and fussiness than the front teeth.
3. My 3-month-old is drooling and chewing on everything. Are they teething already?
It’s possible, but more likely this is the pre-teething phase. At 3 months, babies discover their hands and the world through their mouths. Increased saliva production is also a normal developmental stage. While an early first tooth isn’t impossible, the classic “3-month old teething” is often a combination of normal developmental exploration and the early stirrings of teeth moving beneath the gums.
4. Is there a link between teething and diarrhea?
The AAP states there is no proven medical link. The old theory was that excess swallowed saliva upset the stomach. However, loose stools during teething are more likely coincidental, as this stage overlaps with a time when babies are exploring the world orally (introducing germs) and starting solids (which changes digestion). Significant diarrhea should be treated as a possible stomach bug, not a teething symptom.
5. When should I schedule my baby’s first dentist visit?
The American Academy of Pediatric Dentistry recommends scheduling the first visit within 6 months of the first tooth erupting, and no later than their first birthday. This “well-baby” check establishes a dental home, allows for early cavity prevention advice, and can address any concerns about teething, injury, or development. Getting comfortable with the dentist early is a great step for long-term health, much like establishing good feeding habits from the start. For tips on that early journey, our post on best breastfeeding positions for a good latch can help build a strong foundation.
