Teething: 4 to 7 Months

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Ages & Stages

Ages & Stages

​Teething usually starts during these months. The two front teeth (central incisors), either upper or lower, usually appear first, followed by the opposite front teeth. The first molars come in next, followed by the canines or eyeteeth.

The timing of teething: 

There is great variability in the timing of teething. If your child doesn’t show any teeth until later than this age period, don’t worry. The timing may be determined by heredity, and it doesn’t mean that anything is wrong.

How to ease your baby’s discomfort:

Teething occasionally may cause mild irritability, crying, a low-grade temperature (but not over 101 degrees Fahrenheit or 38.3 degrees Celsius), excessive drooling, and a desire to chew on something hard. More often, the gums around the new teeth will swell and be tender. Try gently rubbing or massaging the gums with one of your fingers. Teething rings are helpful, too, but they should be made of firm rubber. (The teethers that you freeze tend to get too hard and can cause more harm than good.) Pain relievers and medications that you rub on the gums are not necessary or useful since they wash out of the baby’s mouth within minutes. Some medication you rub on your child’s gums can even be harmful if too much is used and the child swallows an excessive amount. Stay away from teething tablets that contain the plant poison belladonna and gels with benzocaine. Belladonna and benzocaine are marketed to numb your child’s pain, but the FDA has issued warnings against both due to potential side effects.​ If your child seems particularly miserable or has a fever higher than 101 degrees Fahrenheit (38.3 degrees Celsius), it’s probably not because she’s teething, and you should consult your pediatrician.

How should you clean the new teeth? 

Simply brush them with a soft child’s toothbrush when you first start seeing her teeth. To prevent cavities, never let your baby fall asleep with a bottle, either at nap time or at night. By avoiding this situation, you’ll keep milk from pooling around the teeth and creating a breeding ground for decay.

Last Updated

10/6/2016

Source

Adapted from Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

At what age do babies start teething?

There are a lot of exciting milestones in your baby’s growth and development. There’s when they roll over for the first time. Then crawling, their first step, their first word, and on and on. And one of the biggest events is when your baby’s smile starts to turn into a toothy grin.

But when do babies get their first tooth? Do teeth come in a certain order? How do you soothe a baby’s sore gums?

Below, we answer these questions, explain other teething symptoms and answer common questions about cleaning baby teeth.

At what age do babies start teething?

The average age for a baby’s first tooth to come in is around 6 months old, but every child is different. Girls’ teeth usually come in a little earlier than boys’ do. But by the time a baby is 12 months old, they typically have 2-4 teeth. And by 3 years old, most kids have all of their primary or “baby” teeth.

How many baby teeth do kids have?

Children have a total of 20 primary teeth.

What order do baby teeth come in?

Baby teeth don’t always come in the same order for each kiddo. There are typical ranges for when certain teeth come in or “erupt,” but those ranges overlap. For example, many babies get their bottom central incisors sometime between 6 months old and 10 months old, and their top central incisors between 8 months old and 12 months old. But it’s also possible that a baby can start teething as early as 2 months old.

Baby teeth chart

Again, the exact timing and order that babies’ teeth come in can vary. But here’s when they generally tend to come in:

• Bottom central incisors: 6-10 months
• Top central incisors: 8-12 months
• Bottom lateral incisors: 10-16 months
• Top lateral incisors: 9-13 months
• Bottom canines: 17-23 months
• Top canines: 16-22 months
• Bottom first molars: 14-18 months
• Top first molars: 13-19 months
• Bottom second molars: 23-31 months
• Top second molars: 25-33 months

How do I know if my baby is teething? Watch for these baby teething symptoms

Not all babies show signs of teething. But common teething symptoms can include:

• Increased fussiness
• Increased drooling, which can cause coughing and lead to a rash on baby’s face, chin or chest
• Chewing on their hands or gnawing on objects
• Rubbing their cheek or ear
• Red or swollen gums that appear to be bulging
• A low-grade fever (less than 101 degrees Fahrenheit)

Usually, signs of teething will start a few days before a new tooth comes in, and go away once it has.

Is teething painful for babies?

Some babies will experience discomfort or pain while teething, which helps explain some of the teething symptoms you’ll notice. Gum soreness and swelling can lead to fussiness, or cause your little one to rub their cheeks or chew on anything they can get their hands on. The good news is that most discomfort will pass quickly.

Which are the most painful teeth for babies as they come in?

Typically, the first teeth to come in are the most uncomfortable for babies, as the feeling of a tooth coming in is new and unfamiliar. The molars can also be painful because they’re larger than other teeth.

How long does teething fussiness last?

If your baby is fussy during teething, you can expect it to last for a couple days to a week before the tooth erupts through the gums. If it lasts longer than this, check in with your child’s doctor.

When to talk to a doctor about teething concerns

Again, teething symptoms are usually mild and improve in a couple of days. But talk to your child’s doctor if:

• Symptoms are prolonged or get more severe (such as constant irritability or especially aggressive chewing)
• Your child has a fever higher than 101 degrees Fahrenheit
• Your child gets diarrhea alongside teething symptoms

How to soothe baby’s gums during teething

If your baby is showing signs of discomfort when they’ve got a tooth coming in, there are a few different things you can do to make them more comfortable.

• Wipe away drool from their chin regularly – This can help prevent skin irritation and rashes.
• Massage your baby’s gums – You can simply use a clean finger or chilled teething ring.
• Give your baby a cold washcloth or chilled teething toy to chew on – If your baby has already been introduced to solid foods that can be chilled, you can also use those. Only use a fridge to chill things (rather than the freezer), and don’t use toys that have liquid in them.
• Talk with your child’s doctor about over-the-counter pain relievers – Medications like acetaminophen or ibuprofen can help relieve pain and inflammation. Just make sure you’re using one that is meant for babies, and you follow all the instructions on the label.

Don’t try to relieve your baby’s symptoms with teething gels or teething tablets, as they may contain harmful ingredients. If you have questions about a method or teething product that isn’t listed above, talk to your child’s doctor.

Baby oral care: Answers to frequently asked questions

With the arrival of teeth comes the need to keep them clean. Here’s what to know to get your baby’s dental health off to a good start.

When should I start brushing my child’s teeth?

Start brushing as soon as the first tooth has come in.

How do I brush my baby’s teeth?

Use a small, soft toothbrush or washcloth twice a day. Start with water or a fluoride-free training toothpaste. Once your child is around 3 years old, you can start using small amounts of fluoride toothpaste.

Flossing should start when your child has teeth that have come in next to each other. If regular floss is too tricky, try using a floss pick.

Why do I need to brush my baby’s teeth?

Even though baby teeth will fall out, they’re still important. Healthy baby teeth support the health, spacing and alignment of the permanent teeth that come in after them. And getting your child used to regular brushing early on will help them form good oral hygiene habits.

Plus, tooth decay can start at a very young age. Children with tooth decay are more likely to have ear and sinus infections, and develop conditions like obesity, diabetes and heart disease. Healthy teeth help children speak quickly and clearly, too, which can give them more confidence as they grow up.

What else can I do to keep my baby’s teeth healthy?

If your child is still nursing or drinking a bottle at bedtime or overnight, talk with their doctor about when it makes sense to wean them from these feedings. This is because the sugars in your own milk or formula can sit on your baby’s teeth for prolonged periods of time overnight.

Most babies are able to sleep through the night without needing to eat sometime between 4 and 6 months old. And once they’re around 12 months old, nighttime bottles before bed can usually be stopped as well.

You can also take steps to reduce or discourage pacifier use or thumb sucking. Pacifiers specifically can be helpful early in your child’s development. They can provide comfort and have even been shown to reduce the risk of SIDs. But as your child gets older, pacifiers – and aggressive thumb sucking – can cause issues with tooth alignment.

When does my baby need to visit the dentist?

Along with brushing and flossing, regular dental visits are key to your baby’s dental health. The American Academy of Pediatric Dentistry recommends that kids see a dentist by their first birthday, or within 6 months of their first tooth coming in.

During these visits, the dentist will examine your child’s soft tissues, gums and jaws. The earlier your child sees a dentist, the more likely they are to have good oral health in the future.

A child’s teeth grow out of order – what to do, who to contact?

The first teeth are a long-awaited and exciting event. It brings with it joy – and anxiety if it doesn’t go according to plan. Any pediatric dentist will say that teething not according to the established pattern is a variant of the norm. But parents are still worried: maybe this is an alarming symptom?

Among the reasons why teeth erupt out of order and out of time, there can really be serious illnesses: rickets, dyspepsia. But they are always accompanied by more characteristic symptoms.

For example, with rickets, the baby sweats a lot, especially in the head area, lags behind in physical development, is naughty a lot, is afraid of bright light. Dyspepsia is accompanied by a distinct disorder of the gastrointestinal tract: the child’s stool changes, severe colic is observed. It is impossible to miss these symptoms.

Therefore, problems in pediatric dentistry are not a reason to suspect a serious diagnosis.

When you should definitely not worry:

• If the family has already had a case of “wrong” teething. The timing and order of the appearance of milk teeth are genetically determined. If a child’s teeth grow out of order and the parents or grandparents had the same feature, there is nothing to worry about.
• In difficult childbirth and if the child was ill in the first days or months of life. While he is recovering, temporary problems in pediatric dentistry may appear – the body simply does not have enough resources to compensate for all birth disorders at once.
• If the child is generally healthy, eats fully and walks. This makes it possible to exclude complex disorders in the development and formation of the skeleton.

The order of appearance of teeth was formed in the course of evolution. To date, pediatric dentistry has accumulated a lot of data on this interesting topic. Marine predators have the same teeth – conical, so that it is convenient to grab slippery prey. And in land mammals, they were divided into incisors, canines, premolars and molars.

Ask a pediatric dentist to tell your child how teeth have changed depending on their purpose. Fangs served for protection, sharp incisors helped to bite off food, and powerful molars helped to chew. Depending on the species, the order of the appearance of teeth developed: for example, in puppies and wolf cubs, fangs appear first, because they are predators.

Man quickly became an omnivore, mastered hunting and farming. This is one of the answers to the question why baby teeth in children can erupt out of order. We are no longer tied to the evolutionary code, so we have many variants of the norm.

Science does not yet know the exact answer. But it is known for sure that it is impossible to influence the order of appearance of teeth. No pediatric dentist will be able to prescribe medications or procedures to make teeth fit “correctly” or to speed up their growth. The only working strategy is to wait and monitor the health of the child as a whole.

Sometimes parents are concerned not with the order, but with the timing of eruption. On average, milk teeth appear about 6 months. Deviations of three months in both directions are normal. You can show your child to a pediatric dentist if the baby got teeth at three months or did not appear at eight, but both situations fit into the norm.

Possible reasons for the delay:

• heredity;
• difficult childbirth, diseases of newborns;
• congenital or genetic diseases (always have other, more characteristic symptoms).

It is believed that the rate of appearance of teeth is influenced by the method of feeding and complementary foods. However, it has not received official confirmation in pediatric dentistry. The child needs good nutrition, and from what source is not so important.

Can teeth not erupt at all? They can. In 1% of cases, pediatric dentists diagnose congenital adentia. It is associated with ectodermal dysplasia, a serious tissue pathology, which is also accompanied by underdevelopment of hair and nails, skeletal deformity, and other noticeable problems. If your child does not have the listed signs, then the delay in teething is temporary and they will definitely appear soon.

So, the timing and order of appearance of milk teeth is very variable. And their mutual arrangement in the oral cavity is not. If your teeth grow crooked, uneven, you should contact a pediatric dentist. Crooked teeth are a sign of malocclusion, which can lead to serious problems.

Why malocclusion is harmful:

• The risk of caries increases due to the fact that adjacent teeth press against each other.
• Diction is broken, it will be difficult for a child to master sounds.
• Possible pain in the jaw area due to muscle strain.
• Smile looks unaesthetic.
• In severe cases, the oval of the face changes, headaches develop.

Most bite defects are easily corrected in a pediatric dental clinic with plates or braces. Usually, correction is started at the age of 5-6, after the change of teeth to permanent ones. But if the location of the milk teeth (milk bite) is significantly outside the norm, the pediatric dentist will offer a plate or cap.

Why correct milk bite?

• It will be easier for a child to master speech and to establish diction.
• The masticatory muscles and articulatory apparatus will develop correctly.
• Reduces the risk of misalignment of permanent teeth.

• Individual features, heredity.
• Complications during childbirth and during the neonatal period.
• Chronic diseases (always have other, more characteristic symptoms).

Let’s sum it up: the time and order of the appearance of teeth may differ from the generally accepted ones. This is normal, not dangerous and will not cause problems in the future.

It is worth contacting a pediatric dentist if the teeth grow unevenly, as this indicates an abnormal bite. The bite is usually corrected after 6 years, on permanent teeth. Milk bite is corrected only in case of severe pathologies that affect the health and development of the child as a whole.

It is possible to identify problems in time only in pediatric dentistry, where doctors have experience working with babies. It is very important not only to understand the features of the formation of the milk dentition, but also to conduct an examination carefully and accurately. Many babies are afraid of strangers, and the doctor’s approach is very important.

“Mira” is a children’s dental clinic where they work with patients of any age. We pay much attention to the comfort of our little visitors. The sooner the kid visits the dentist and makes sure that treating his teeth is not painful and not scary, the less likely it is to start health in the future. And you will be sure that we will not miss real problems and will not make a false diagnosis.

Mira is your children’s dental clinic. Contact.

Why a child does not grow teeth

Parents always look forward to the appearance of their child’s first teeth. Sometimes the appearance of teeth is delayed, and this circumstance is very disturbing.

Delayed eruption of some teeth may occur not only in the first years of a child’s life, but also at an older age.

Facts about teething

Teething is a complex physiological process that lasts for several years. During this period, the formation of tooth germs and their movement inside the jaw. The process of eruption is most often quite painful. There is a gradual change in bite: a temporary (milk bite) changes to a permanent one. This is due to the development of bones in a child, in particular, with the growth of the bones of the skull. Also during this period, the formation of bone structures, soft tissues that surround the tooth, and the resorption of the roots of milk units to make room for permanent ones take place.

The first stage of tooth formation begins in the embryonic period. The complete completion of this process occurs with the eruption of wisdom teeth by about 25 years.

When the first teeth appear

At the time of birth, the baby’s teeth are in a state of formation inside the jawbones. The bone contains a complete set of milk teeth at different stages of growth.
The anterior incisors are the earliest to form and begin to erupt through the gums at the age of six months. With the correct development of the child, the dental units continue to erupt in pairs, i.e. one on each side. A full set of twenty milk teeth should appear in the first three years of a child’s life.

How to determine the delay in eruption

If a child is 1.5 years old and still does not have a single tooth, then this is a serious reason to seek advice from a dental clinic.

The normal period for the appearance of the first dental units in the oral cavity is considered to be between 4 and 16 months of age, subsequent teeth appear gradually after the first.

Permanent teeth begin to grow by the age of 6-7 years.

A slight discrepancy with the established deadlines is not yet a reason to sound the alarm, it is worth worrying about the complete absence of teeth in a child.

Types of delay in eruption

More than half a year difference from the average period in the eruption of milk teeth is considered a delay.

The delay from the average time in the appearance of permanent teeth should not exceed a year. There are two types of late eruption.

1. Late dental follicle formation. In such a situation, the relationship between the development of the tooth and its appearance in the oral cavity is observed, but both processes proceed more slowly than the due date.
2. Late eruption. With this development, the tooth is fully formed, its root grows, but the dental unit cannot erupt. Fully formed teeth remain in the bone – impacted. They can be completely under the gum or partially visible from under it.

Before worrying about delayed eruption, it is necessary to diagnose the presence of a tooth germ in the bone. For this, a panoramic picture is taken, which makes it possible to distinguish the complete absence of the rudiment from a delay in formation.

Causes of delayed eruption

Many reasons can contribute to delayed eruption.

• Hereditary factor. If parents teeth erupted later than other children, then this symptom can be observed in their children.
• Prematurity or low birth weight.
• Diseases of the expectant mother during pregnancy, trauma during childbirth, as well as illnesses of the child in the first few months after birth.

The factors listed above most of all influence the timing of eruption, as well as the quality of the formation of dental units.

Other reasons include:

• violations in the child’s diet;
• – lack of certain vitamins and minerals;
• Hypothyroidism;
• Rickets and its consequences.

It should also be taken into account that girls are ahead of boys in development, and, consequently, their teeth appear earlier.

What do deadlines depend on?

The timing of the formation of both temporary and permanent dental units in children can be compared with some phenomena.

1. Pos. In girls, all teeth, except for the first upper chewing one, erupt earlier than in boys.
2. Jaws. The teeth on the lower jaw appear faster than on the upper.
3. Position of teeth. Molars and premolars most often erupt with a delay.
4. Bite. In the milk bite, the delay occurs much less frequently than in the permanent one.
5. Population. Scientists have found that people living in different countries have different terms for the appearance of teeth. For example, among Europeans, delayed eruption is a fairly common occurrence.
6. Climatic conditions. Teeth erupt faster in warm climates than in cold climates.
7. Level of urbanization.