Tooth Eruption Chart: When Baby Teeth and Permanent Teeth Come In

Normal Variation in Eruption Timing

The ages listed in eruption charts represent averages. It is normal for teeth to appear several months earlier or later than the chart suggests. Some babies are born with one or two teeth already present (natal teeth), while others may not get their first tooth until 12 to 14 months. Both scenarios are usually within the range of normal. Girls tend to develop teeth slightly earlier than boys on average.

Central Incisors (Bottom Then Top)

The lower central incisors are usually the first teeth to appear, erupting between 6 and 10 months of age. The upper central incisors follow, typically between 8 and 12 months. These are the two front teeth on each jaw. Parents often notice increased drooling, gum swelling, and irritability in the weeks before these teeth break through.

Lateral Incisors

The upper lateral incisors (the teeth flanking the central incisors) erupt between 9 and 13 months. The lower lateral incisors appear between 10 and 16 months. Once all eight incisors are in, the child has a row of four teeth on top and four on the bottom.

First Molars

The first primary molars appear between 13 and 19 months. These are the flat, broad teeth used for grinding food. They erupt behind the canine position (leaving a temporary gap where the canines will later fill in). Molar eruption can be more uncomfortable than incisor eruption because of the larger surface area pushing through the gums.

Canines (Cuspids)

The canines fill in the gaps between the lateral incisors and first molars, erupting between 16 and 23 months. The upper canines typically come in slightly before the lower canines. These pointed teeth are important for tearing food.

Second Molars

The second primary molars are the last baby teeth to erupt, appearing between 23 and 33 months (roughly age 2 to 3). Once these teeth are in, the child has a complete set of 20 primary teeth. Most children have all baby teeth by their third birthday.

First Permanent Molars (Age 6 to 7)

The first permanent molars, often called 6-year molars, are typically the first permanent teeth to appear. They erupt behind the last baby teeth, not replacing any primary tooth. Because no baby tooth falls out to make room for them, parents sometimes do not realize these are permanent teeth. Dental sealants are recommended for these molars as soon as they are fully erupted.

Central and Lateral Incisors (Age 6 to 9)

The lower central incisors are replaced between ages 6 and 8, followed by the upper central incisors between ages 7 and 8. The lower lateral incisors come in between ages 7 and 8, and the upper lateral incisors between ages 8 and 9. During this phase, children often have a mix of baby and permanent teeth, sometimes called the "mixed dentition" stage. It is normal for permanent front teeth to look large relative to the child's face at this age.

Premolars and Canines (Age 9 to 13)

The first premolars replace the first baby molars between ages 10 and 12. The second premolars replace the second baby molars between ages 10 and 12. The canines erupt between ages 9 and 12. The upper canines are often the last non-molar permanent teeth to appear and sometimes erupt slightly out of alignment due to space constraints, which may require orthodontic evaluation.

Second Permanent Molars (Age 11 to 13)

The second permanent molars, sometimes called 12-year molars, erupt behind the first permanent molars between ages 11 and 13. Like the first molars, they do not replace a baby tooth. Once these teeth are in, the child has 28 permanent teeth. Dental sealants are also recommended for these molars.

Third Molars / Wisdom Teeth (Age 17 to 25)

Wisdom teeth, when they develop, typically erupt between ages 17 and 25. Many people do not have enough room in their jaws for wisdom teeth, which can lead to impaction (the tooth gets stuck below the gum or bone). An oral surgeon or dentist will monitor wisdom teeth with X-rays during the teen years and recommend extraction if they are likely to cause problems.

Common Teething Symptoms

Common signs of teething include increased drooling, swollen or tender gums, irritability or fussiness, disrupted sleep, decreased appetite, and the urge to chew or bite on objects. A slight increase in temperature (under 100.4 degrees F) may occur, though high fever is not caused by teething and should be evaluated by a pediatrician.

Safe Teething Relief Methods

Chilled (not frozen) teething rings or a clean, cold washcloth provide safe counter-pressure against sore gums. Gently rubbing the gums with a clean finger can also help. For children over 6 months, children's acetaminophen or ibuprofen can be used as directed by a pediatrician for significant discomfort.

Avoid teething gels containing benzocaine, which the FDA warns should not be used in children under age 2 due to the risk of methemoglobinemia, a rare but serious blood condition. Amber teething necklaces are not recommended due to choking and strangulation hazards, and there is no scientific evidence that they relieve teething pain.

When Baby Teeth Become Loose

Baby teeth become loose as the permanent tooth underneath dissolves (resorbs) the baby tooth's root. The process is gradual and usually not painful. Most children can wiggle the tooth out with their tongue or fingers once it is very loose. Do not force a tooth out before it is ready, as this can damage the gum tissue or the underlying permanent tooth. If a baby tooth has not fallen out and the permanent tooth is erupting beside it, consult a dentist.

Routine Exam and X-Ray Costs

A pediatric dental exam typically costs $50 to $150 per visit. Dental X-rays (panoramic or periapical) to evaluate developing teeth cost $25 to $150 depending on the type and number taken. Fluoride treatment, often applied at checkups, costs $25 to $50. Most dental insurance plans and Medicaid cover preventive visits, including exams, X-rays, cleanings, and fluoride, at 100% for children.

Orthodontic Evaluation Costs

The American Association of Orthodontists recommends an initial orthodontic evaluation by age 7 to identify emerging alignment or bite issues during the mixed dentition stage. Many orthodontists offer free or low-cost initial consultations. If early treatment is recommended, Phase 1 orthodontic treatment typically costs $1,500 to $3,500. Insurance orthodontic benefits, when available, often cover 50% up to a lifetime maximum.