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When do babies get first tooth
Jun 13, 2024

Baby Teeth Coming in Late: When is it a Cause for Concern?

The arrival of a baby’s first tooth is a much-anticipated milestone for many parents. However, some babies may experience delays in teething, which can lead to concerns and questions. This article will explore why baby teeth might come in late, the common causes, when to worry, and available treatments to address late teething. Our aim is to provide information to help parents better understand this developmental stage.

When to Worry About Baby Teeth Not Coming In

Average Age for First Tooth

The first baby teeth to appear are typically the bottom middle teeth (central incisors), usually emerging between 4 and 10 months of age. By the age of 3, most children will have all 20 of their baby teeth.

Children will have 20 baby teeth by the time they are 3 years old.

What to Do If Teeth Are Delayed

If your baby’s teeth are delayed, don’t panic. A variation of a few months is generally not a cause for concern. However, you should consult a pediatric dentist if your baby has no teeth by 18 months. They can help determine if there are any underlying issues.

Causes for Baby Teeth Coming in Late

Research from Cambridge University Press shows  that many factors influence when a baby’s first tooth arrives. These include the baby’s weight and length at birth, if the mothers smoked during pregnancy, or if the growing baby didn’t get enough nutrition before birth. Different groups of kids might have different times for teeth coming in, especially children from diverse ethnic backgrounds. Knowing why this happens can help parents understand their baby’s teeth better.

Genetic Factors

Late teething can often be hereditary. If parents or close relatives experienced late teething, the baby might likely follow the same pattern. Delayed teeth are normal is some families due to their genes. Some genetic conditions, such as cleidocranial dysplasia, can make teeth come in very late.

Nutritional Deficiencies

Deficiencies in vitamins and minerals can delay teething. Specifically, deficiencies in vitamin A, vitamin C, vitamin D, and calcium can impact when teeth come in. Vitamin D is crucial for calcium absorption, and a lack of these nutrients can weaken the bone structure necessary for teeth to emerge. Ensuring a balanced diet rich in these nutrients is crucial for healthy dental development​.

Premature Birth

Babies born prematurely often experience delays in various developmental milestones, including teething. This delay is usually temporary, and teeth will eventually erupt as the baby grows. Premature infants might also have lower levels of certain nutrients, which can further postpone teething.

Systemic Diseases

Certain systemic diseases can also delay primary dentition. Conditions such as hypothyroidism, which slows down overall growth and metabolism, and rickets, a bone development disorder caused by vitamin D deficiency, can interfere with normal tooth development. Anemia, characterized by a lack of healthy red blood cells, can also delay the growth of teeth due to reduced oxygen supply to developing tissues.

Endocrine Disorders

Endocrine disorders, such as hypothyroidism or growth hormone deficiencies, can delay the eruption of teeth. These conditions affect hormone levels that are crucial for growth and development. Hormones play a significant role in the timing of tooth eruption, and any imbalance can disrupt this process.

Environmental Factors

Environmental influences such as low birth weight and chronic malnutrition can also cause delays in teething. Babies who are underweight or not receiving adequate nutrition may experience slower overall development, including delayed tooth eruption. Chronic malnutrition affects the body’s ability to support the growth and development of new tissues, including dental tissues.

Medical Interventions and Medications

Certain medical interventions and medications can also delay teething. For instance, children who have undergone multiple or prolonged courses of antibiotics or steroids might experience delayed dental development. These medications can affect the body’s natural growth processes and immune responses, indirectly influencing tooth eruption.

Baby Teeth Timeline

Understanding the typical timeline for teething can help parents recognize what is normal and when to seek advice. Here’s a detailed timeline of the teething process:

  • 6 months: The first baby teeth to erupt are usually the lower two front incisors (mandibular central incisors).
  • Around 6 to 12 months: Teething usually begins, with the two front teeth (central incisors) on either the top or bottom row appearing first.
  • Around 13 to 19 months: The first molars start to come in.
  • By 2 1/2 to 3 years: All 20 baby teeth have usually come in.
  • Around 6 years: The first permanent molars (upper and lower) and lower permanent incisors begin to erupt.
  • Between 6 and 12 years: Children have a mixture of permanent and deciduous teeth, known as the mixed dentition stage.
  • By age 12: Most children have all their permanent teeth, except for their wisdom teeth.

As mentioned earlier, by the time children are 3 years old, they typically have a full set of 20 baby teeth. Between the ages of 6 and 12, children will experience the mixed dentition stage, where they have both baby and permanent teeth. While these are rough averages, it is considered late teething if a baby shows no signs of teeth by 12 months.

Infant tooth eruption chart

Brushing Mistakes to Avoid

Proper dental hygiene is crucial from the moment a baby’s first tooth appears. Here are common brushing mistakes to avoid:

  • Using Too Much Toothpaste: For children under three, use a smear of fluoride toothpaste about the size of a grain of rice. For children aged three to six, a pea-sized amount is sufficient.
  • Brushing Too Hard: Brushing too vigorously can damage gums and tooth enamel. Use a soft-bristled toothbrush and gentle strokes.
  • Skipping the Gums: It’s important to gently brush the gums and the tongue to remove bacteria and prevent infections.
  • Not Brushing Long Enough: Ensure that brushing lasts for at least two minutes to thoroughly clean all teeth and gums.
  • Ignoring the Back Teeth: Focus on brushing all teeth, not just the front ones. Molars and back teeth are prone to cavities and need careful attention.
  • Infrequent Brushing: Brush your child’s teeth twice a day – once in the morning and once before bed.
  • Letting Children Brush Alone Too Early: Supervise brushing until your child can do it properly on their own, usually around age 7 or 8.

By avoiding these common mistakes, you can help ensure your child’s teeth and gums stay healthy, promoting good oral hygiene habits early on.

Treatment for Baby Teeth Coming in Late

In most cases, late teething does not require treatment and will resolve on its own. However, there are steps you can take to support your baby’s dental health.

Nutritional Support

Ensuring your baby receives adequate nutrition is essential. A diet rich in vitamins A, C, D, and calcium can support dental development. Breast milk or formula should be complemented with age-appropriate solid foods that provide these nutrients.

Dental Checkups

Regular dental checkups starting at 12 months, or within six months after the first tooth appears, are important. A pediatric dentist can monitor your baby’s dental health and provide guidance on teething and oral care.

Medical Intervention

If a baby shows no signs of teething by 18 months, a pediatric dentist may recommend further evaluation to rule out any underlying health conditions. Treatments may include addressing nutritional deficiencies or managing health conditions that could impact teething.

Request a Consultation at TrueCare: Affordable Dental Care in San Diego & Riverside, CA

TrueCare offers comprehensive dental care services for children and adults. If you are concerned about your baby’s teething timeline, we encourage you to schedule a consultation with our experienced pediatric dentists. We provide personalized care and guidance to ensure your child’s dental health is on the right track. Visit our Dental Care Services page to learn more and book an appointment.

Ensuring Your Baby’s Dental Health

Late teething can be a source of worry for parents, but understanding the common causes and knowing when to seek advice can provide reassurance. Most cases of delayed teething are normal and do not indicate any serious issues. By ensuring proper nutrition and regular dental checkups, you can support your baby’s dental development and address any concerns early on.

For more information and resources on dental care for children, check out our Pediatric Dental Health Guide to ensure a healthy smile for your little one.


The information, including but not limited to, text, graphics, images, and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you read on this website.

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