A reference chart for what teeth come in when, what is normal variation, and the developmental milestones that warrant a closer look.
Baby tooth eruption - ages 6 months to 3 years
6-10 months: Lower central incisors (the bottom front two).
8-12 months: Upper central incisors.
9-13 months: Upper lateral incisors (the ones beside the front teeth).
10-16 months: Lower lateral incisors.
13-19 months: First molars (top and bottom).
16-23 months: Canines (the pointed teeth, top and bottom).
23-33 months: Second molars (top and bottom).
Most children have all 20 baby teeth by age 30-33 months. Variation of ±6 months is normal. Significantly delayed eruption may indicate genetic factors, congenital issues, or rarely a missing tooth bud - worth a panoramic X-ray to confirm.
Permanent tooth eruption - ages 6 to 12
Age 6-7: The first permanent molars erupt behind the baby molars (the "6-year molars"). Lower central incisors fall out and are replaced.
Age 7-8: Upper central incisors are replaced; lower laterals follow.
Age 8-9: Upper lateral incisors are replaced.
Age 9-12: Baby canines and molars are gradually replaced.
Age 11-13: Second permanent molars erupt behind the first ones (the "12-year molars").
Age 17-25: Third molars (wisdom teeth) erupt - often need removal due to crowding.
Common concerns by age
- Late teething (no teeth by 14 months): Usually still normal but worth a check.
- Tooth missing entirely (congenital absence): Most common with upper lateral incisors and lower second premolars. Discovered on X-rays, planned for at orthodontic timing.
- Crooked baby teeth: Often resolve as more teeth erupt. We re-evaluate at 5-7 when the bite is taking shape.
- A baby tooth that won't fall out (over-retained): Sometimes the permanent tooth erupts behind it ("shark teeth"). Usually self-corrects within months; if not, the baby tooth is gently extracted.
- Discoloration of new permanent teeth: A grayish or yellow shade in newly erupted teeth can indicate fluorosis or rare developmental conditions - worth a check.
- Crowding when permanent teeth erupt: Common; we monitor and may refer for early orthodontic intervention if severe.
When to call us about eruption
Most variation is normal, but call if:
- No teeth by 14 months
- No permanent teeth by age 7-8
- A baby tooth has been loose for more than 6-8 weeks without coming out
- A permanent tooth erupts in an unusual location (e.g., far above the gum line)
- Pain or swelling around an erupting tooth in a child older than 18 months (most teething is mild)
- A "double row" of teeth (shark teeth) for more than 2 months
- Teeth that look discolored or chalky when they first emerge
We can usually answer over the phone whether a visit is needed.
How baby teeth shape adult teeth
Baby teeth do more than chew - they hold space for permanent teeth and guide them into position. Losing a baby tooth too early (to decay or trauma) can cause:
- Space loss - neighboring teeth drift, leaving no room for the permanent tooth.
- Eruption delays - without a baby tooth's root to dissolve, permanent teeth sometimes stall.
- Bite shifting - overall bite can be thrown off.
To prevent these problems, we recommend a space maintainer when a baby tooth is lost more than 18 months before its replacement is due. This small appliance preserves the space until the permanent tooth comes in.
Frequently asked questions
- My 12-month-old still has no teeth - should I worry?
- Not yet. Most teeth erupt by 14-15 months at the latest. If your child reaches 15-18 months with no teeth, schedule a visit so we can take a look and possibly a panoramic X-ray.
- My 7-year-old has "shark teeth" - should I be alarmed?
- No. This is when the permanent tooth erupts behind the baby tooth before the baby tooth falls out. It usually self-corrects within 1-3 months as the tongue pushes the new tooth forward. If the baby tooth is still firmly in place after 2 months, we extract it gently.
- When do permanent molars come in?
- The first permanent molars erupt around age 6 (often called "6-year molars"), and the second permanent molars around age 11-13. Wisdom teeth (third molars) come last, between 17-25.
- Is teething painful for babies?
- Usually mild - drooling, fussiness, and a desire to chew on things. A clean cold teething ring or gentle gum massage helps. Avoid teething necklaces (choking hazard) and benzocaine gels (FDA warning for infants).