Snap as many pictures of baby’s adorable gummy grin while you still can. Those little teeth will crop up in the blink of an eye—and you’ll sure know when it happens. Teething can be pretty uncomfortable for babies, and they’ll express it the only way they know how—by fussing and crying and not sleeping.

If baby is showing signs of fussiness, you may start wondering if the time for teething has arrived. So when do babies start teething? The truth is, every baby is unique. Still, there’s a general time frame—plus a few important things that all parents should know to make the process easier.

In this article:
When do babies start teething
What a baby teething chart can tell you
How to tell if baby is teething
How long does teething last?
How to soothe baby teething pain
When to call the doctor about infant teething

When Do Babies Start Teething?

Babies usually start getting their primary teeth between 3 and 6 months old, says Mark S. Wolff, DDS, PhD, a professor of cariology and comprehensive care at the New York University College of Dentistry in New York City. But it’s quite possible that it could happen later too. In fact, some babies may not get their first teeth until as late as a year old, says Whitney Schutzbank, MD, MPH, a pediatrician at the MassGeneral Hospital for Children in Boston.

Genetics play a significant role in determining teething age, says Jeffrey Bourne, MD, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California. “It tends to run in families,” he says. “Some families have teeth that come in early, some not until later.”

What is late teething?

Babies are considered late teethers when they reach their first birthday and still have no teeth, Schutzbank says. If your little one is 12 months old and you’ve yet to see any signs of teething, give your pediatrician a call. They can assess the situation during your child’s well visit and may suggest a mouth X-ray if there’s any concern.

What a Baby Teething Chart Can Tell You

When do babies start teething? It’s hard to know exactly, but the order in which baby’s 20 teeth will come in (or “erupt,” in dental lingo) is pretty predictable. As you see from the chart below, the first teeth to break through baby’s soft gums are the middle teeth (central incisors)—you’ll notice the two bottom ones first, followed closely by the two top ones. The next to crop up are the adjacent teeth, and the process continues to work its way toward the back of the mouth, with the molars surfacing last. Baby’s gums are ingeniously rigged so both the upper and lower teeth come in right and left pairs. “The order supports tooth and jaw growth and helps provide for straight teeth,” Wolff says.

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Want to keep track of baby’s progress? Print out our handy teething chart.

How to Tell If Baby Is Teething

During the teething process, the tooth pushes up through the bone and then the gumline. It’s no wonder it hurts! So the answer to “when do babies start teething?” for your child is most likely when you start spotting a combination of the telltale signs of teething. When babies start teething, they may have the following symptoms:

crying
drooling
low-grade fever under 101 degrees F
trouble sleeping
swollen gums
loss of appetite

For more details, check out our post on teething symptoms and remedies.

How Long Does Teething Last?

There’s no clear-cut answer to this question, just as there isn’t one for the question “when do babies start teething?” But in general, babies will grow new teeth every four to six months, and they’ll usually have their complete set of baby teeth by around 24 months, Wolff says.

How long does teething pain last?

Good news! Not 24 straight months, even though it takes that long for all the teeth to come in. That’s because the pain flares up only when the teeth are actually breaking through the gums, and it subsides between episodes. So the severe symptoms usually last just a few days, Schutzbank says. What’s more, children tend to get used to the process over time, according to Bourne. While the symptoms are obvious with the first tooth or two, they become milder as baby’s mouth fills in.

How to Soothe Baby Teething Pain

Teething can be uncomfortable for baby, so you’ll want to have some tricks up your sleeve for helping to ease that discomfort as much as you can. If baby seems to be experiencing signs of teething, try some of the easy, reliable at-home remedies below.

• Gum massage: Often, babies find the most relief from gentle pressure on their sore gums, which is why you’ll find them gnawing on anything they can get in their mouths. According to the American Academy of Pediatrics (AAP), a safe way to provide light pressure on the gums is to give baby a gum massage. With clean hands, use your finger or knuckle to rub the sore spots in baby’s mouth. Repeat as often as necessary.

• Teethers: Babies old enough to navigate a teether in their hands and mouths may enjoy using a teether to put pressure on their gums themselves. Offer a teething ring, pacifier or clean, wet washcloth for baby to chew on. “I like these remedies as they have no side effects and are quite effective,” Schutzbank says.

• Cold: Cold can help ease discomfort too, but don’t give baby ice or teething rings that have been frozen solid; according to the AAP, it’s too hard on baby’s gums. Instead, try putting a teething toy or clean, wet washcloth in the fridge before giving it to baby.

• Something to suck on: “Some children like the feeling of sucking when teething,” Schutzbank says. You can try offering a pacifier, baby bottle or a breastfeeding session when infant teething pain is making baby cranky.

• Pain medication: If you’ve already tried the previous soothing methods and baby still seems extremely uncomfortable, you can try over-the-counter pain medication like acetaminophen (Tylenol) as a last resort, Schutzbank says. Ibuprofen is another choice, but should only be given to babies over 6 months.

What not to use for infant teething pain

Well-meaning friends and loved ones may have a variety of suggestions for how to soothe infant teething pain—but some of them may not in fact be safe for baby. Do not use any of the following for teething pain:

• Aspirin: This medication should never be given to babies or children as it can cause Reye’s Syndrome.

• Teething gel: Teething gel is not FDA-approved for infant teething, since it offers little to no benefit but can come with serious risks. “I avoid numbing gels as they can numb baby’s throat and lead to choking or aspiration of liquids into the lungs,” Schutzbank says. Plus, numbing gels can contain benzocaine, which can lead to a serious and sometimes fatal condition called methemoglobinemia, in which not enough oxygen is delivered to baby’s cells.

• Homeopathic teething tablets: These teething tablets are also not FDA-approved and often contain potentially dangerous ingredients, Schutzbank says.

• Teething jewelry: Amber teething necklaces and other jewelry can pose a choking or strangulation hazard to baby, which is why the FDA and APP strongly advise against using them.

When to Call the Doctor About Infant Teething

They may not be super pleasant for baby, but signs of teething are usually nothing to be concerned about. However, there are some situations in which you might want to call your pediatrician for infant teething. Call the doctor if:

Baby’s temperature rises above 100℉
Baby’s low-grade fever lasts longer than two days
Baby has diarrhea
Baby won’t eat or drink

The general rule of thumb is that if baby seems unusually uncomfortable, is acting sick or has signs of teething that can’t be soothed, it’s a good idea to call the pediatrician. Your little one may have an illness or infection that needs to be treated. If you think baby needs to be seen, trust yourself and call the doctor.

About the experts:

Mark S. Wolff, DDS, PhD, is a professor of cariology and comprehensive care at the New York University College of Dentistry in New York City. He received his doctor of dental surgery degree and PhD in oral biology and pathology from Stony Brook University. Before joining the NYU College of Dentistry in 2005, he served as associate dean at Stony Brook University School of Dental Medicine.

Whitney Schutzbank, MD, MPH, is a pediatrician at the MassGeneral Hospital for Children in Boston. Her clinical interests lie in newborn medicine and nutrition. She earned both her medical degree and master's of public health degree from Tulane University School of Medicine.

Jeffrey Bourne, MD, FAAP, is a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, and has been practicing for more than 20 years. He earned his medical degree from the University of Washington and is a fellow of the American Academy of Pediatrics.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

Teething Symptoms and Remedies: What You Need to Know

Safe Teething Necklaces Parents Can Wear to Soothe Baby's Gums

The Truth About the Safety of Amber Teething Necklaces