Just like crawling and walking, teething is a developmental process that unfolds on its own timetable. Whether your child gets her first tooth early, late or right on time, the process is the same. You may have heard babies that tooth later have healthier teeth. Although tooth health does have a genetic component that may be related to the time of teething, how you care for those teeth plays a more important role.
The first teeth appear anywhere between 3 and 18 months, although 4 to 6 months is the most common time frame. The first to appear are typically the lower middle teeth. Thereafter, expect about one tooth per month until all 20 teeth have emerged, a process which is typically completed by age 2 1/2.
The Pros and Cons
You can't control when teeth emerge, but if you could, you'd probably opt for a time frame between eight to 12 months. A mouthful of pearly whites turns nursing into a potentially painful experience for mom when baby bites down. Early teething can mean an early end to nursing. On the other end of the spectrum, substantially delayed teething can interfere with normal speech development and eating solid foods.
In most cases, those baby teeth emerge on their own genetically determined biological clock, and there's nothing you can do to alter the timing. Teething patterns in families are often similar—if you were an early teether, your baby probably will be too. Occasionally, a medical issue plays a role in late teething. For example, premature or underweight babies may get teeth later than others, and the teeth may have enamel defects, according to the American Academy of Pediatrics. More rarely, delayed teething may be caused by congenital hypothyroidism, osteopetrosis or rickets.
Comfort and Care
Babies vary widely in their response to teething. Some breeze through the process with barely a symptom, while others are downright miserable. Generally, though, babies drool more when they're teething. Your baby might be more irritable or more likely to mouth objects. Some will have a low-grade fever—less than 101 degrees Fahrenheit—and may have mild diarrhea. Teething can increase mucus production and congestion, which makes the baby more prone to ear infections. Talk with your pediatrician about comfort measures, such as offering acetaminophen or frozen wash cloths or fruit. Once the teeth emerge, wipe them with a wash cloth or brush them with a small, soft toothbrush. Don't use toothpaste until the baby is at least 2 years old.
Although the age-span for gaining a first tooth varies widely, you should see those pearly whites by the time your baby is 12 to 18 months. Talk with your pediatrician if no teeth have emerged by 18 months. It's rare, but teeth may fail to emerge because they're obstructed by bone or each other.