At what age do teeth typically erupt?

Timing of Tooth Eruption in Children

Primary teeth typically begin to erupt at around 6-8 months of age, with the lower central incisors appearing first, followed by a predictable sequence of eruption that continues until approximately 24-30 months of age when all primary teeth have emerged. 1, 2

Primary Teeth Eruption Timeline

• The first primary teeth to erupt are typically the mandibular (lower) central incisors at a median age of 7.1 months for males and 7.6 months for females 2
• Maxillary (upper) central incisors typically erupt next at a median age of 8.7 months for males and 9.2 months for females 2
• Maxillary lateral incisors follow at approximately 10.0 months for males and 10.3 months for females 2
• Mandibular lateral incisors emerge around 10.4 months for males and 10.8 months for females 2
• The remaining primary teeth continue to erupt in a predictable sequence until all 20 primary teeth have emerged by approximately 24-30 months of age 1

Factors Affecting Tooth Eruption Timing

• Birth weight has a significant impact on eruption timing - lower birth weight is associated with delayed tooth eruption 3

• In premature infants, tooth eruption may be delayed based on several factors:

  • Very low birth weight (<1000g) is significantly associated with later eruption 4
  • Gestational age ≤30 weeks is associated with delayed eruption 4
  • Duration of oral intubation is the strongest predictor of delayed eruption in premature infants 4
  • Nutritional factors including age when full enteral feedings were attained and average weight gain per day correlate with eruption timing 4

• Indigenous children may experience primary tooth eruption at earlier ages than other children, which may contribute to earlier colonization by cariogenic bacteria and increased risk of early childhood caries 1

Permanent Teeth Eruption

• First permanent molars (M1) typically erupt between:
  • Girls: 5 years 3 months to 7 years 8 months (mean 6.1 years) 5
  • Boys: 5 years 2 months to 7 years 10 months (mean 6.3 years) 5
• Second permanent molars (M2) typically erupt between:
  • Girls: 8 years 11 months to 14 years 4 months (mean 11.3 years) 5
  • Boys: 9 years 11 months to 13 years 11 months (mean 12.0 years) 5
• There is substantial individual variation in eruption timing and duration 5

Clinical Implications

• The American Academy of Pediatric Dentistry (AAPD) recommends that the first oral examination occur within six months of the eruption of the first primary tooth but no later than 12 months of age 1
• The American Academy of Pediatrics recommends initial dental evaluation at 24 months of age 1
• Early dental intervention provides an opportunity to supplement oral health education for parents regarding proper oral hygiene, prevention of dental injuries, and prevention of nursing caries 1
• Oral health care should begin with the eruption of the first tooth, including twice-daily brushing with fluoridated toothpaste (rice grain-sized portion for children <36 months) 1

Important Considerations

• Delayed tooth eruption may be a sign of underlying health issues and should be evaluated if significantly outside the normal range 4
• Contrary to popular belief, research has not confirmed strong associations between tooth eruption and commonly reported teething symptoms such as fever, mood changes, or illness 6
• There is tremendous variation in both the timing and duration of tooth eruption among children, highlighting the importance of individualizing dental care and monitoring 5
• Parents often observe tooth eruption earlier than what is documented during dental check-ups, suggesting that parental monitoring may detect eruption at an earlier stage 2