At what age does teething typically occur?

Teething Timeline in Children

Primary teeth typically begin to erupt at around 6-8 months of age, starting with the lower central incisors, and continue in a predictable sequence until approximately 24-30 months when all primary teeth have emerged. 1

Normal Eruption Timeline

• The first teeth (primary dentition) typically begin to appear at 6 months of age 1, 2
• Lower central incisors are usually the first teeth to erupt 1, 2
• Teething continues in a predictable sequence until approximately 24-30 months of age 1
• By age 3 years, all 20 primary teeth have typically erupted 1, 3

Factors Affecting Tooth Eruption

• Genetic factors may influence eruption timing, with some indigenous children experiencing earlier primary tooth eruption 1
• Individual variation is common, with some infants beginning teething as early as 4 months or as late as 12 months 3, 4
• Premature infants may experience delayed tooth eruption when age is adjusted for prematurity 4

Common Symptoms Associated with Teething

• Irritability (40.5%), fever (38.9%), and diarrhea (36%) are commonly reported symptoms 4
• Gum sensitivity, drooling, and increased biting/mouthing behaviors are frequently observed 3, 5
• Despite parental beliefs associating numerous symptoms with teething, research shows limited evidence for strong associations between tooth eruption and many reported symptoms 6

Clinical Implications

• The American Academy of Pediatric Dentistry recommends the first oral examination within six months of the first tooth eruption but no later than 12 months of age 1
• Oral healthcare should begin with the eruption of the first tooth, including twice-daily brushing with fluoridated toothpaste (rice grain-sized portion for children under 36 months) 1, 7
• Non-pharmacological management of teething discomfort is preferred as first-line treatment, including cold teething rings, breastfeeding during teething episodes, and skin-to-skin contact 2, 8
• Pharmacological interventions such as acetaminophen should be reserved for significant pain that interferes with feeding, sleeping, or normal activity 2

Caution

• Many symptoms commonly attributed to teething may actually be signs of other conditions requiring medical attention 6
• Research has shown that fever is not strongly associated with teething, contrary to common belief 6
• Parents should be cautious about attributing significant symptoms solely to teething without considering other potential causes 5, 6