Teething usually begins between four and seven months, although a small number of babies cut their first tooth as early as three months and a few don’t get going until close to their first birthday. The lower central incisors tend to come through first, followed by the uppers, and a full set of twenty primary teeth is normally in place by around two and a half years old. Most babies sail through the process with little more than a bit of dribble and a chewy disposition, but for some it’s genuinely uncomfortable, and parents are often left wondering what’s normal and what isn’t.
If you’d like a clinician to take a look as the first teeth arrive, our children’s dentistry team in Westcliff-on-Sea is happy to introduce babies to the dental chair from around six months, and we’ll talk you through brushing and weaning at the same visit.
When does teething start, and in what order?
The general timeline is well documented, but every baby varies. The NHS publishes a useful summary of the typical sequence in its baby teething symptoms guidance, and we’ve reproduced a simplified version below.
| Tooth type | Typical age of eruption | What parents tend to notice |
|---|---|---|
| Lower central incisors | 5 to 7 months | Visible white ridge on the gum, dribbling, chewing |
| Upper central incisors | 6 to 8 months | Mild irritability, broken sleep for a night or two |
| Upper and lower lateral incisors | 9 to 16 months | Reduced appetite, more dribble, occasional flushed cheek |
| First molars | 13 to 19 months | This is often the trickiest stage, larger crown surface, more discomfort |
| Canines (eye teeth) | 16 to 23 months | Sleep disruption returns briefly |
| Second molars | 23 to 33 months | Final push, the full primary set is now in |
If your baby is approaching their first birthday and there’s no sign of any teeth, that’s still within the normal range, but it’s worth mentioning at a routine appointment so we can have a quick look.
Symptoms that genuinely indicate teething
The honest answer is that teething produces fewer dramatic symptoms than parenting folklore suggests. The signs that genuinely correlate with a tooth pushing through the gum are: increased dribbling, a tendency to chew on hands and toys, mild gum redness or swelling at the eruption site, and a general fussiness that lasts a day or two around each tooth. Some babies will have one slightly flushed cheek on the side a tooth is coming through.
Sleep can be disrupted, but typically only for a night or two per tooth.
What teething does NOT cause, despite widespread belief: high fever (above 38°C), diarrhoea, vomiting, cough, or rashes anywhere other than mild dribble rash on the chin. If your baby has any of those symptoms, the cause is something else, usually a coincidental viral infection, and they should be assessed by your GP rather than written off as “just teething”. This is one of the most important points to take away from this article, because babies have been let down by the assumption that a fever is teeth.
Practical ways to ease teething discomfort
The aim is gentle, sustained pressure on the gum and a bit of cold to numb the area. The following all work and are safe.
- A clean, chilled (not frozen) teething ring made of solid silicone or rubber. Frozen rings can be too cold and bruise the gum.
- A clean cold flannel for your baby to gnaw on, dampened and chilled in the fridge.
- Gently rubbing the gum with a clean finger, just for a minute or so. Babies often find this very settling.
- If your baby is weaning, chilled cucumber sticks or cold apple wedges (under supervision, never if there’s any choking risk).
- A bib to manage the dribble, and a barrier cream like petroleum jelly or Vaseline on the chin to prevent dribble rash.
If discomfort is genuinely interfering with feeding or sleep, paediatric paracetamol or ibuprofen at the dose stated on the bottle for your baby’s age and weight is appropriate. Always read the leaflet, and don’t combine without advice. Sugar-free is a must.
What to avoid
The following come up regularly and are best left alone.
Amber teething necklaces have no evidence of effect and pose a strangulation and choking risk. The British Dental Association and the Medicines and Healthcare products Regulatory Agency have both raised safety concerns. Please don’t use them.
Teething gels containing benzocaine or lidocaine for under-twos are no longer recommended in the UK. The MHRA advises that sugar-free, lidocaine-free options should be tried first, and that any teething gel is a short-term measure rather than a regular fixture. If you do reach for one, ask the pharmacist for a current recommendation.
Anything containing sugar, honey, or fruit juice on a dummy or in a bottle. Once that first tooth is through, sugar contact is a real concern, and putting a baby to bed with a sweetened bottle is the single biggest cause of early childhood tooth decay we see in clinic.
When the first tooth arrives, start brushing
The day the first tooth pokes through is the day brushing begins. Use a soft baby toothbrush and a smear (rice-grain size) of fluoride toothpaste containing at least 1,000ppm fluoride. Brush twice a day, including last thing at night. You’re not aiming for a thorough scrub, you’re establishing the habit and getting fluoride onto the enamel.
Sit your baby on your lap, lean their head back, and brush in small circles. They’ll wriggle. That’s fine, the goal is consistency rather than perfection.
In our experience, parents who start brushing the moment the first tooth appears have a far easier time at the toddler stage, because the baby has never known anything different. Parents who wait six or twelve months tend to face genuine resistance.
Sleep, feeding, and the night-time question
Two questions come up at almost every appointment with a teething baby. Should I give a bottle in the cot, and is it okay for them to feed to sleep?
The answer on bottles in the cot is a clear no, once any tooth is through. Milk, formula, juice, sweetened water, anything other than plain water creates a sustained sugar bath against the upper front teeth and is the most reliable way we know to produce early childhood caries. If your baby genuinely needs a bottle to settle, water only, and ideally only as a transition you’re working out of.
Breastfeeding to sleep is a different question. Breast milk does contain lactose, but the mechanism of feeding (the latch, the active swallow) keeps the milk away from the teeth in a way bottle feeding doesn’t. The risk arises if a baby falls asleep at the breast with milk pooled in the mouth. The practical compromise: feed on demand, but wipe the gums and teeth with a clean damp cloth after the last feed before deep sleep, or do the proper night brush before that final feed. Don’t lose sleep over this, just be aware.
Disrupted sleep at the molar stages is normal. A few nights of broken sleep around 14 to 16 months is the price of admission. If your baby is unsettled for longer than a week, or if there’s fever or feeding refusal, look for another cause.
When to see a dentist
The recommendation across the UK is for a child’s first dental visit by their first birthday, or sooner if you have any concerns. A parent brought their nine-month-old in to see us recently because the lower incisors had come through with a small white patch on one of them. It turned out to be enamel hypoplasia, a developmental quirk that’s harmless but worth monitoring, and the parent left reassured rather than worrying for months. That’s the value of an early visit, even if there’s nothing wrong.
Worth knowing: NHS dental treatment is free for children under 18 in England, and routine check-ups for babies and toddlers are entirely free. There’s no excuse to delay.
If your baby is teething and you’d like a friendly check-up as the first teeth come through, please get in touch with us at Westcliff Dental Practice. We see babies, toddlers, and the whole family, and we’ll talk you through brushing, weaning, and what to expect over the months ahead. Call our team on 01702 344 500 to book a first appointment.
