Most of us donʼt recall from childhood the events surrounding teething. There are a great many questions generated by parents regarding this topic, which happens in several stages, and so, here we will provide some insights as to when, how and why teething occurs.

One of the most common questions about teething is regarding when baby teeth start to erupt. What is normal? The best answer to this question is that there is a very wide range of normal. Most children will have teeth beginning to erupt between 3 and 9 months old. There are variations to this timeframe, however, and it is not unusual for babies to have a tooth erupt within the first month of life, or even more rarely, to be born with a tooth. On the other hand, some children do not have any teeth before their first birthday…but rest assured, they will come! Normally, the first teeth to arrive on the scene are the lower incisors, or the lower 2 middle teeth. These are generally followed by the upper incisors. This is not to say that this is the only pattern, but it is the most common.

The general pattern for the 20 baby teeth (10 on top, 10 on the bottom) is: the four incisors (squares) first, followed by the first molars at about 1 year old, then the canines (pointed teeth) at about 1 1/2 years, and then finally the second molars at about 2 1/2 years old. As mentioned, though, there is variation with both the pattern and timing. Another common question is about spacing and alignment. Generally, the most favourable configuration for baby teeth is for children to have spacing between all of the teeth. This pattern also shows a great deal of variation. The two biggest reasons that spacing is good are

1) ease of cleaning, and
2) relief of crowding.

As has been previously discussed, cleaning between teeth can be challenging, and really only accomplished with floss if there is no space. If there are spaces between the teeth, however, the between-teeth surfaces become much more cleansable, and more likely to benefit from the brushing action of the toothbrush. Also, studies show that children with no extra space between their baby teeth, or crowding, experience a great deal more crowding when permanent teeth begin to come in, and are much more likely to require orthodontics (braces) in the future if straight teeth are desired. Interestingly, studies also show that the plethora of issues, such as fevers, and rashes to name a few are not attributable to teething directly…however, irritability, thatʼs another story.

On occasion, baby teeth can erupt so that they are not perfectly straight, regardless whether there are spaces or not. Primary teeth alignment can change over time as the child grows and the muscles of the lips and tongue help the teeth find their equilibrium position in the arch. This does not necessarily mean that when permanent teeth come in they will the same. There is very little predictive value between how the baby teeth look from an alignment standpoint and how the permanent teeth will look, other than what we have already discussed about spacing.

The bottom line is that there is a great deal of variation with regard to baby tooth eruption times, and spacing or alignment. The best thing to do if you have questions about these or other related issues, is to make an appointment to see your dental professional. He or she will take the time to put your mind at ease and let you know what to expect in the future.