Baby teeth coming in late — normal teething ranges and when to check

Key facts

• First tooth usually around 6 months, often anywhere from 4 to 15 months
• Family pattern and prematurity are common causes of late teething
• Check if no teeth by about 18 months or very uneven eruption
• X-rays only when they would change management
• High fever or a very unwell baby is not 'just teething'

Normal teething ranges

Most babies get their first tooth, usually a lower front tooth, at around six months, but the normal window is wide. Many cut the first tooth between four and fifteen months, and a smaller number of healthy children are later. Upper front teeth tend to follow, then the first baby molars around the first to second year, the canines, and finally the second baby molars. Most children have all twenty baby teeth by around two and a half to three years. The order matters less than the overall pattern: a few months either way is common, and teeth on the left and right usually appear within a few months of each other.

Common reasons teeth come in late

Family pattern is the most common explanation; if parents or siblings teethed late, a child often does too. Babies born prematurely or with low birth weight frequently get teeth later, and it helps to count from the due date rather than the birth date. Thick, firm gum tissue can slow a tooth breaking through. Less commonly, nutritional factors such as low vitamin D, thyroid or pituitary conditions, and certain genetic syndromes are associated with delayed eruption, but these usually come with other signs that a paediatrician would notice. Rarely, a tooth is congenitally missing or blocked by an extra tooth or a cyst.

When to have a dental check

A check is reasonable if there are no teeth at all by about 18 months, if one side has teeth and the matching tooth on the other side is many months behind, if teeth appear in an unusual order, or if a gum swelling looks bluish or does not change over several weeks. A check is also wise if your child has other growth or developmental concerns. The dentist looks at gum shape and colour, feels for teeth underneath, reviews medical and family history, and may suggest coordinating with your paediatrician. Most of the time, the outcome is reassurance and a plan to review.

Is an X-ray needed?

Not routinely. For most late teethers, examination alone is enough, because a tooth can often be felt as a firm bump under the gum before it breaks through. An X-ray may be recommended if there are still no teeth well past the usual range, if a specific tooth is many months overdue compared with its partner, or if there is concern about missing teeth, extra teeth or a cyst. Dental X-rays for children use low doses and are taken only when the result would change management. The dentist will explain why one is suggested and what it can show.

Caring for gums while you wait

Even before teeth arrive, wipe your baby's gums after feeds with a clean damp cloth to build the habit. Once a tooth appears, start brushing twice daily with a soft infant brush and a rice-grain smear of fluoride toothpaste. Teething discomfort can be eased with a chilled, not frozen, teething ring or gentle gum massage with a clean finger. Avoid teething necklaces because of choking and strangulation risk, and avoid numbing gels unless advised by a doctor or pharmacist. Teething can cause drooling and fussiness, but high fever, diarrhoea or a very unwell baby should be assessed by a doctor rather than put down to teething.

Positive early visits shape a child's attitude to dentistry for life. We keep appointments short, explain everything in child-friendly language, and focus on prevention.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Fariba Alnoory

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.